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July 2012, Volume 42 Number 7 , p 32 - 35


  • R. Bryan Simon RN, CNOR, FAWM


I DON'T REMEMBER the motorcyclist's name, but I'll never forget him. We crossed paths between life and death on a beautiful late spring day in North Cascades National Park in Washington State. I was with my wife and friends, enjoying the amazing scenery of the region. Driving up a short incline toward a mountain pass, we watched helplessly as the man lost control of his motorcycle on a gravel-filled turn and collided with the guardrail at the edge of a cliff. We immediately pulled over and attempted to help him, but it was no use. He died on a lonely stretch of road far from the nearest hospital.Despite my extensive nursing knowledge and years of education, the care I could provide was limited. I'd read about wilderness medicine, but until that day I hadn't considered my need for it. My feeling of helplessness led me to correct that deficiency and ultimately made me a better nurse.The most commonly accepted definition of wilderness medicine is the practice of medicine where definitive care is more than 1 hour away, resources are limited, and care must be continued over an extended period.1 Wilderness medicine means caring for injured or sick people in the middle of nowhere without the clinical resources found in a hospital setting, often under adverse environmental conditions.Other names for wilderness medicine include expedition medicine and medicine for the outdoors. Two closely related and often overlapping fields include disaster medicine and humanitarian medicine.Many nurses who aren't avid backpackers, climbers, boaters, or outdoor enthusiasts are skeptical about their need to learn about wilderness medicine. But you don't have to be participating in these activities to encounter a wilderness medicine situation.Almost weekly, we read about deadly disasters: a hurricane on the Gulf Coast, tornadoes in the Midwest and Southeast, a terrorist bombing in Europe, or an earthquake, tsunami, and nuclear contamination in Japan. If a natural disaster hit your hometown,

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