Practicing Wilderness Medicine and Protocols
Volume 33 Number 1
Frank Hubbell, D.O.
Are the official procedure or system of rules governing an agency. In this case EMS.
These rules are produced by and established by an authoritative body, such as a state EMS Bureau, not a school, college, university, business, or individual.
This continues to be a gray area in the world of EMS that needs to be discussed. The practice of providing care outside of the “Golden Hour” and using techniques that are not within the usual scope of practice of EMS remains controversial and, most importantly, has never been tested in a court of law, which would establish precedence.
This becomes more important as EMS continues to mature and become better defined and embedded in rules and law. The idea of having to apply different standards of care based on time to definitive care is accepted, but those techniques used in the austere environment remain somewhat illusive with wide variations.
The term, evidence-based medicine, is commonly used to help define and justify medical care on all levels, but it does not exist for the wilderness environment. There are just simply not enough backcountry rescues or case studies in the different areas of providing care to test and prove the validity of the techniques. So, experts come together to provide a “best practices” based on their collective experiences.