The Appalachian Center for Wilderness Medicine (ACWM) is a non-profit organization dedicated to promoting wilderness medicine in the southern Appalachian region of the United States of America. Dr. Seth C. Hawkins, an emergency physician who specializes in EMS and wilderness medicine, founded ACWM in 2007 in the state of North Carolina. It is the first regional wilderness medicine non-profit of its kind in the United States. [1] [2] Contemporary authorities in wilderness medicine have noted its importance in establishing a mechanism for regionally pooling information and resources in a field that otherwise has little connection between local or regional experts. [3] Critical to that effort have been uses of the internet in ways not previously seen in wilderness medicine. [4]
At the time of its founding, ACWM served the American states of North Carolina, South Carolina, Georgia, Tennessee, Virginia, and West Virginia. With the Knob Creek Resolution of 2011, ACWM expanded to include Alabama, Maryland, and Kentucky. [5]
Although its primary purpose as a non-profit is promoting communication and awareness of programs already in place, ACWM developed a number of programs of its own to fill holes in the region. Chief among them was an Advanced Wilderness Life Support (AWLS) course and the ACWM Southeastern Student Wilderness Medicine Conference-–neither previously available on a regular basis in the southern Appalachians.
The ACWM version of the AWLS course has been recognized for its innovative use of high-technology medical simulation, using state of the art simulation mannequins in wilderness scenarios, [6] as well as its role in attracting healthcare professionals into the nascent profession of wilderness medicine. [7] The ACWM AWLS course was run continuously from 2007-2016 in southern Appalachian locations: in Linville Gorge NC from 2007-2009, in New River Gorge WV from 2010-2012, in Black Mountain NC from 2014-2015 (with transitional organizing in 2013), and in Roanoke VA in 2016. In 2012 Outside Magazine cited the AWLS program as one of the top four wilderness medicine training programs in the United States. [8]
Over a thousand medical students and wilderness enthusiasts were introduced to wilderness medicine through the ACWM student conference. It used a novel organizational strategy, moving every year to a new medical school in the southeast. This strategy increased geographic access throughout the region and provided organizational experience for the medical students at each host school. In the summer of 2012, the conference became independent of the Center and is now run through Blue Ridge Adventure Medicine as the Southeastern Student Wilderness Medicine Conference. The Center promotes this independently configured conference as it does all quality wilderness medicine conferences in the southeast, also including the Southeast Wilderness Medicine Conference, the Appalachian Wilderness Medicine Conference, and Wilderness Medical Society conferences in the region.
Past ACWM Southeastern Student Wilderness Medicine Conference locations:
2008: Wake Forest School of Medicine, Winston-Salem, NC 2009: UNC-Chapel Hill School of Medicine, Chapel Hill, NC [9] 2010: Medical College of Georgia, Augusta, GA [10] 2011: Quillen College of Medicine, East Tennessee State University, TN [11] 2012: Wake Forest School of Medicine, Winston Salem, NC [12]
In addition to its primary regional organizing function, ACWM has served as an incubator for other local and national programs, such as the Green EMS Initiative, [13] a precursor to the International Institute for Sustainability in Emergency Services. It has also served as a partner in multiple regional wilderness medicine and safety initiatives. These include partnership with the New River Alliance of Climbers in Fayetteville WV (arising from the need to address wilderness medicine education within the southeastern climbing community) and Friends of Seneca (positioning first aid caches at the popular and historic climbing area Seneca Rocks). [14] ACWM staff have also provided instruction at multiple conferences and festivals, including the Roanoke GO Outside Festival and the New River Rendezvous. [15] [16]
The ACWM also sponsors the Mountain Laurel Award every year, which has been cited as the most prestigious wilderness medicine award in the southeastern United States. [17] This lifetime achievement award is given to individuals or groups who have made “extraordinary, lasting and substantial contributions to wilderness medicine in the southern Appalachians.”
Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.
An emergency medical technician (EMT), also known as an ambulance technician, is a health professional that provides emergency medical services. EMTs are most commonly found working in ambulances. In English-speaking countries, paramedics are a separate profession that has additional educational requirements, qualifications, and scope of practice.
Appalachian State University is a public university in Boone, North Carolina. It was founded as a teachers college in 1899 by brothers B. B. and D. D. Dougherty and the latter’s wife, Lillie Shull Dougherty. The university expanded to include other programs in 1967 and joined the University of North Carolina System in 1971.
NOLS is a non-profit outdoor education school based in the United States dedicated to teaching environmental ethics, technical outdoors skills, wilderness medicine, risk management and judgment, and leadership on extended wilderness expeditions and in traditional classrooms. It was previously known as the National Outdoor Leadership School, but in 2015 this label was retired in favor of the independonym "NOLS". The NOLS mission is to be the leading source and teacher of wilderness skills and leadership that serve people and the environment. NOLS runs courses on six continents, with courses in a variety of wilderness environments and for almost any age group.
East Tennessee State University (ETSU) is a public research university in Johnson City, Tennessee. Although it is part of the State University and Community College System of Tennessee, the university is governed by an institutional Board of Trustees. As of May 2017, it is the fourth largest university in the state and has off-campus centers in nearby Kingsport, Elizabethton, and Sevierville.
Union College is a private college in Barbourville, Kentucky. The college was founded in 1879 and is affiliated with the United Methodist Church. Union's approximately 825 undergraduate students represent 27 states and 9 countries.
Lincoln Memorial University (LMU) is a private university in Harrogate, Tennessee. LMU's 1,000-acre (4.0 km2) campus borders on Cumberland Gap National Historical Park. LMU is accredited by the Southern Association of Colleges and Schools (SACS). In March 2019, the LMU Duncan School of Law received full accreditation by the American Bar Association.
Nova Southeastern University is a private research university with its main campus in Fort Lauderdale-Davie, Florida. The university consists of 18 total colleges, centers, and schools offering over 150 programs of study. The university offers professional degrees in the social sciences, law, business, osteopathic medicine, allopathic medicine, allied health, pharmacy, dentistry, optometry, physical therapy, education, occupational therapy, and nursing. As of 2019, 20,576 students were enrolled at Nova Southeastern University, with more than 170,000 alumni. With a main campus located on 314 acres in Davie, Florida, NSU operates additional campuses in Dania Beach, North Miami Beach, Tampa, Florida, and centers throughout the state of Florida.
Wilderness medicine is defined by difficult patient access, limited equipment, and environmental extremes. Today, wilderness or expedition medicine is practiced by Wilderness First Responders, Wilderness EMTs, Remote/Offshore/Wilderness Paramedics and Physicians on expeditions, in outdoor education, search and rescue, mountain rescue, remote area operations including research, exploration, and offshore oil platforms, as well as tactical environments. In mainland Europe, where mountain rescue is done by paid professionals, there are courses for physicians that help qualify them to be mountain rescue or expedition doctors. Many of these courses lead to an International Diploma in Mountain Medicine, which is recognized by the Union Internationale des Associations Alpinistes.
Wilderness emergency medical technician (WEMT) is an emergency medical technician that is better equipped than licensed healthcare providers, who typically function almost exclusively in urban environments, to better stabilize, assess, treat, and protect patients in remote and austere environments until definitive medical care is reached. Despite the term, WEMT training is available and geared not just to the EMT, but also the paramedic, prehospital registered nurse, registered nurse, physician assistant, and medical doctor. After all, without an understanding of the applicable gear, skills, and knowledge needed to best function in wilderness environments, including a fundamental understanding of the related medical issues more commonly faced, even an advanced provider may often become little more than a first responder when called upon in such an emergency. WEMT training and certification is similar in scope to wilderness advanced life support (WALS) or other courses for advanced providers such as AWLS, WUMP, WMPP, and RMAP. Unlike more conventional emergency medicine training, wilderness emergency medicine places a greater emphasis on long-term patient care in the backcountry where conventional hospital care can be many hours, even days, away to reach.
Wilderness first responders are individuals who are trained to respond to emergency situations in remote locations. They are part of a wide variety of wilderness medical providers who deal with medical emergencies that occur in wilderness settings. While wilderness first responder can generically refer to anyone providing first response, more typically, this term refers to individuals trained and certified with specific Wilderness First Responder (WFR) certification.
Stonehearth Open Learning Opportunities (SOLO) is the oldest continuously operating school of wilderness medicine in the world. SOLO is one of the originators of today's Wilderness First Responder (WFR) and Wilderness Emergency Medical Technician (WEMT) programs. SOLO is accredited by the University of New Hampshire's Lifelong Learning program. In 2004 it provided first aid training to the cast and crew of PBS' Colonial House program, and a number of colleges and universities across the United States recognize its courses for credit. SOLO also trains advanced providers in disaster recovery medicine and extended remote care through its GEOMEDIC course.
R Adams Cowley was an American surgeon considered a pioneer in emergency medicine and the treatment of shock trauma. Called the "Father of Trauma Medicine", he was the founder of the United States' first trauma center at the University of Maryland in 1958, after the US Army awarded him $100,000 to study shock in people—the first award of its kind in the United States. The trauma unit at first consisted of two beds, and was later expanded to four beds. Many people called the four-bed unit the "death lab." Cowley was the creator of the "Golden Hour" concept, the period of 60 minutes or less following injury when immediate definitive care is crucial to a trauma patient's survival. He was a leader in the use of helicopters for medical evacuations of civilians, beginning in 1969, and founded the Society of Thoracic Surgeons. He also founded the nation's first statewide EMS system, called MIEMSS by Executive Order of Maryland's Governor Mandel, 1972, as well as the National Study Center for Trauma and EMS, enacted by Congress in 1986 and signed into law by President Ronald Reagan. He is also known for being one of the first surgeons to perform open-heart surgery and invented both a surgical clamp that bears his name and the prototype pacemaker that was used by Dwight D. Eisenhower.
The Wilderness Medical Society was created on 15 February 1983 by three physicians from California, United States — Dr. Paul Auerbach, Dr. Ed Geehr, and Dr. Ken Kizer. It is the largest international non-profit membership organization devoted to addressing wilderness medicine challenges, more specifically defined as "medical care delivered in those areas where fixed or transient geographic challenges reduce availability of, or alter requirements for, medical or patient movement resources". It also publishes Wilderness & Environmental Medicine Journal, Wilderness Medicine Magazine, and Wilderness Medicine Clinical Practice Guidelines.
The University of Utah School of Medicine is located on the upper campus of the University of Utah in Salt Lake City, Utah. It was founded in 1905 and is currently the only MD-granting medical school in the state of Utah.
A wilderness medical emergency is a medical emergency that takes place in a wilderness or remote setting affinitive care. Such an emergency can require specialized skills, treatment techniques, and knowledge in order to manage the patient for an extended period of time before and during evacuation.
Seth Christopher Collings Hawkins is an American emergency physician, writer, anthropologist, and organizational innovator. He has made notable contributions to the fields of wilderness medicine, Emergency Medical Services (EMS), and medical humanities. His work has particularly specialized in EMS and wilderness medicine in the southeastern United States, where he is the founder of the Appalachian Center for Wilderness Medicine, the Appalachian Mountain Rescue Team, and the Carolina Wilderness EMS Externship.
Neal Pollock is a Canadian academic and diver. Born in Edmonton, Canada he completed a bachelor's degree in zoology; the first three years at University of Alberta and the final year at the University of British Columbia. After completing a master's degree he then served as diving officer at University of British Columbia for almost five years. He then moved to Florida and completed a doctorate in exercise physiology/environmental physiology at Florida State University.
William 'Will' R. Smith, is an emergency physician and wilderness medicine consultant who lectures about integrating combat medicine into wilderness rescues around the world. He started Wilderness & Emergency Medicine Consulting, a company that helps people with pre-trip planning, online medical support, travel medicine in remote areas and provides expert witness testimony in court cases related to wilderness medicine. As medical director for the National Park Service, he oversaw the largest rescue event ever to occur in Grand Teton National Park. He lives in Jackson, Wyoming where he is an emergency medicine physician at St. John’s Medical Center.
The Carolina Wilderness EMS Externship (CWEMSE) is an out-of-hospital medical training for 4th year medical students and resident physicians interested in furthering their educational interests in wilderness EMS.