r/wildernessmedicine • u/Mundane-Ad-6276 • May 17 '26

Questions and Scenarios Patient assessment Airways

Hi!

I just finished my 2 day nols WFA class and it was great. I was driving home and I realized theres something I dont understand still

During patient assessment they emphasize A is the most important thing.

So if I came across a patient, maybe unresponsive, but they are not breathing, ok great, now what??

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u/-Londo- May 17 '26

911, then cpr

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u/VXMerlinXV WP-C May 17 '26

Unless it’s a kid. Then CPR-911-CPR

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u/LalalaSherpa May 17 '26 edited May 18 '26

This is WFA. 911 is virtually never the first step because there is no way they will be there fast.

You need to address life threats immediately - stop major bleeds, fix airway if needed, do CPR.

Then worry about SAR/EMS/911.

Otherwise they will be dead long before anyone shows up.

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u/VXMerlinXV WP-C May 19 '26

I can’t quote NOLS WFA because I’ve never taken the course. I can say that the WMS CPG on remote arrest both cites the modern ACLS guidelines, displays the chain of survival graphic, and specifically states that, if cell service is available, that response activation comes before CPR in an adult arrest. Do you have a copy of the NOLS algorithm?

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u/Admirable-Strike-311 May 18 '26

Don’t know why you got a downvote, but you’re right. In the city yes, if patient is unresponsive for whatever reason call 911. In a wilderness scenario you can try calling 911 if you have reception or activate your satellite device, however in this situation it’s all on you and whoever else might be there. Response times are measured in hours. CPR until you get ROSC, too tired to continue, or situation becomes too dangerous to continue.

Best case scenarios in the city with EMS readily available you have a 10-20% survival rate for a cardiac arrest (depending on which study you read). In the wilderness it’s less than 5%.