R2Ri is a Wilderness Medical Society Affiliate
// Remote Area and Wilderness Casualty Care (TM) Series: RAW Casualty Care (TM):
// Remote Area and Wilderness First Responder:
We believe that this course is simply the most up to date and relevant Pre- Hospital Care course for civilian, non medic remote area operatives and expedition leaders in the UK. Medical School Accredited. Delivered by 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.
The R2Ri Remote Area and Wilderness First 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.
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, field workers, field geologists, forestry staff, and exploration teams amongst others - those non medics responsible for the care of others in the wilderness.
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):
Wilderness Medical Training
Risk Management knowledge (we run expedition/wilderness specific risk management courses that are Royal Geographical Society accredited).
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). Our delivery of the course, uniquely, globally, carries credits for the Wilderness Medical Society Faculty in the Academy of Wilderness Medicine). We allow our WFR delegates to progress to PHTLS.
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 (US and U.K. certified, medical school accredited) Wilderness First Responder course will very nicely cover all the wilderness medic competencies for non medics at level 1 in 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 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 drawn on some of our Faculty members to develop a 7 day Remote Area and Wilderness First Responder course, delivered at the National Mountain Centre, Plas Y Brenin, Snowdonia (and other locations by arrangement).
The course is certificated as a Remote area and 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 U.S. Wilderness First Responder aspect is accredited for 2 years (with an additional 12 months grace period thereafter where delegates only need to undertake a 3 day WFR refresher rather than re do the whole course) by the University of Utah School of Medicine under their 7 day Wilderness First Responder/ Basic Wilderness Life Support Scheme (only referred to as 'Basic' because they also run a course for Doctors - which we also run - entitled 'Advanced Wilderness Life Support').
Undertake the WFR within 3 years and both certifications renew. We also include Competent Administrator certification for Penthrox (pain relief medication). There is also an option (at additional cost - i.e. what it costs us to provide the additional manuals, certification and administration) for those undertaking the full, 7 day course, to undertake the Ofqual Regulated QNUK Level 3 Award in First Response (RQF) - a level D qualification on the Pre Hospital Emergency Medicine framework - (as is FREC 3) and the Ofqual Regulated Level 3 Award in Administering Emergency Oxygen (RQF). This allows the delegates to secure additional, optional, non wilderness specific certifications that would normally cost circa £525.00, for the nominal additional sum of £100.00. These certifications are at event first responder level . The QNUK Level 3 First Responder Award also meets the SIA criteria for Close Protection Operative medical requirements.
In addition, the course content meets international requirements for Wilderness First Responder courses including the Wilderness First Responder Scope of Practice Consensus published on 25 January 2016. Our courses comply with that Scope of Practice consensus. This course meets those requirements and should be recognised internationally wherever WFR courses are recognised. We have delegates coming from all over Europe to undertake this course.
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 74-hour course lectures 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) and 118 hours post course (non compulsory) wilderness specific post course reading and resources via our CPD Portal.
The course consists of:
74 minimum hours of lectures and hands on training
Additional training in decision making and administering medications
Pre Course reading supported by a comprehensive manual and self assessment questions
Post course CPD and resources via online portal access.
Certifying body advises that the WFR element exceeds NOLS WFR equivalent
WFR course accredited by the University of Utah School of Medicine
Course Directors are UK qualified, genuine remote area medics (including Pre Hospital Trauma Life Support instructors).
Additional certifications including Penthrox Competent User (pain relief medication)
The focus is on:
A basic physical exam to identify obvious injuries or abnormalities, assessing
signs, symptoms, and vital sign patterns, along with obtaining a relevant patient
Prevention of medical problems anticipated by the activity and environment,
Recognition of environmental conditions that may lead to problems and taking
steps to mitigate the environmental challenge,
Treatment focused on stabilization of emergencies, initiation of specific and
appropriate medical treatments (splints, wound care, spine injury management, managing environmental threats, etc.) and assisting patients utilizing their personal medications,
Conservative decisions on the need for, urgency of and appropriate type of evacuation and for interventions appropriate for this level of training.
The course content (including lectures, scenarios and pre and post course study) includes:
First Aid Kits
Difference between Outdoor and Remote Area First Aid
Evacuation necessary ailments
Communications including trackers, sat phones and radios
Calling for help and what to say
Prolonged Field Care
Packaging and evacuation including practice with multiple commercial and improvised stretcher options.
Handing over to rescue medical teams
Law and the Wilderness - delivered by an expedition legal expert.
Patient Assessment scene sizeup, primary & secondary survey
Airway management including OPA's, NPA's & iGELS.
Breathing including BVM's and Oxygen Administration.
Bleeding and Shock including catastrophic bleeding, tourniquets and haemostatic agents - using high quality woundcubes, skill trainers and manikins.
Vitals Workshop including blood pressure, pulse oximetry and more
Heat Induced Injuries
Hypothermia and Cold Injuries
Head trauma and spinal injuries
Lightning Injuries and Prevention
Medical Problems in the field
Anaphylaxis and Allergies
Musculoskeletal Injuries: Dislocations, Fractures, Sprains & strains
Drowning and water safety
Eye injuries and disorders
Water Disinfection and hydration
Wilderness Medical Kits
Wilderness Wound Management including wound cleaning and closure
Gastro intestinal problems
Bites and stings
Altitude Illness including hands on training with Portable Altitude Chambers
Fractures & dislocations including SAM Splints, Pelvic Binders (commercial and improvised) and Kendrick Traction Devices
Bites and stings
Evacuation Guidelines for complex situations
Head & Spine
Gender specific Emergencies
Hydration and nutrition
Medical Problems including diabetes, asthma, heart attack, stroke, epilepsy (amongst others)
Psychological issues in the wilderness
Athletic Injuries (sprains, strains, etc).
Pain relief including the Penthrox Competent Administrator certification
Misc wilderness problems
Costs: £750.00* ** (no vat) for the WFR certification. During 2020, we are also offering a free*** Off Site Safety Management course (usually £190.00) for those booking a full WFR course (not WFR Refreshers) in 2020, to assist in meeting the guidelines regarding risk management knowledge for wilderness medics. Thats 9 days training for £750.00.
*Optional addition of the Ofqual Regulated QNUK Level 3 Award in First Response (RQF) and the Ofqual Regulated Level 3 Award in Administering Emergency Oxygen (RQF) - is an additional £100.00.00
**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, the courses are run at venues where very reasonably costed accommodation and food are available, youth hostel accommodation and camping, cafes and shops are available nearby. We know that many clients prefer to camp and arrange their own food. Group discounts apply for in house courses for groups of 16 or more. Courses can be delivered at your venue or suitable venues around the country by arrangement. Terms and Conditions apply.
****Terms and Conditions apply. Only applies to accepted and concluded bookings. The cost of a 2 day OSSM course, delivered by us will be waived. Delegates will have to cover their own attendance costs, food, travel and accommodation. The OSSM course free places are our April and November 2020 course dates. Subject to availability. Not transferable to anyone else. Only one OSSM place per delegate. Offer only applies to those completing the WFR course paid and booked.
Delegates need to be over the age of 18, hill fit and competent to operate on uneven ground and must be able to swim in open water.
The course is certificated as a Remote area and Wilderness First Responder by Remote Area Risk International for 3 years. The course meets and exceeds most UK NGB awards.
The U.S. Wilderness First Responder aspect is accredited for 2 years (with an additional 12 months grace period thereafter where delegates only need to undertake a WFR refresher rather than re do the whole course) by the University of Utah School of Medicine under their 7 day Wilderness First Responder/ Basic Wilderness Life Support Scheme (only referred to as 'Basic' because they also run a course for Doctors - which we also run - entitled 'Advanced Wilderness Life Support').
Once you have done the 7 day Remote Area and Wilderness First Responder with us, you can simply undertake a three day refresher (the first three days of a WFR) plus test paper and practicals, to refresh both the US WFR and the R2Ri certifications.
We also issue WFR certificates after a 3 day refresher for those who have done a WFR elsewhere subject to that course being with a provider that we and our US Partner accepts. The original WFR must be in date when undertaking the WFR with us and that certificate must be provided to us as evidence.
This includes full WFR previously done in the US or Canada with NOLS WMI, SOLO, WMA - 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.
Why undertake the course with us ?
A unique course, meeting relevant 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.
It is recommended that you have previously undertaken a 2 day Outdoor First Aid Course.
Our next Remote Area and Wilderness First Responder and WFR Refreshers which are open to the public are:
28 Sept - 4 Oct - This course is full.
2021 course dates coming soon.
WFR 2020 cost: £750.00 which includes course fee, certification, course materials, licence fee, plus access to (non compulsory) post course CPD materials, wipe clean field aide memoire, course manual, free OSSM course place ***. Pre course study is necessary.
The optional additional qualifications cost an additional £100.00. We strongly recommend you take up this option as the additional qualifications usually cost £525.00 as a stand alone. These additional certifications are not available for the 3 day WFR Refresher. Please tell us when booking if you want to undertake these additional certifications.
WFR Refresher cost: £425.00 which includes course fee, certification, course materials, licence fee, plus access to (non compulsory) post course CPD materials and course manual.
Accommodation and food are not included as clients tell us that they want flexibility and we wish to be as inclusive as possible. Inexpensive camping, bunk house and YHA options are available very close to the venue and accommodation can be booked at the venue itself.
Venue: The National Mountain Centre, Capel Curig, Plas Y Brenin, Snowdonia, Wales.
Covid19: We have limited places to ensure social distancing and have also significantly upscaled kit to minimise cross handling of kit. Wearing of masks will be mandatory. Scenarios will be individual and/or socially distanced. Masks and face shields plus gloves and sanitiser will be issued to all delegates. There will be pre screening of all delegates prior to attending the venue. Please view the venue website regarding the steps that they are taking regarding Covid precautions - that all our delegates will have to comply with on site.
How to book:
Click the link below to access the booking course pack for the course you are interested in. Download the pack, save it your computer and you can complete the booking form electronically and email to us. Alternatively, print off the pack, complete and scan the booking form back to us.
‘Invaluable learning experience’
‘Really impressive knowledge but always focused on our level of understanding’
‘An intensive but really enjoyable week. My knowledge and confidence is so much stronger...’
‘I have done many 2 day outdoor first aid courses for my work and although I only book with first responders/mountain rescue, the course content is nowhere near the teaching on this course’.
‘Previously qualified with NOLS in the US. Both (NOLS and Remote Area Risk International) excellent with different approaches. (NOLS more ‘American’)’
‘Much more comprehensive than 2 day outdoor first aid courses. 2 day courses really not sufficient for outdoor professionals. WFR ... should be more widely encouraged.’
‘Very impressive. Couldn’t ask for more experience’
‘Very thorough and useful. Thank you !’
‘I’m naturally a very critical person. I like things correct. I simply cannot think of any improvements what so ever!!’
‘This course is on par with National Mountain Centre level standards - Glenmore Lodge, Rescue 3, Plas Y Brenin, Plas Menai. It is of that ‘ilk’ in standards and delivery’.
‘First class. Absolutely superb’
‘I have had a week with sector leaders’
‘Fantastic value for money’
‘Specialists in their field. Leaders in their field. Brilliant’
‘More professional, thorough and engaging than previous courses’
‘The wealth of information from the 3 of you and how it was delivered to us was second to none. Your different teaching styles complement each other’
‘Far better in every way (than previous courses)’
‘As good as it gets’
‘Extremely helpful and often fascinating’
‘Vast amount of experience put across in extremely professional delivery styles’
‘Excellent course, highly recommended’
‘Massive experience. No egos, just teaching’
"100% one of the best things I have ever done, I can’t commend the course enough”
“Yep. Totally loved the course. A MUST for anyone working with groups abroad and / or needing to up-skill themselves above the 16 hour Outdoor First Aid Course. Fantastic instructors, fantastic hands on kit usage and amazing venue. Well done guys!”
“Incredible course, keep it up, so worth it, perfect”
Top possible rating for each of: instructors knowledge, ability, training resources and equipment across the board.
“Excellent Knowledge and great practical practice and use”
“Instructors have been incredible”
“It has been perfect”
“Awesome course, huge knowledge base to gain from”
“Loved every moment, the instructors are incredible.”
“Brilliant course. Loads for us to take away”
“I loved the course”
“Great to see, feel and use real kit”
“Brilliant instructors, obviously knowledgeable both theoretically and practically. This resulted in a very enjoyable and informative experience”