Jeffrey Isaac - Outward Bound Wilderness First-Aid Handbook

Jeffrey Isaac is an experienced physician assistant with a particular interest in remote and extreme environments. In 30 years of medical practice, he has served as an ambulance medic, fire/rescue crewman, professional ski patroller, ships medical officer, and emergency department practitioner. He is with the Curriculum Director for Wilderness Medical Associates International and a former Outward Bound instructor and course director. He is also a licensed captain and an experienced blue-water sailor, having logged thousands of miles in the Atlantic and Pacific Oceans and the Caribbean Sea.

While teaching on Hurricane Island in 1982, Isaac met with Dr. Peter Goth about the challenge of designing appropriate medical training for the Outward Bound instructors working there. They found common ground in a practical and commonsense approach to medicine and a depth of experience well suited to their task. Their early efforts set the stage for Dr. Goths founding of Wilderness Medical Associates and the pairs coauthorship of the first edition of The Outward Bound Wilderness First-Aid Handbook in 1991.

Isaac now lives in Crested Butte, Colorado, where he practices emergency medicine with the Crested Butte Medical Center and serves as team leader and medical officer for Crested Butte Mountain Rescue. In addition to this publication, he is coauthor of Wilderness and Rescue Medicine, which is used as a text for Wilderness Medical Associates International worldwide.

Outward Bound, Americas preeminent experiential education organization, has been a pioneer in the field of wilderness experiential learning since it was established in the United States in 1961 and has continued to deliver unparalleled outdoor educational programs ever since. Today Outward Bound provides adventure and learning for teens, adults, veterans, at-risk youth, and professionals, helping them achieve their full potential and inspiring them to serve others.

Outward Bound is based on the educational ideas of Kurt Hahn, an influential German-born educator. Hahn established the school at Schloss Salem in an attempt to combat what he perceived as the deterioration of values in postWorld War I Germany. Salems progressive curriculum focused on character development through physical fitness, skill attainment, self-discipline, and compassionate service. In 1933, thirteen years after establishing Salem, Hahn fled Nazi-ruled Germany to Britain. Soon after his arrival, he set about establishing the Gordonstoun School in Scotland to continue his work under the motto Plus est en vous (There is more in you than you know).

In 1941, in a joint effort with British shipping magnate Sir Lawrence Holt, Hahn founded the first Outward Bound Sea School in Aberdovey, Wales. The name of the school was adopted from the nautical term used when ships leave the safety of the harbor for the open seas: They were said to be outward bound for unknown challenges and adventures. The school not only taught sailing skills but also integrated Hahns core belief that character development was just as important as academic achievement. Hahns goal was to teach self-reliance, fitness, craftsmanship, and compassion as a way to provide the youth of Great Britain with the benefits of life experience and prepare them to serve their nation in the struggle against Nazi Germany. The program revolved around a series of increasingly rugged challenges designed to develop the self-confidence, fortitude, and leadership skills required to survive harsh physical and mental challenges.

Josh Miner, an American who taught under Hahn at Gordonstoun, was inspired to bring Outward Bound to the United States. Working with a small group of committed supporters, Miner founded the Colorado Outward Bound School in 1961, bringing the principles of hands-on learning and compassionate service through outdoor adventure to America.

Today Outward Bound has expanded to thirty-six countries throughout the world. In the United States the organization has close to one million alumni who stay connected and engaged through Outward Bounds alumni association (www.outwardboundalumni.org). Central to its mission are the values of inclusion and diversity, evidenced by its scholarship program designed to attract and benefit populations that are typically underserved. Approximately 25 percent of participants receive financial support, and they span ethnic, socioeconomic, and geographic diversity.

In the United States, to advance goals of transforming lives and developing compassionate, purposeful people, Outward Bound now offers its unique blend of adventure-based programs fitted to the needs of:

• Teens and young adults
• At-risk youth
• Adults
• Veterans
• Professionals

Although programs vary broadly in target population, location, and objective, they all contain the elements that Kurt Hahn espoused as central to the development of effective and compassionate citizens: adventure and challenge; learning through experience; integrity and excellence; inclusion and diversity; social and environmental responsibility; leadership and character development; and compassion and service. For participants in any of the varied programs, in any part of the world, these core values provide the foundation for their Outward Bound experience.

Outward Bound instructors are highly trained, qualified educators and outdoor skills specialists. Participant safety is a high priorityfoundational to every program. Every course is accompanied by instructors who hold wilderness first-responder-level certifications at the minimum and who have received hundreds of hours of educational, safety, student- and activity-management training. Staff members are proficient inand passionate aboutthe specific wilderness skills of the activity they teach, whether rock climbing, sailing, mountaineering, sea kayaking, canoeing, or whitewater rafting. To help participants along their personal growth paths, instructors are trained in managing groups and individuals. A vital component of every course is the instructors ability to not only shepherd participants through individual course challenges but also to help them work as effective leaders and contributing members of the team.

The impact of each expedition extends well beyond the course itself. This impact is different for each individual but can be seen in a variety of ways, including improved school performance, closer relationships with family and friends, and a new commitment to service. When Outward Bound participants return home, they bring with them a new sense of responsibility, an enhanced appreciation of the environment, and a strong service ethic that they share with friends and family. Most important, they bring a newfound belief that There is more in you than you know and an inspiration to act on that knowledge. In one participants words, What I was lacking I have found; now I have the tools to keep growing and to work hard to accomplish my dreams and to do anything I can to help others accomplish their dreams as well.

This book is the result of a basic idea that has enjoyed years of refinement, elaboration, and critique by hundreds of generous and thoughtful people. The original concept belongs to Dr. Peter Goth, an emergency physician with the courage, insight, and patience to promulgate a training philosophy and curriculum that truly made sense for the wilderness setting. His efforts began with the staff of the Hurricane Island Outward Bound School and later resulted in the creation and successful growth of Wilderness Medical Associates International (WMA), now one of the largest wilderness medical training organizations in the world. My appreciation is extended to all of my fellow WMA and Outward Bound instructors for generously sharing their experience, comments, and encouragement. In particular I would like to thank Dr. David Johnson, WMAs president and medical director, for his support and friendship and for permission to use the material that serves as the foundation for much of this book. And finally to Laura, my wife and companion, I remain grateful for your patience with this itinerant medic, writer, sailor, and wilderness traveler.