

// Remote I Austere I Wilderness: Casualty Care (TM) Series: RAW Casualty Care (TM):
// Remote Medical Responder®️: A Wilderness First Responder Course (TM)
International Mountain Leader: “Hands down best course I’ve done in my career so far.”
Mountain Leader/Exped Leader: “More useful than all the other medical courses I have done, combined !”
Veterans Charity Exped leader: “Brilliant!”.
Remote field scientist doing a WFR requal: Faculty were “Exceptional”.
Polar kayaking guide: “Great experience, amazing faculty.”
We believe that our long-standing Remote Medical Responder®️: A Wilderness First Responder course is simply the most up to date and relevant Pre- Hospital Care course for civilian, non medic remote area operatives, overseas disaster responders, field workers and expedition leaders in the UK. Delivered and honed to rave reviews over many years by our team of multiple, subject matter expert, genuine remote area medics. It takes genuine, experienced, remote area medics to impart relevant, correct and up to date knowledge and skills, competently and authoritatively, at this level. We deliver the internationally respected Wilderness First Responder syllabus with upgrades on the 7 days course including Oxygen, pain relief, blood sugar, airway adjuncts and more. This allows us to issue Wilderness First responder and Remote Medical Responder certification on the 7 day course.
Remote Medical Responder®️course is a big part of why R2Ri was set up - our aim is to advance the cause and knowledge and practice of suitable duty of care considerations worldwide - we can deliver this course at client venues, outdoor activity centres and elsewhere, by prior arrangement.
Remote Medical Responder ®️ is a Registered Trademark, wholly owned by Remote Area Risk International.
What does the course cover?
This evidence based medical course covers both the issues that statistics and research from quality organisations, tell us commonly arise in the field, from gastro intestinal issues, blisters, cuts, grazes, twisted ankles, eye and dental issues etc, as well as less frequent yet high impact occurrences that may impact the ability of your team to remain in the field and/or could be life threatening, such as catastrophic bleeds and spinal injuries. The statistic sets from multiple authoritative, evidenced based sources, are addressed at the start of our courses.
The course is is suitable for expedition leaders, outdoor instructors, outdoor guides, rafting guides, aid workers, SAR Team members, TV & Media safety, field workers, field geologists, forestry staff and exploration teams amongst others - those non medics responsible for the care of others in the wilderness. As there is a mix of delegates on the course, we have aimed to make the course relevant to anyone operating in an outdoor AND remote area operations capacity.
Up to date and fit for purpose:
We aren't in the 1990's anymore and standards move on and develop. To this end, and noting international debates on Wilderness First Responder v Wilderness Medical Responder (Wilderness Medical Responders having higher level of medical knowledge) we have brought the traditional Wilderness First Responder syllabus up to date and in line with UK good practice for provision of wilderness medical care, allowing delegates to cover all the usual WFR content but also ensuring it is fit for purpose and allowing delegates to operator as Remote Medical Responders by underpinning the full (not the refresher) course with UK Ofqual regulated First Responder and Emergency Oxygen certifications, including training on lightweight, essential kit and skills such as airway adjuncts, oxygen administration, checking blood sugar levels and pain relief. If you are looking after others in a professional capacity, you should be carrying up to date, modern, lightweight kit. We teach delegates all the traditional aspects of improvisation - but as a well trained, well prepared professional, you should rarely, if ever, have to - you should be carrying relevant, low cost, lightweight kit that can be multi purposed.
The additional Ofqual regulated First Responder qualifications should also allow delegates to gain patient care experience as event first responders.
“The Remote Medical Responder®️Course with R2Ri was excellent, with detailed course content, plenty of practical scenarios and a highly experienced and professional team of instructors. It was a privilege to be one of RE:ACT’s delegates.”
2022 Testimonial from RE:ACT Disaster Response
All of their International Disaster Responders attend this course
What does UK guidance say about remote medical training standards for non Health Care Professionals?
What guidance are we looking at?
The Faculty of Pre - Hospital Care at the Royal College of Surgeons Edinburgh produced a Consensus Paper on Medical Provision for Wilderness Medicine. This was published on 1 December 2015 in the Extreme Physiology and Medicine Journal.
The guidance was updated in february 2020. See the link here. The update guidance placed an emphasis on a blend of skills for medics operating in remote areas, which included (but not limited to):
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Medical skills
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Wilderness Medical Training
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Wilderness Skills
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Risk Management knowledge (we run expedition/wilderness specific risk management courses that are Royal Geographical Society accredited).
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For some of the higher grades, a trauma course is indicated. We run a remote area emphasis Pre Hospital Trauma Life Support course (delivered in 64 countries - delivered by us in the UK as a UK localised edition, endorsed by the College of Paramedics and JRCALC compliant). We allow our WFR delegates to progress to PHTLS.
Please also have a read of our blog post considering the new guidelines in some detail.
The solution:
The guidance continues to mirror our own views that training some way above and beyond a standard, basic 2 day outdoor first aid course (usually an Emergency First Aid at Work in an outdoor context plus an additional day of practice and content) is highly desirable/necessary for anything but the lowest risk expeditions within fairly short timescales to definitive treatment (well equipped ER, not an ambulance). In fact, the guidance refers to ‘Advanced First Aid’ at the lowest level. A standard outdoor first aid course is not ‘Advanced’.
The guidance for wilderness medical expertise band 1 (lowest) on the skills framework refers to a need for ‘Advanced First Aid Training’ - ‘A minimum of 16 hours is essential, 2-4 days course specific to wilderness environment.’ This is for the lowest risk expeditions. Our initial analysis is that this means a basic 16 hour of essentials plus 2-4 days on specific wilderness medical content. That interpretation would make sense given that most well regarded level D courses on the Pre Hospital Emergency Medicine framework take 4-5 days - without wilderness content. A 6-7 day training period to encompass all the content would fit with our delivery experience. There is only so much that can be taught in a day and a quality learning day can only last so long.
The guidance is simply that - guidance - but would be a document waved round in court to demonstrate what a panel of experts considered to be ‘good practice’. Medic provision should be guided by expedition specific risk assessment. We have espoused our (widely supported) views for a number of years that many organisations are not equipping their medic role fulfilling leaders with training that meets good practice for the risk level and remoteness of the activities they are delivering.
Our Remote Medical Responder®️: A Wilderness First Responder course will very nicely cover all the wilderness medic competencies for non medics at level 1 on the skills framework. It’s clear a more urban based First Responder course simply delivered in an outdoor context isn’t a Wilderness First Responder course in the internationally accepted sense of the title and won’t cut the mustard for anything but the lowest risk expeditions near to definitive care. Wilderness, activity, risk and environment specific emphasis medical training is necessary. The Remote Medical Responder/Wilderness First Responder course will nicely cover all the category 1 (non medic) competency subjects and will probably be even more relevant than previously for qualified medics to undertake to widen their skill base.
Crucially, our course offering is a UK specific solution delivered to UK standards and addressing international standards, delivered by UK based highly experienced and UK qualified remote area medics along with subject matter experts in fields such as law, Search and Rescue and more - all of whom understanding are expert in requirements for UK based organisations operating overseas.
We have worked with international partners and our own Faculty members to develop a 7 day Remote Medical Responder: An Wilderness First Responder course, delivered at the National Outdoor Centre, Plas y Brenin, Snowdonia (and other locations by arrangement). The additional elements we include allow delegates to have a wider, pre hospital emergency care skillset, in line with good practice for UK First Responder level qualifications.
“An inspirational week under the instruction of professionals who seemed to really want to pass on their real-world knowledge and experience. I’d recommend it to any of RE:ACT’s International Responders.”
Certifications
The course is certificated as a Remote Medical Responder®️ A Wilderness First Responder by Remote Area Risk International for 3 years. The course meets and exceeds most UK NGB awards. The course is delivered at Level 'E' on the Pre Hospital Emergency Medicine Framework. The traditional WFR course has been upgraded to meet UK good practice including airway adjuncts, tourniquets and haemostatic agents.
For 2023, we have decided to continue to include the following upgrade certifications in the cost of the full (not the Requal) course:
Ofqual Regulated QNUK Level 3 Award for First Responders (RQF) - a level D qualification on the Pre Hospital Emergency Medicine framework - (as is FREC 3).
Ofqual Regulated QNUK Level 3 Award in Administering Emergency Oxygen (RQF).
This allows the delegates to secure additional, non wilderness specific certifications (that would normally cost circa £525.00). These certifications are at event first responder level and would be useful to assist delegates getting hands on experience at event medical cover level or similar. The QNUK Level 3 First Responder Award also meets the SIA Close Protection Officer medical requirements.
Benchmarked to and compliant with U.S. and internationally respected WFR standards: U.S. CPR/BLS & AED options also available for those needing U.S. certifications.
Internationally respected.The RMR/WFR course content meets and exceeds international requirements for Wilderness First Responder courses. This course should be recognised internationally wherever WFR courses are recognised. We have had delegates attend from all over Europe and as far away as New Zealand, to attend this course. Delegates have undertaken the course to work in Antarctica, as International Mountain Leaders around the globe, media safety professionals operating in remote areas, multiple alumni working as Canadian Ski patrollers, disaster responders, those working in the USA and more.
The course meets the requirements of the US Wilderness Medical Education Collaborative and the newly updated October 2022 Wilderness First Responder Scope of Practice Criteria. As required in the US WMEC Scope of practice, BLS, CPR and AED is taught to ILCOR standards (International Liaison Committee on Resuscitation) - where both American and UK standards are drawn from. The Wilderness Medical Society has mandated that from January 2023, all courses carrying credits from the WMS must comply with the WEMC requirements.
For those needing U.S. certifications for BLS/AED and CPR, we are certified to deliver and issue separate U.S. certifications in these subjects at cost.
The Course lasts 7 days and covers lectures, skills stations and scenarios (including medical moulage simulations) with delivery being across all seven days with additional lectures and scenarios of a night. Pre reading and self assessment prior to the course is compulsory.
The course is taught as a minimum 80-hour course lectures, study, class preparation and face to face hands on training - with an emphasis on practical skills and drills. The scope of practice is to prevent and identify medical problems, initiate reasonable and prudent field management and identify red flag signs and symptoms necessitating evacuation for potentially life-threatening problems. There is pre reading (including self assessment questions) of approximately 48 hours and 118 hours post course (non compulsory) wilderness specific post course reading and resources via our CPD Portal. The course meets and exceeds the U.S.WMEC standards.
The course consists of:
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80 minimum hours of lectures, study and hands on training
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Additional training in decision making & administering medications (including pain relief - penthrox and epinephrine)
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Pre Course reading supported by a comprehensive manual
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Post course CPD and resources via online portal access.
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Course Directors are UK qualified, genuine remote area medics (including Pre Hospital Trauma Life Support instructors)
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Additional certifications including Penthrox Competent User (pain relief medication) - this is by face to face training & online post course study module
The course meets the requirements of the Wilderness Medical Society mandated WEMC Wilderness First Responder Scope of Practice Consensus update published in October 2022. Assessment is by exam and practical assessments. Course pre-reading is essential. Delegates need to pass the course to achieve certification. The Remote Medical Responder course includes additional, UK specific content and a Penthrox Competent Administrator certification as well as many of the elective subjects specified in the WEMC SOP including airway adjuncts, use of stethoscopes, administration of oxygen and more.
The scope of practice for a WFR is to prevent and identify medical problems, initiate reasonable and prudent field management, and identify signs and symptoms necessitating evacuation for potentially life-threatening problems.
The course focuses on the following proficiencies:
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Rescuer and patient safety and protection, a basic physical exam to identify apparent injuries or abnormalities, assessing signs, symptoms, and vital sign patterns, and obtaining a relevant patient history.
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Prevention of medical problems anticipated by the activity and environment.
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Recognition of environmental conditions that may lead to problems and taking steps to mitigate the environmental challenge.
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Stabilizing emergencies, initiation of specific and appropriate medical treatments (e.g., splints, wound care, spine injury management, managing environmental threats, etc.), and assisting patients with their medications.
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Informed decisions regarding the need and urgency of an evacuation.
The course content (including lectures, scenarios and pre and post course study) includes:
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First Aid Kits
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Difference between Outdoor and Remote Area First Aid
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Evacuation necessary ailments
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Communications including trackers, sat phones and radios
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Calling for help and what to say
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Telemedicine
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Aspects of Prolonged Field Care
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Packaging and evacuation including practice with multiple commercial and improvised stretcher options.
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Handing over to rescue medical teams
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Law and the Wilderness - delivered by an expedition legal expert.
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Consent
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Hygiene
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Scene Safety
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Patient Assessment scene sizeup, primary & secondary survey
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Airway management including OPA's, NPA's & iGELS.
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Breathing including BVM's and Oxygen Administration.
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Bleeding and Shock including catastrophic bleeding, tourniquets and haemostatic agents - using high quality woundcubes, skill trainers and manikins.
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Vitals Workshop including blood pressure, pulse oximetry and more
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Heat Induced Injuries
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Hypothermia and Cold Injuries
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Head trauma and spinal injuries
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Lightning Injuries and Prevention
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Medical Problems in the field
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Anaphylaxis and Allergies
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Musculoskeletal Injuries: Dislocations, Fractures, Sprains & strains
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Drowning and water safety
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Eye injuries and disorders
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Water Disinfection and hydration
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Wilderness Medical Kits
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Wilderness Wound Management including wound cleaning and closure
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Chest Injuries
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Abdominal Injuries
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Gastro intestinal problems
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Chest injuries
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Bites and stings
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Altitude Illness including hands on training with Portable Altitude Chambers
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Fractures & dislocations including SAM Splints, Pelvic Binders (commercial and improvised) and Kendrick Traction Devices
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Avalanche Survival
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Evacuation Guidelines for complex situations
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Dive Medicine
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Head & Spine
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Gender specific Emergencies
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Hydration and nutrition
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Poisoning
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Skin conditions
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Tropical illnesses
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Infectious disease
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Medical Problems including diabetes, asthma, heart attack, stroke, epilepsy (amongst others)
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Wilderness Dentistry
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Abdominal pain
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Psychological issues in the wilderness
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Athletic Injuries (sprains, strains, etc).
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Pain relief including Penthrox administration
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Misc wilderness problems
Please see the course calendar for current costs as they may vary by venue. We aim to make courses as accessible as possible and as inclusive as possible. Accommodation and food is not included in that cost. However, very reasonably costed accommodation and food are available at Plas Y Brenin (the course venue). Courses can be delivered at your venue or suitable venues around the country by arrangement. Terms and Conditions apply.
Delegates need to be over the age of 18, hill fit and competent to operate on uneven ground.
Recertification/requalification courses:
The course is certificated as Remote Medical Responder®️: A Wilderness First Responder Course by Remote Area Risk International for 3 years. The RMR:WFR course meets and exceeds most UK NGB award requirements.
Once you have done the 7 day RMR:WFR with us, you can simply undertake a three day recert/requal, being the first three days of the RMR:WFR course. At the end of the 3 days, recert/refresher delegates will undertake practical assessments and the course exam. 3 days is a common arrangement for WFR recerts/requals, internationally. We recommend that delegates undertake a Basic Life Support or Intermediate Life Support refresher once a year.
We issue WFR certificates (rather than Remote Medical Responder®️ after a 3 day recert/requal for those who have done a full (7 day face to face or longer) WFR elsewhere subject to that course being with a provider that we accept. The original WFR must be in date when undertaking the WFR with us and that certificate must be provided to us as evidence. Please note that we specifically do not no accept WFR courses of less than 7 days face to face training, for a 3 day requal.
We accept 7 day + face to face day WFR courses previously done in the US or Canada with NOLS WMI, SOLO. Wild Medix of South Africa, University of Utah 7 day Basic Wilderness Life Support, WMA WFR (7 day face to face only) - and in the U.K., WEMSI WFR courses.
Those having undertaken a WFR with another organisation would need to check with us first to see if it is accepted.
Limitations of WFR refreshers/ recert training Good Practice.
Please note that recert/requal courses cannot cover all the content from your original WFR course. WFR courses are generally 7 - 9 long days. The requal is to demonstrate your competence including by assessment. If you demonstrate competence, a WFR certificate will be issued. It is an opportunity for you to refresh knowledge of the basics, practice the basics (basics done well, every time, is what saves lives) - then demonstrate your knowledge and skills by way of exam and scenarios at the end of day 3. If you are not regularly using your skills (eg ski patroller) and are not already very comfortable and experienced in undertaking primary and secondary assessments - and very confident of your abilities as a WFR, we recommend that you undertake the whole course instead. In 2023, we are offering first requal delegates to stay on for the whole 7 day course at the requal price. We strongly recommend you do this. The requal is a short course to cover the basics to allow you to keep your certificate alive. You should only do a requal once, before undertaking the whole course on the next occasion, at the full cost.
Why undertake the course with us ?
A unique course to us, yet meeting relevant WFR, CPR and AED requirements - and delivered by genuine remote area medics with huge and recent experience AS remote area medics - not just as theoretical instructors. Our team also happen to be highly professional, passionate and experienced clinical educators. The R2Ri difference (experience, qualifications and instructional ability) is why deploying professionals and instructors from other organisations, come to us for training. We have been trusted to deliver expedition medical training to delegates drawn from all branches of UK military, are a training provider of choice for the UK Environment Agency field teams, have delivered the RMR/WFR to those operating all over the globe - from Antarctica to the Amazon, Nepal to North Wales, Greenland to Canada, USA to Australia - any many more. Our clients range from military to the US State Department, academic establishments to Disaster Response organisations operating around the Globe. Faculty members have been asked, as Subject Matter Experts, to contribute to the new 3rd Edition of the Oxford Expedition Handbook as well as as being asked to contribute as editors for the UK localised edition of the internationally respected (C.64 countries) 9th Edition of the NAEMT Pre Hospital Trauma Life Support and Tactical Emergency Casualty Care manuals. Finally, the certifications we deliver, evidence that we meet requirements for some of the most highly respected training courses and bodies, internationally.
Don't take our word for it - check out the testimonials below and on the page of every course we deliver. You may find this winter 2022 article regarding the Remote Medical Responder: A Wilderness First Responder course, instructive:
Pre Requisites:
We require delegates to have an in date), 2 day Outdoor First Aid Course or 3 day First Aid at Work course, or higher. Delegates must be 18 or over.
Progression:
We allow delegates to progress to our Pre Hospital Trauma life Support course. This is a BIG step up from RMR/WFR, so thorough study and revision of the manual is essential. RMR/WFR delegates can also practice their skills on our overnight exercise Prolonged Field Care course.
Course Dates:
26 June - 2 July 2023 - . COURSE FULL UPDATE: Joining instructions and invoices have been dispatched to all delegates who have booked individually. Group/corporate bookings are dealt with in line with agreements with respective organisations. We are operating a waiting list in case of last minute drop outs (eg medical grounds).
07-13 October 2023 - The course is FULL. Candidates who have successfully secured a place will be notified on 08.06.23, by email. We are operating a waiting list in case of drop outs. More places may be released nearer the time, in which case, places will be allocated in the waiting list order.







Who was involved in writing our Remote Medical Responder®️ A Wilderness First Responder Course?
The International team that wrote/developed/contributed to and honed our unique and sector leading RMR:WFR course course was made up of a multi disciplinary team, all with significant experience in one or more of: overseas, expeditionary, disaster response, SAR or adventurous activities experience - and all at the top of their game, including;
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6 x Fellows of the Royal Geographical Society
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3 x Fellows in the Academy of Wilderness Medicine
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3 x Authors/editors of the Oxford Handbook for Wilderness and Expedition Medicine
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2 x Authors of the UK edition of the Pre Hospital Trauma Life Support Manual
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1 x Off Shore Rope Rescue Medic and Off Shore Medic
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1 x ODP/ Military Medic and experienced expedition medic
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2 x ex British Antarctic Survey Doctors
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2 x Doctors who are Diploma in Mountain Medicine holders
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3 x Anaesthetists
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3 x ED Doctors
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1 x Diploma in Tropical and Travel Health Doctor
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1 x Diploma in Remote and Offshore Medicine Doctor
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1 x Mountain Rescue Medical Lead Doctor (and overseas expedition leader)
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1 x ex British Antarctic Survey Dentist, remote area dentist. also responsible for training Special Operations Forces from multiple NATO countries
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1 x Hyperbaric/Dive Medicine Doctor
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3 x HEMS Doctors
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1 x Dive Medic
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1 x HART Paramedic (previously served in medical wing of UKSF)
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1 x Adult Nursing lecturer - ex Mountain Rescue, Water Rescue and Medical Rescue
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1 x Military Paramedic with extensive expeditionary (non military) and small team operational deployment (military) experience
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1 x remote area risk management specialist
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1 x remote area operations/expedition specialist lawyer (one of the authors of BS 8848 - the safety standard for overseas expeditions, field trips, adventure travel and expeditions, and ISO 31030 - the international standard for Travel Risk Management)
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Input from multiple expedition leaders
What does the course look like - see for yourself in the gallery below: