Navigating the Rapids: Choosing the Right Wilderness Medicine Training for Whitewater and Remote River Trips

For enthusiasts of river sports like kayaking, rafting, fishing and packrafting, the wilderness serves as both playground and challenge. River runners all love the exhilaration of navigating rapids and exploring remote waterways, but there's an inherent risk that demands preparedness in rescue skills and wilderness medicine. Below is a look at wilderness medicine training courses tailored for river runners, including kayakers, rafters, and packrafters. The nuances of the training levels, the importance of wilderness medical training for both single day and multi-day trips are included. This is relevant to river guides, recreational boaters, and river company owners.

Choosing the Right Level of wilderness medical Training:

Basic First Aid/CPR:

This is often the bare minimum that land managers require of guides and is arguably very inadequate for river running due to the inherent remoteness and delay in outside help arriving on the side of a river. While having CPR and Basic First Aid is helpful it does not provide the depth of knowledge or level of practice you will need to adequately address the types of injuries often seen on river trips. You will need a wilderness focused class for this. 

• Bare minimum for recreational boaters and novice river enthusiasts.

• Covers fundamental skills like wound care, CPR, and managing common injuries.

• Provides some knowledge for handling emergencies until professional medical help arrives.

Wilderness First Aid (WFA):

This course is 16 hours of hands-on in person learning. It provides more time for practice and introduces river runners to patient assessments and many more skills and topics that are covered in a Basic FA/CPR course. These include medical emergencies, environmental emergencies, splinting, patient packaging and evacuation. 

• Ideal for river guides and experienced boaters leading single day trips.

• Expands upon basic first aid with a focus on wilderness scenarios.

• Covers topics such as improvised splinting, treating hypothermia, and assessing water-related injuries. Provides direction on remote CPR. 

• Equips guides with a basic skillset to handle medical emergencies in remote environments effectively

Wilderness First Responder (WFR):

The Wilderness First Responder is the industry standard for trip leaders and head guides. WFR courses are typically 70–90 hours and provide far more time for practice of the skills, more scenarios, and time for questions and specific learning for river related emergencies. These include risk mitigation and prevention, decision making about evacuation, more indepth look at all the topics related to environmental emergencies, trauma, medical emergencies, mental health emergencies, bites and stings, wound care and infection, spine assessment, patient packaging, evacuation methods, and much much more. 

• Essential for leading multi-day river expeditions, trip leaders, and head river guides.

• Comprehensive training in wilderness medicine, including patient assessment, long-term care, and evacuation procedures.

• Prepares guides to manage complex medical situations and prolonged emergencies in remote settings.

• Provides a deeper understanding of legal considerations and risk management in wilderness medical care.

• Benefits of remote and wilderness focused first aid and first responder training:

• Client and river trip participants: Patient Care Perspective:

• Higher levels of training ensure better patient care and increase the likelihood of successful outcomes.

• WFR-trained guides can offer a higher standard of care, enhancing the overall experience for participants.

• Trip participants and clients feel reassured knowing their trip leaders and guides are equipped to handle medical emergencies with competence and confidence.

Legal Risk Management:

• Investing in comprehensive training reduces liability for river companies by demonstrating a commitment to safety and risk mitigation.

• WFR certification provides legal protection by ensuring guides meet industry standards for wilderness medical care.

• Properly trained guides can mitigate risks and respond effectively to emergencies, minimizing the potential for legal repercussions.

Considerations for River Company Owners:

River company owners should prioritize WFR training for head river guides and trip leaders to uphold safety standards and mitigate legal risks. Doing this will also have retention, loyalty, and other intangible benefits.

• Investing in staff training enhances the reputation of the company and fosters trust with clients, leading to repeat business and positive word-of-mouth.

• We recommend requireing all new hires,  guides and especially trip leaders to annually demonstrate good patient assessment and care for both the most common injuries you see on your river and worst case scenarios. Have them utilize your existing Emergency Action Plan and try to find the holes you have in your plan and training. 

• Providing this training or paying additional money to those who have and maintain these certifications shows investment into your staff and will provide more loyal staff and higher retention rates. 

Where to find WFA and WFR Training?

Choose the level and training company wisely, look for a company that can provide a course tailored to your activity and type of adventures. We work hand in hand with Wounded Bear Medicine to ensure that the WAF and WFR courses are specific to river runners and guides. These instructors are guides and have extensive experience in wilderness rivers and expeditions along with patient care in these settings with wilderness medical principles.

In the dynamic realm of river sports, wilderness medicine training is not just a precaution but a necessity. By selecting the appropriate level of training, from wilderness first aid to wilderness first responder certification, river runners can enhance safety, improve patient care, and mitigate risks. For private river runners having this training can save a trip from having to evacuate unnecessarily, lose time on the river or incur expenses related to rescues. For guides and company owners, investing in comprehensive training is not only a legal imperative but also a testament to their commitment to safety and professionalism in the wilderness.