Wilderness Medicine Blended Learning Standards

WFR Core Curriculum Topics and Objectives 

Documentation and Reporting 

Mandatory Verbal Report 

The objectives for this topic are currently being written and reviewed.  

Mandatory Patient Care Report  

The objectives for this topic are currently being written and reviewed.  

Radio Report  

The objectives for this topic are currently being written and reviewed. 

Medical Legal Practices and Responsibilities 

Mandatory WFR Scope and Responsibilities 

Knowledge Objectives 

Describe the general definition of a Wilderness First Responder. (Understand) Describe the major responsibilities of a Wilderness First Responder. (Understand) 

Recognize that there are other scopes of practices for each level of medical licensure. (Remember) 

Identify the hierarchy of medical licensure. (Remember) 

Distinguish the WFR SOP as the boundaries of a Wilderness First Responder. (Understand) 

Articulate the legal and practical importance of staying with the WFR SOP. 

(Understand) 

Medical Legal 

Mandatory Consent 

Knowledge Objectives 

Describe the different forms of consent. (Understand)  

Recognize that the failure to obtain consent infringes on the patient’s right to autonomy. (Remember) 

Recognize a patient’s right to refuse medical treatment. (Remember) 

Determine which form of consent applies to a given situation. (Apply) 

Skill Objectives 

Attain the appropriate form of consent during each scenario. (Apply) 

Privacy 

Knowledge Objectives 

Recognize the legal requirement to protect a patient’s privacy. (Remember) 

Duty to Act 

Knowledge Objectives 

Describe the concept of Duty to Act as it applies to a WFR. (Remember) 

Good Samaritan Law 

Knowledge Objectives 

Describe the Good Samaritan Law. (Understand) 

Recognize the Good Samaritan Law may differ per state. (Understand) 

Abandonment  

Knowledge Objectives 

Describe abandonment. (Understand) 

Negligence 

List the tenets of negligence. (Remember) 

Decision Making 

Mandatory Rescuer & Patient safety concerns 

Knowledge Objectives 

Evaluate a situation for hazards that threaten the safety of one’s self, other rescuers, and the patient. (Evaluate) 

Evaluate a situation for hazards related to the terrain and environment. (Evaluate) 

Determine the appropriate Personal Protective Equipment needed based on the given situation. (Apply) 

Skill Objectives 

Demonstrate appropriate PPE based on the provided scenario. (Apply)  

Mandatory Risk Mitigation 

Knowledge Objectives 

Contrast the risks of self-evacuation to technical evacuation. (Understand) 

Identify high risk evacuation operations. (Remember) 

Recognize that every situation requires a risk vs benefit analysis. (Remember) 

Skill Objectives 

Evaluate the risks vs benefits of a given evacuation decision. (Evaluate) 

Apply risk mitigation strategies based on evaluation of safety hazards. (Apply)

Mandatory Evacuation Decision 

Knowledge Objectives 

Recognize that urgency of an evacuation is determined by the severity of the situation. (Remember) 

Recognize that urgent evacuation is needed any time a patient’s condition is high risk, is worsening, or is not  treatable. (Recognize) 

Evaluate the available and needed resources. (Evaluate) 

Skill Objectives 

Determine appropriate evacuation decisions based on the scenario provided.  

Basic Lifts/Moves  

Mandatory B.E.A.M. 

Skill Objectives 

Perform patient BEAM lift to move patients appropriately. 

Mandatory Log Roll 

Skill Objectives 

Perform patient log roll to clear the airway appropriately. 

Mandatory Recovery Position 

Knowledge Objectives 

Distinguish the recovery position as the protective position for the airway. (Understand) 

Skill Objectives 

Place a patient into a recovery position as appropriate for the given situation. (Apply)

Mandatory Litter Packaging  

Knowledge Objectives 

Describe the function and importance of padding under and around a patient in a litter basket. (Understand) Evaluate the risks and benefits of patient litter packaging and transport. (Evaluate) 

Skill Objectives 

Demonstrate appropriate patient litter packaging. (Apply) 

Demonstrate appropriate Spinal Motion Restriction application to a patient in a litter basket. (Apply) 

Demonstrate correct litter carrying techniques with and without a litter wheel. (Apply) 

Patient Assessment  

Mandatory Patient Assessment System 

Knowledge Objectives 

Recognize the importance of using the same systematic approach for every patient interaction. (Remember) 

Skill Objectives 

Complete a comprehensive patient assessment in less than 15 min for a simple scenario. (Apply) 

Mandatory Scene Size Up 

Skill Objectives 

Evaluate a scene as it relates to safety, surrounding terrain, environment, resources, and patient condition. (Evaluates)  

Analyze how aspects relating to safety, terrain, environment, resources, and patient condition may influence  the situation. (Analyze) Successfully complete the scene size up using S.T.E.R.I. with each scenario. (Apply) 

Mandatory Primary Assessment 

Knowledge Objectives 

Prioritize the assessment of life threats over other aspects of the Patient Assessment System. (Analyze) 

Prioritize the management of life threats over other aspects of the Patient Assessment System. (Analyze) 

Skill Objectives 

Successfully complete a Primary Assessment survey in each scenario. (Apply) Assess for life threats before moving on to the secondary assessment. (Evaluate) 

Apply appropriate treatment to life threats in a timely manner before moving on to the secondary assessment.  (Apply) 

Ensure patient protection from the environment based on a scenario provided. (Analyze) 

Basic Life Support  

Mandatory Airway & Breathing 

Airway & breathing Assessment 

Knowledge Objectives 

Distinguish signs and symptoms of airway and breathing compromise. (Understand)  

Distinguish need for higher level medical care for airway and breathing concerns. (Analyze) 

Skill Objectives 

Assess for airway and breathing compromise. (Evaluate) 

Airway & Breathing Management 

Knowledge Objectives 

Prioritize the management of airway and breathing concerns over less concerning patient problems. (Analyze) Determine which airway maneuver is appropriate for the given situation. (Apply) 

Identify need for airway repositioning in semi and unconscious patients. (Analyze) 

Skill Objectives 

Apply appropriate treatment to airway and breathing concerns in a timely manner. (Apply) 

Determine need for higher level medical care and evacuation for airway and breathing concerns. (Analyze) 

Jaw Thrust 

Skill Objectives 

Demonstrate how to open a patient’s airway using jaw-thrust as appropriate. (Apply) 

Head Tilt/Chin lift  

Skill Objectives 

Demonstrate how to open a patient’s airway using head-tilt chin lift as appropriate. (Apply) 

Mouth-Mask Respirations  

Knowledge Objectives 

Identify need for mouth-to-mask ventilations in patients with decreased or absent respiratory effort. (Analyze) 

Skill Objectives 

Demonstrate correct mouth-to-mask ventilations on an airway mannequin. (Apply) 

OPA  

Knowledge Objectives 

Identify an OPA as an adjunct that facilitates obtaining and maintaining a patent airway. (Analyze) 

Describe the indications for an OPA. (Understand) 

Skill Objectives 

Determine appropriate size OPA for a patient. (Evaluate) 

Demonstrate correct insertion of an OPA in an airway mannequin. (Apply) 

NPA 

Knowledge Objectives 

Identify an NPA as an adjunct that facilitates obtaining and maintaining a patent airway. (Analyze) 

Identify an NPA as an adjunct option for obtaining and maintaining a patent airway in conscious or semi conscious patients. (Analyze) 

Describe the indications for an NPA. (Understand)

Skill Objectives 

Determine appropriate size NPA for a patient. (Evaluate) 

Demonstrate correct insertion of an NPA in an airway mannequin. (Apply) 

Suctioning 

Knowledge Objectives 

Identify the indications for airway suctioning . (Evaluate) 

Review commercial battery-operated and manually operated suction devices. (Remember) 

Skill Objectives 

Demonstrate correct suctioning technique on an airway mannequin. (Apply) 

Avoid suctioning longer than 10 seconds. (Apply) 

Oxygen Administration 

Knowledge Objectives 

Identify indications for supplemental oxygen administration. (Evaluate) 

Determine appropriate oxygen delivery device for a given patient. (Evaluate) 

Determine appropriate flow rate for a given oxygen delivery device. (Evaluate) 

Skill Objectives 

Demonstrate correct oxygen tank and regulator assembly. (Apply) 

Demonstrate correct oxygen tank and regulator disassembly. (Apply) 

Demonstrate appropriate application and use of a nasal cannula. (Apply) 

Demonstrate appropriate application and use of a non-rebreather mask. (Apply) 

Ventilation 

Knowledge Objectives 

Explain tidal volume. (Analyze) 

Describe the benefits and risks associated with positive-pressure ventilation. (Evaluate)  

Explain the importance of avoiding overinflation when delivering positive pressure ventilation to a patient.  (Analyze) 

Identify the indication for positive pressure ventilation. (Evaluate)  

Skill Objectives 

Demonstrate correct bag-valve-mask seal techniques. (Apply) 

Demonstrate appropriate operation of a bag-valve-mask to deliver positive pressure ventilations. (Apply) 

Demonstrate correct ventilation rate with a BVM on an airway mannequin. (Apply)  

Assess patients for complications associated with positive pressure ventilations. (Apply) 

Mandatory Circulation Assessment 

Knowledge Objectives 

Distinguish signs and symptoms of circulation compromise. (Understand) 

Distinguish need for higher level medical care for circulation concerns. (Analyze) 

Skill Objectives 

Assess for circulation compromise. (Evaluate) 

Circulation Management 

Knowledge Objectives 

Prioritize the management of circulation concerns over less concerning patient problems. (Analyze) 

Skill Objectives  

Assess for circulation compromise. (Evaluate) 

Apply appropriate treatment to circulation concerns in a timely manner. (Apply) 

Determine need for higher level medical care and evacuation for circulation concerns. (Analyze) 

Bleed Control 

Skill Objectives 

Complete a blood sweep in 90 secs or less. (Apply) 

Prioritize correction of heavy bleeding over airway and breathing concerns. (Analyze) 

CPR 

AED 

Secondary Assessment 

Mandatory Patient Interview 

Knowledge Objectives 

Distinguish SAMPLE history as a necessary means of gathering subjective patient information. (Analyze) 

Identify when a situation requires further information gathering beyond SAMPLE. (Analyze) 

Distinguish OPQRST as means of gathering subjective patient pain information. (Analyze) 

Hx Activity ? 

Skill Objectives 

Complete a full patient history. (Apply) 

Attain OPQRST when appropriate for a given situation. (Apply) 

Attain a history of activity when appropriate for a given situation. (Apply) 

Mandatory Vital Signs 

Knowledge Objectives 

Evaluate vital signs as a measurement of a patient’s health status. (Evaluate) 

Interpret a given vital sign or set of vital signs as abnormal or normal. (Evaluate) 

Distinguish need for higher level medical care in patients with abnormal vital signs. (Analyze) 

Skill Objectives 

Complete basic WFR appropriate vital signs (HR, RR, LOC, Skin, BP). (Apply) 

Heart Rate  

Skill Objectives 

Acquire a patient’s heart rate. (Apply) 

Palpate carotid, radial, and pedal pulses. (Apply)

Respiratory Rate 

Skill Objectives 

Acquire a patient’s respiratory rate. (Apply) 

Skin 

Skill Objectives 

Assess a patient’s skin temperature, color, and moisture. (Apply) 

Level of Consciousness - A&Ox4, AVPU 

Skill Objectives 

Determine patients AVPU mental status based on scenario. (Evaluate) 

Determine the extent of a patient’s alertness using A&O x4 assessment as appropriate for a given situation.  (Evaluate) 

Blood Pressure 

Skill Objectives 

Demonstrate appropriate technique for obtaining a patient's blood pressure. (Apply) 

Acquire a patient's blood pressure via auscultation. (Apply) 

Acquire a patient's blood pressure via palpation. (Apply) 

Pulse Oximetry 

Knowledge Objectives 

Recognize that external environmental factors may influence a pulse oximetry reading. (Remember) 

Skill Objectives 

Demonstrate appropriate technique for obtaining a pulse oximetry reading. (Apply) 

Oral Temperature 

Skill Objectives 

Demonstrate appropriate technique for obtaining a patient's oral temperature. (Apply) 

Mandatory Physical Exam 

Knowledge Objectives 

Distinguishes the Physical Examination as an essential component of the Patient Assessment System. (Understand) 

Skill Objectives  

Completes a thorough physical examination. (Apply) 

Palpation 

Skill Objectives 

Distinguishes normal versus abnormal palpation findings. (Understand) 

Motor Function 

Knowledge Objectives 

Identify abnormal motor function findings as an urgent concern. (Analyze) 

Skill Objectives  

Evaluate gross motor function distal to an injury before and after injury management. (Evaluate) 

Sensation 

Knowledge Objectives 

Identify abnormal sensation function findings as an urgent concern. (Analyze) 

Skill Objectives  

Evaluate gross sensation function distal to an injury before and after injury management. (Evaluate) 

Skin temp/color/moisture  

Knowledge Objectives 

Identify abnormal skin findings as a concern that warrants further investigation. (Analyze) 

Skill Objectives  

Evaluate skin distal to an injury before and after injury management. (Evaluate) 

Evaluate skin for abnormalities. (Evaluate) 

Cap Refill  

Knowledge Objectives 

Identify abnormal cap refill findings as a possible urgent concern. (Analyze) 

Identify reasons for slowed cap refill in absence of pathology. (Analyze) 

Distal Pulses 

Knowledge Objectives 

Identify absent distal pulses as an urgent concern. (Analyze) 

Skill Objectives  

Evaluate pulses distal to an injury before and after injury management. (Evaluate) 

Mandatory Shock 

Shock Assessment 

Knowledge Objectives 

Describe perfusion as the delivery of oxygen and other nutrients by circulation of blood to the cells, tissues  and organs. (Understand) 

Describe the major body systems and functions that maintain perfusion. (Understand) 

Identify that life threats lead to shock due to decreased perfusion. (Analyze) 

Identify the signs and symptoms of shock. (Analyze) 

Identify shock as a life threatening condition that requires urgent management. (Analyze) 

Skill Objectives 

Identify shock or the potential for shock within the primary assessment. (Analyze) 

Shock Management 

Knowledge Objectives 

Distinguish a decrease in a patient’s body temperature as a potentiator of shock. (Analyze)

Determine ABC maintenance, environmental exposure protection, and immediate evacuation as the management of a shock patient. (Evaluate) 

Skill Objectives  

Apply appropriate treatment to a shock patient in a timely manner. (Apply)

Apply appropriate measures to prevent a decrease in patient body temperature and protect patients from the environment. (Apply) 

Complete continuous monitoring and maintenance of ABC's. (Evaluate) 

Recommend immediate and urgent evacuation of shock patients. (Evaluate) 

Mandatory Bleed Control 

Bleed Control Assessment 

Knowledge Objectives 

Distinguish bleeding as capillary, venous, or arterial. (Analyze) 

Identify junctional bleeds from extremity bleeds. (Analyze) 

Distinguish that significant bleeding and blood loss can occur internally. (Understand) 

Identify injuries and mechanisms that are high risk for internal bleeding. (Analyze) 

Determine significant blood loss as a life threat. (evaluate) 

`Skill Objectives  

Prioritize significant bleed management over the management of airway and breathing concerns. (Analyze) 

Determine the need for immediate and urgent evacuation of patients with a significant bleed. (Evaluate) 

Bleed Control Management 

Knowledge Objectives 

Distinguish the need for management of significant bleeding before the management of airway and breathing  concerns. (Understand) 

Skill Objectives  

Apply appropriate bleed management during the primary assessment. (Apply) 

Direct Pressure 

Knowledge Objectives 

Identify direct pressure as the initial management of all types of bleeding. (Analyze) 

Skill Objectives  

Apply direct pressure to a bleed site with a gloved hand. (Apply) 

Pressure Dressing 

Skill Objectives  

Construct a pressure dressing with basic bandages appropriately. (Create) 

Tourniquet 

Knowledge Objectives 

Identify the need for a tourniquet to control blood loss in a timely manner. (Analyze) 

Identify the potential need for a second tourniquet. (Analyze)  

Recognize that a tourniquet must not be removed or loosened after tourniquet application. (Remember) 

Skill Objectives 

Demonstrate correct application of an improvised tourniquet. (Apply)  

Hemostatic Dressings 

Knowledge Objectives 

Identify the need for a hemostatic dressing for junctional bleeds. (Analyze)  

Skill Objectives 

Demonstrate correct application of a hemostatic dressing. (Apply)  

Pelvic Splint 

Skill Objectives 

Apply an improvised pelvic splint to high risk patients. (Apply) 

Mandatory Spine Injury 

Spine Injury Assessment 

Knowledge Objectives 

Identifying mechanisms can cause spinal injury. (Analyze) 

Identify the signs and symptoms of spinal injury. (Analyze) 

Identify spinal injury as a life threatening injury. (Analyze) 

Evaluate the risks and benefits of spinal motion restriction created for patients and rescue personnel. (Evaluate) 

Skill Objectives  

Evaluate need for Spinal Motion Restriction in appropriate patients. (Evaluate) 

NEXUS 

Knowledge Objectives 

Describe NEXUS as the basis of assessment for determining the necessity of Spinal Motion Restriction. (Understand) 

Skill Objectives  

Assess a patient using NEXUS with the assistance of a study aid. (Apply) 

Spine Injury Management 

Knowledge Objectives 

Describe Spinal Motion Restriction. (Understand) 

Prioritize the limitation of spinal movement in spinal injury patients. (Analyze) 

Identify B.E.A.M. lift as the preferred patient maneuver. (Understand) 

Skill Objectives  

Apply spinal motion restriction as appropriate for the provided situation. (Apply) 

Complete a patient transfer utilizing the B.E.A.M. lift. (Apply)

Complete a patient log roll. (Apply) 

Mandatory Head Trauma 

Severe Head Injury 

Severe Head Injury Assessment  

Knowledge Objectives 

Identify the signs and symptoms of a severe head injury. (Analyze) 

Identify the mechanisms that may cause a severe head injury. (Analyze) 

Distinguish a severe head injury as a life threat. (Understand) 

Define increasing intracranial pressure. (Remember) 

Define Traumatic Brain Injury. (Remember) 

Skill Objectives  

Assess and monitor the ABC’s. (Apply) 

Assess and monitor a patient’s level of consciousness. (Evaluate) 

Determine the need for immediate and urgent evacuation of patients with a severe head injury. (Analyze) 

Severe Head Injury Management  

Knowledge Objectives 

Describe ABC monitoring, LOC monitoring, environmental exposure protection, the limiting of spine movement, elevating the head, and immediate evacuation as the appropriate management of severe head  injury patients. (Understand) 

Skill Objectives  

Apply appropriate measures to prevent a decrease in patient body temperature and protect patients from the environment. (Apply) 

Apply Spinal Motion Restriction appropriately for severe head injury patients. (Apply) 

Apply appropriate head elevation of severe head injury patients. (Apply) 

Mandatory Concussion  

Concussion Assessment  

Knowledge Objectives 

Define a concussion. (Remember) 

Identify signs and symptoms of a concussion. (Analyze) 

Identify a potential concussion. (Analyze)  

Concussion Management  

Knowledge Objectives 

Explain how further activity will increase morbidity in concussion. (Analyze)  

Skill Objectives  

Remove a possibly concussed patient from further activity, observe for signs of worsening, and arrange for further medical evaluation and treatment. (Apply)  

Mandatory Chest Trauma 

Chest Trauma General Assessment 

Knowledge Objectives 

Review the organs and structures within the chest cavity. (Understand)  

Identify mechanisms that increase risk for chest injury. (Evaluate)  

Skill Objectives  

Expose a patient's chest to adequately assess for injury. (Apply)  

Chest Trauma General Management 

Skill Objectives  

Assess and monitor the ABC's of a patient with a chest injury. (Apply) 

Rib Injuries 

Rib Injuries Assessment 

Knowledge Objectives 

Identify the possibility of lung injury to underlying tissues from an isolated fractured rib. ( Remember)  

Describe flail chest. (Understand)  

Identify the high risk of lung injury associated with flail chest injury. (Analyze)  

Rib Injuries Management 

Knowledge Objectives 

Identify flail chest management as the application of a bulky dressing, lying the patient down on their injured  side, monitoring ABC's, and immediate evacuation. (Analyze) 

Skill Objectives  

Apply a bulky dressing appropriately to flail chest injury. (Apply)  

Determine the need for immediate and urgent evacuation for a patient with flail chest injury. (Evaluate)  

Lung Injury 

Lung Injury Assessment  

Knowledge Objectives 

Describe basic lung anatomy, including the pleural membranes. (Understand)  

Identify an open chest wall injury. (Analyze) 

Describe a pneumothorax. (Understand) 

Describe a hemothorax. (Understand) 

Explain the basic pathophysiology of a tension pneumothorax. (Evaluate) 

Identify the signs and symptoms of respiratory compromise. (Evaluate)  

Lung Injury Management 

Knowledge Objectives

Identify the management of an open chest wall injury as application of an occlusive dressing, monitoring ABC's, and immediate evacuation. (Analyze) 

Skill Objectives  

Apply a gloved hand over an open chest wall injury immediately upon its discovery. (Apply) 

Construct an improvised occlusive dressing taped on four sides over a chest wall injury. (Apply) 

Determine the need to immediate and urgent evacuation of a patient experiencing a lung injury. (Evaluate) 

 Cardiac Injuries 

Heart Injury Assessment 

Knowledge Objectives 

Identify the possibility of compromised cardiac function as a result of chest trauma. (Evaluate) 

Identifying the signs and symptoms can compromise circulation. (Evaluate) 

Heart Injury Management 

Skill Objectives  

Determine need for immediate and urgent evacuation of a patient with compromised cardiac function from  chest trauma. (Evaluate)  

Abdominal Trauma 

Abdominal Trauma Assessment 

Knowledge Objectives 

Distinguish that injuries within the abdominopelvic cavity can be life threatening. (Understand) 

Recognize that solid organ injury can be a source of life threatening internal bleeding. (Remember)

Recognize that hollow organ injury within the abdominal cavity can be life threatening. (Remember)

Identify the location of the liver and spleen. (Remember) 

Identify the signs and symptoms of abdominal trauma.  

Define evisceration. (Remember)  

Skill Objectives  

Examine the abdomen for signs of trauma and internal bleeding. (Apply)  

Abdominal Trauma Management 

Knowledge Objectives

Avoid removing impaled objects, unless the object interferes with CPR efforts. (Apply)

Identify evisceration management as the application of clean, moist dressings, an occlusive dressing, protecting the patient from the environment, and urgent evacuation. (Evaluate)  

Skill Objectives  

Stabilize impaled objects in the abdomen. ( Apply)  

Construct an appropriate evisceration dressing. (Apply)  

Determine the need for immediate and urgent evacuation of patients with an evisceration. (Evaluate)  

Determine the need for immediate and urgent evacuation of patients with an impaled object. (Evaluate)  

Mandatory Orthopedic Injuries  

Orthopedic Injuries General Assessment  

Knowledge Objectives 

Differentiate normal vs abnormal CMS findings. (Analyze) 

Identify abnormal CMS findings distal to an orthopedic injury as an emergency that requires urgent evacuation. (Analyze) 

Skill Objectives 

Assess circulation, motor, and sensation (CMS) function distal to injury before and after orthopedic injury  management. (Evaluate) 

Orthopaedic Injury General Management  

Knowledge Objectives 

Describe orthopedic injury management as injury stabilization, protection, and monitoring. (Understand) 

Skill Objectives 

Complete CMS monitoring distal to orthopedic injury throughout patient care. (Apply) 

Apply appropriate splinting techniques for orthopedic injuries. (Apply)

Manage pain with over-the-counter Acetaminophen as recommended on medication packaging. (Analyze) Splinting 

Knowledge Objectives 

Identify the necessary criteria for constructing an adequate improvised splint. (Analyze)  

Skill Objectives 

Splint injury in position found. (Apply)

Create an adequate improvised splint following the splinting criteria with or without the help of an aid.(Create) 

Sling and Swathe 

Skill Objectives 

Create an adequate improvised sling and swathe as appropriate for the injury. (Create) 

Buddy Tape 

Fractures 

Fractures Assessment 

Knowledge Objectives 

Describe a fracture. (Understand) 

Differentiate between an open and closed fracture. (Apply) 

Identify the signs and symptoms of a fracture. (Analyze) 

Skill Objectives

Identify high risk fractures. (Analyze) 

Fractures Management 

Skill Objectives 

Apply appropriate management techniques of high risk fractures during the primary assessment. (Apply) 

Apply gentle traction to align the limb into an anatomically neutral position. (Apply) 

Apply direct pressure to open fractures to control bleeding. (Apply) 

Complete irrigation for open fractures. (Apply) 

Pelvis and Hip Injuries 

The objectives for this topic are currently being written and reviewed.  

Sprains, Strains, and Dislocation 

Sprains and Strains Assessment 

Knowledge Objectives 

Describe a sprain or strain. (Understand) 

Dislocation Assessment 

Knowledge Objectives 

Describe a dislocation. (Understand) 

Identify the risk of circulation, sensation, and motor function damage associated with a dislocation injury. (Analyze) 

Other objectives for this topic are currently being written and reviewed.  

Compartment Syndrome 

Compartment Syndrome Assessment 

Knowledge Objectives 

Describe compartment syndrome. (Understand) 

Identify the signs and symptoms of compartment syndrome. (Analyze) 

Compartment Syndrome Management 

Knowledge Objectives 

Identify compartment syndrome as an emergency that requires urgent evacuation. (Analyze) 

Skill Objectives  

Determine the need for immediate and urgent evacuation for patients experiencing compartment syndrome.  (Evaluate) 

Mandatory Wound Care 

Wound Care Assessment 

Knowledge Objectives 

Identify which wounds are high risk wounds. (Analyze) 

Identify signs and symptoms of wound infection. (Analyze) 

Identify situations that are high risk for skin injury. (Analyze) 

Associate wound tissue irritation with increased infection risk. (Understand) 

Determine which wounds require immediate and urgent evacuation. (Evaluate) 

Skill Objectives 

Assess CMS distal to wound injury before and after wound management. (Evaluate) 

Wound Care Management 

Knowledge Objectives 

Determine appropriate wound dressing for the given environment and circumstances. (Evaluate) 

Avoid topical ointments and impregnated dressings over the surface of the wound. (Apply) 

Identify the need to change wound dressings every 24 hours. (Understand) 

Skill Objectives 

Apply appropriate wound dressing for the given environment and circumstances. (Apply) 

Wound Irrigation 

Knowledge Objectives 

Distinguish pressurized wound irrigation with clean drinking water free of additives as the best mechanism of  preventing infection. (Analyze) 

Skill Objectives 

Demonstrate proper wound irrigation. (Apply) 

Avoid use of additives such as soaps and disinfectants in irrigation solutions. (Apply) 

Non-Invasive Wound Closure 

Knowledge Objectives 

Determine which wounds can be closed with non-invasive wound closure techniques. (Evaluate) 

Skill Objectives 

Apply adhesive bandages (such as steri strips) for wound closure appropriately. (Aplpy) 

Blisters 

Blister Assessment 

Knowledge Objectives 

Describe the mechanisms of blister formation. (Understand) 

Blister Management 

Knowledge Objectives 

Determine which blisters should be drained. (Evaluate)  

Identify the reasons for leaving the roof of a blister intact. (Analyze)  

Burn Injuries 

Burn Assessment 

Knowledge Objectives 

Describe a minor burn as .... 

Describe a major burn as... 

Identify signs and symptoms of a possible airway burn. (Analyze) 

Identify which burns are high risk burns that require immediate and urgent evacuation. (Analyze)  

Identify hypothermia, hypovolemic shock, and infection as risks associated with major burns. (Analyze) 

Burn Management 

Knowledge Objectives 

Identify burn management as stopping the burning process, dressing the burn wounds, protecting the patient  from environmental exposure, monitoring the ABC's, and urgent evacuation. (Analyze) 

Skill Objectives 

Apply cool water to burn wounds to stop the burning process. (Apply)  

Apply dry, non-adherent dressing to the burn site. (Apply) 

Avoid the application of topical ointments to burn wounds and dressings. (Apply) 

Apply appropriate measures to prevent a decrease in patient body temperature and protect patients from the environment. (Apply) 

Manage pain with over-the-counter Acetaminophen as recommended on medication packaging. (Analyze) 

Mandatory Altered Mental Status  

Altered Mental Status General Assessment  

Knowledge Objectives 

Identify various causes of altered mental status. (Analyze) 

Identify behavioral presentations of altered mental status. (Analyze) 

Identify altered mental status as a symptom of a problem. (Analyze) 

Identify altered mental status as a life threatening concern that needs further investigation. (Analyze)  

Skill Objectives  

Recognize a patient with abnormal behavior as having altered mental status. (Remember)  

Create a differential problem list for patients exhibiting altered mental status. (Create)  

Altered Mental Status General Management  

Skill Objectives  

Determine the need for immediate and urgent evacuation of patients exhibiting an altered mental status. (Evaluate)  

Seizures  

Seizure Assessment  

Knowledge Objectives 

Recognize that there are different types and causes for seizures. (Remember)  

Define a seizure as abnormal brain activity typically manifesting as repetitive jerking movements and/or loss  of consciousness 

Distinguish that a Postictal patient with persistent unresponsiveness more than 20 minutes is atypical and worrisome 

Create a differential problem list for patients exhibiting altered mental status. (Create)  

Skill Objectives  

Evaluate the need for evacuation of a seizure patient. (Evaluate)  

Seizure Management  

Knowledge Objectives 

Identify seizure management as providing patient protection, monitoring the ABC's, monitoring mental status,  and possibly evacuation. (Analyze)  

Skill Objectives  

If available and training has been provided, assess the patient's blood glucose level. (Apply)  

Apply appropriate protective measures for a patient during and after seizure activity. (Apply) 

Stroke  

Stroke Assessment  

Knowledge Objectives 

Describe stroke as an interruption of cerebral circulation leading to brain cell death. (Understand) 

Identify stroke as a time critical emergency that requires higher level medical care and immediate evacuation.  (Analyze) 

Identify signs and symptoms of a stroke. (Analyze) 

Skill Objectives  

Create a differential problem list for patients exhibiting stroke symptoms. (Create)  

Demonstrate the FAST assessment for stroke victims with or without help of an aide. (Apply) 

Stroke Management  

Knowledge Objectives 

Identify stroke management as monitoring the ABC's, avoiding oral intake of medication administration, and immediate evacuation. (Analyze) 

Skill Objectives  

Avoid oral intake or medication administration to stroke victims (including Aspirin). (Apply) 

Determine need for immediate and urgent evacuation. (Evaluate) 

Psychological Issues & First Aid 

The objectives for this topic are currently being written and reviewed.  

Mandatory Respiratory Difficulty 

Respiratory Difficulty General Assessment 

Knowledge Objectives 

Describe basic anatomy and physiology of the respiratory system. (Understand) 

Identify respiratory difficulty of any nature as an emergency that requires higher level care and urgent evacuation. (Analyze) 

Identify general pathophysiologies that result in respiratory difficulty. (Analyze) 

Identify signs and symptoms of respiratory difficulty. (Analyze)

Skill Objectives  

Assess respiratory difficulty within the primary assessment. (Apply)  

Complete a focused patient history interview. (Apply) 

Respiratory Difficulty General Management 

Knowledge Objectives 

Identify general management of respiratory difficulty as monitoring of ABC's and immediate and urgent evacuation. (Analyze) 

Skill Objectives 

Determine need for immediate and urgent evacuation. (Apply)  

COPD  

COPD Assessment 

Knowledge Objectives 

Describe the basic pathophysiology of Asthma. (Understand) 

Describe the basic pathophysiology of Chronic Bronchitis. (Understand) 

Describe the basic pathophysiology of Emphysema. (Understand) 

Identify the signs and symptoms of COPD. (Analyze)  

Identify COPD as a potential life threat that requires higher level care and evacuation. (Analyze)  

COPD Management 

Skill Objectives  

Assist with administration of the patient's own emergency inhaler. (Apply)  

Determine the need for patient evacuation. (Evaluate) 

Cardiac and Circulation Issues 

Chest Pain  

Chest Pain Assessment 

Knowledge Objectives 

Describe Angina Pectoris. (Understand) 

Describe Myocardial Infarction. (Understand)  

Identify unstable Angina Pectoris. (Analyze)  

Differentiate between Angina Pectoris pain and Myocardial Infarction pain. (Analyze) 

Identify the signs and symptoms of possible myocardial infarction. (Analyze)  

Identify cardiac issues as life threatening and require urgent evacuation to higher level medical care. (Analyze) 

Identify the need for higher level medical care and urgent evacuation with patients experiencing unstable Angina Pectoris. (Analyze)  

Skill Objectives  

Assess patient's cardiac history and illness with focused patient history interview. (Evaluate)  

Chest Pain Management 

Knowledge Objectives 

Identify management of possible myocardial infarction as monitor ABC's, reducing patient's physical exertion,  administering 325 mg ASA, and urgent evacuation. (Analyze) 

Skill Objectives  

Avoid patient physical exertion. (Apply) 

Determine the requirement of higher level medical care and urgent evacuation. (Evaluate) 

Syncope 

The objectives for this topic are currently being written and reviewed.  

Palpitations  

The objectives for this topic are currently being written and reviewed.  

Mandatory Allergic Reaction 

Allergic Reaction Assessment  

Knowledge Objectives 

Differentiate between an isolated allergic reaction and anaphylaxis. (Analyze) 

Identify the signs and symptoms of anaphylaxis. (Analyze)

Identify an anaphylactic reaction as a life threatening problem that requires higher level medical care and immediate evacuation. (Analyze) 

Skill Objectives  

Assess for respiratory difficulty and compromised circulation during the primary assessment. (Apply) 

Allergic Reaction Management  

Knowledge Objectives 

Identify management of an anaphylactic reaction as removal of allergen, administration of epinephrine, administration of diphenhydramine, monitoring the ABC's, and immediate evacuation to higher level medical  care. (Analyze) 

Describe the basic pharmacologic actions of epinephrine. (Understand) 

Describe the basic pharmacologic actions of diphenhydramine. (Understand) 

Skill Objectives  

Determine need for epinephrine as soon as an allergic reaction threatens the airway or circulation compromise. (Evaluate) 

Demonstrate proper administration of an epinephrine auto-injector. (Apply) 

Administer over-the-counter diphenhydramine as recommended on medication packaging. (Apply) 

Determine need for immediate and urgent evacuation, even with patient improvement. (Evaluate) 

Mandatory Hypoglycemia 

Hypoglycemia Assessment 

Knowledge Objectives 

Describe basic metabolism as the breakdown of glucose into energy for the body. (Understand) 

Recognizing the brain requires glucose to function normally. (Remember) 

Describe hypoglycemia. (Understand) 

Describe the various mechanisms that may lead to hypoglycemia. (Understand) 

Describe hyperglycemia. (Understand)  

Identify hypoglycemia as an immediate life threat. (Analyze) 

Identify signs and symptoms of hypoglycemia. (Analyze) 

Hypoglycemia Management  

Knowledge Objectives 

Identify management of hypoglycemia as the administration of sugar, monitoring the ABC's, and possible evacuation. (Analyze)  

Skill Objectives 

Administer oral glucose in alert patients. (Apply) 

Administer buccal glucose in semi-conscious patients. (Apply) 

Avoid administration of insulin. (Apply) 

Reassess the patient and determine the need for evacuation appropriately. (Evaluate) 

GI/GU 

Abdominal Pain 

The objectives for this topic are currently being written and reviewed.  

Gastrointestinal Issues 

The objectives for this topic are currently being written and reviewed.  

Genitourinary Issues 

The objectives for this topic are currently being written and reviewed.  

HEENT 

Eye Injury 

The objectives for this topic are currently being written and reviewed.  

Vision Issues 

The objectives for this topic are currently being written and reviewed.  

Dental Injury  

The objectives for this topic are currently being written and reviewed.  

Nose  

The objectives for this topic are currently being written and reviewed.  

Mandatory Hypothermia 

Hypothermia Assessment 

Knowledge Objectives 

Describe the mechanisms of evaporation, conduction, convection, and radiation heat loss into the environment.  (Analyze)  

Identify the signs and symptoms of mild hypothermia. (Analyze)  

Identify the signs and symptoms of moderate hypothermia. (Analyze) 

Identify the signs and symptoms of severe hypothermia. (Analyze)  

Recognize the need to gently handle severely hypothermic patients to avoid cardiac dysrhythmia. (Remember)  

Skill Objectives 

Assess patient mentation. (Evaluate) 

Verify that the patient has adequate and dry clothing layers to maintain warmth. (Evaluate) 

Assess for other causes of altered mental status in a hypothermic patient. (Evaluate) 

Avoid prolonged exposure to the environment when assessing a patient. (Apply)  

Hypothermia Management 

Knowledge Objectives 

Identify moderate to severe hypothermia management as removal of patient from environment into a headwrap, removal of wet clothing, monitoring ABC's and mentation, and immediate evacuation. (Analyze)  

Identify the immediate need to isolate the patient from the ground. (Analyze)  

Skill Objectives 

Demonstrate gently handling of severely hypothermic patients. (Apply)  

Provide ground insulation for a patient in a timely manner. (Apply) 

Remove the patient's wet clothing. (Apply) 

Provide warm, sugary foods and liquids to patients with normal mentation. (Apply) 

Reassess mild to moderate hypothermic patients for need of possible evacuation. (Evaluate) 

Hypothermia Wrap 

Knowledge Objectives 

Identify the components of a hypo wrap as ground insulation, patient insulation, heat reflection, and a vapor  barrier. (Analyze) 

Explain the function of each component of a hypothermia wrap. (Understand) 

Determine the need to evacuate severe hypothermic patients. (Analyze)  

Skill Objectives 

Construct a hypothermia wrap successfully. (Create) 

Explore options to improvise the various components of a hypowrap when limited resources are available. (Analyze) 

CPR and Resuscitation Concerns 

Knowledge Objectives 

Recognizing CPR for a hypothermic patient is different. ( Remember) 

Skill Objectives 

Determines when to not initiate CPR as appropriate based on the provided situation. (Evaluate)  

Assesses for carotid pulse for a minimum of 60 seconds in hypothermic patients. (Apply) 

Cold Injuries 

Frostbite 

Frostbite Assessment 

Knowledge Objectives 

Define frostnip. (Remember)  

Recognize the presence of frostnip as the precursor to frostbite. (Remember) 

Define Frostbite. (Remember) 

Identify the signs and symptoms of frostbite before and after thawing. (Remember) 

Associate discolored, darken tissue post-thawing as necrosed tissue that needs immediate medical attention.  (Understand) 

Skill Objectives 

Assess for the presence of other comorbidities, such as hypothermia, diabetes, etc. (Evaluate)  

Frostbite Management 

Knowledge Objectives 

Identify frostbite management as protecting frostbitten sites from injury and the environment, ceasing further  tissue freezing, and immediate evacuation. (Remember) 

Describe passive and active thawing. (Remember)  

Skill Objectives 

Avoid rubbing or massaging frostbitten sites. (Understand)  

Avoid initiating active thawing efforts for frostbitten areas. (Understand) 

Avoid rupturing blisters. (Understand)  

Apply dry, bulky dressing to frostbitten sites to isolate and protect from further injury and the environment. (Apply) 

Apply measures to prevent refreezing in thawed frostbite injuries. (Apply)  

Determine need for immediate and urgent evacuation. (Evaluate) 

Immersion Foot 

Immersion Foot Assessment 

Knowledge Objectives 

Describe the etiology of immersion foot. (Understand) 

Describe the signs and symptoms of immersion foot. (Understand)  

Immersion Foot Management 

Knowledge Objectives 

Describe the management of immersion feet as removal of wet items, gently drying, and protecting the feet  with clean bulky dressings. (Understand) 

Mandatory Heat Illnesses 

Heat Syncope 

Heat Syncope Assessment 

Knowledge Objectives 

Identify heat syncope as an isolated syncopal episode with no other signs or symptoms after heat exposure.  (Analyze) 

Skill Objectives 

Assess for other possible causes for syncopal episode. (Evaluate) 

Heat Syncope Management 

Knowledge Objectives 

Identify management of heat syncope as removal from the heat, cooling, rest, and hydration. (Analyze)  

Skill Objectives 

Remove or protect patients from the environment. (Apply) 

Heat Exhaustion 

Heat Exhaustion Assessment  

Knowledge Objectives 

Describe heat exhaustion. (Understand) 

Identify heat exhaustion as a precursor to heat stroke. (Analyze) 

Skill Objectives 

Assess for other potential problems besides or in addition to heat exhaustion. (Apply) 

Heat Exhaustion Management  

Knowledge Objectives 

Identify management of heat exhaustion as removal from the heat, cooling, rest, and hydration. (Analyze)  

Skill Objectives 

Remove or protect patients from the environment. (Apply) 

Heat Stroke 

Heat Stroke assessment  

Knowledge Objectives 

Define hyperthermia. (Remember) 

Identify the signs and symptoms of heat stroke. (Analyze) 

Identify heat stroke as a life threat. (Analyze) 

Heat Stroke Management  

Knowledge Objectives 

Identify management of heat stroke as removal/protection from the environment, supporting the ABC's, aggressive cooling, and immediate evacuation. (Analyze) 

Prioritize aggressive cooling on site if evacuation will delay cooling efforts. (Analyze) 

Skill Objectives 

Apply aggressive cooling measures with ice water immersion if possible. (Apply)  

Apply moist clothing and fan to promote patient cooling in the absence of cold-water immersion. (Apply) 

Recommend urgent evacuation of heat stroke patients. (Evaluate)  

Mandatory Lightning  

Lightning Assessment  

Knowledge Objectives 

Describe basic lightning and thunderstorm safety. (Understand) 

Identify risk high lightning locations. (Analyze)  

Describe the lightning crouch position. (Understand) 

Describe possible minor and major lightning-associated injuries. (Understand)  

Skill Objectives 

Assess the scene for safety. (Apply) 

Assess for lightning-associated injuries with a complete head-to-toe physical exam. (Apply) 

Practice reverse triage for the assessment of multiple patients. (Apply) 

Lightning Management  

Knowledge Objectives 

Identify cardiopulmonary arrest as the cause of sudden death in patients with lightning-associated injuries.  (Analyze) 

Prioritize the initiation of Cardiopulmonary Resuscitation efforts. (Analyze) 

Skill Objectives 

Determine the need for immediate and urgent evacuation in critical patients with lightning-associated injuries.  (Evaluate)  

Determine the need for evacuation of stable lightning-associated injury patients. (Evaluate)  

Drowning 

The objectives for this topic are currently being written and reviewed.  

Poisoning 

The objectives for this topic are currently being written and reviewed.  

Bites and Envenomation 

The objectives for this topic are currently being written and reviewed.  

Hyponatremia 

Hyponatremia Assessment 

Knowledge Objectives 

Describe hyponatremia as a decrease in sodium levels within the body. (Understand) 

Identify the primary cause of hyponatremia as overhydration and decreased urine output. (Analyze)  

Identify hyponatremia as a life threatening condition that requires immediate evacuation. (Analyze) 

Identify the signs and symptoms of hyponatremia. (Analyze)  

Skill Objectives 

Assess for other causes of the patient's signs and symptoms. (Apply) 

Assess the amount of fluid the patient has ingested within 24 hours. (Apply) 

Hyponatremia Management 

Knowledge Objectives 

Identify management of hyponatremia as restriction of further water consumption, monitoring the ABC's, and  urgent evacuation. (Analyze)  

Skill Objectives 

Provide a high sodium broth solution to alert and oriented patients if evacuation is delayed. (Apply)  

Determine need for immediate and urgent evacuation. (Evaluate) 

Mandatory Altitude Illness  

Acute Mountain Sickness 

Acute Mountain Sickness Assessment 

Knowledge Objectives 

Describe Acute Mountain Sickness. (Remember)  

Identify the minimum altitude Acute Mountain Sickness may occur. (Remember) 

Describe the signs and symptoms of Acute Mountain Sickness. (Remember)  

Skill Objectives 

Assess for causes other than Acute Mountain Sickness. (Apply)  

Acute Mountain Sickness Management 

Knowledge Objectives 

Describe the recommended guidelines for high altitude acclimatization above 3000 meters (10,000 ft). (Understand) 

Describe management of Acute Mountain Sickness as descent, rest, hydration. (Understand) 

High Altitude Cerebral Edema 

High Altitude Cerebral Edema Assessment

Knowledge Objectives 

Identify High Altitude Cerebral Edema as potentially life threatening brain swelling. (Analyze) 

Identify the signs and symptoms of High Altitude Cerebral Edema. (Analyze) 

High Altitude Cerebral Edema Management  

Knowledge Objectives 

Identify management of HACE as descent by at least 1000 ft., oxygen administration if available, and  immediate evacuation. (Analyze) 

If descent is not possible, recommend the use of a portable hyperbaric chamber is managed until descent  is possible. (evaluate)  

High Altitude Pulmonary Edema 

High Altitude Pulmonary Edema Assessment 

Knowledge Objectives 

Identify High Altitude Pulmonary Edema as a possible life threat. (Analyze) 

Identify the signs and symptoms of High Altitude Pulmonary Edema. (Analyze) 

High Altitude Pulmonary Edema Management 

Knowledge Objectives 

Identify management of HAPE as descent by at least 1000 ft., oxygen administration if available, and  immediate evacuation. (Analyze) 

If descent is not possible, recommend the use of a portable hyperbaric chamber is managed until descent  is possible. (evaluate)  

Medications  

The objectives for this topic are currently being written and reviewed.  

Epinephrine Auto Injector 

Oral glucose 

Oral Hydration 

Oral Nutrition 

Over-the-Counter Medications 

Aspirin  

Acetaminophen 

NSAIDs 

Rescue Inhaler 

Diphenhydramine