Learning things the hard way seems to be my M.O. of late. The Wilderness EMT course by NOLS WMI kicked my ass. I haven’t taken a science class or studied for a standardized test since high school. After bombing the first quiz, I had to do a major turn around on my study habits to keep up. The pace was unrelenting.

Why Wilderness EMT?

I took the course so that Sextantworks can continue be responsible in executing experiences. We have some great medical people who join us regularly, but it’s a different thing to have the core members of the team fully trained and thinking about safety from the get go. Given what we have pulled off already, we’re only getting more ambitious.

The course covers everything that a regular urban Emergency Medical Technician training does plus variations and practice for administering care when you don’t have access to more advanced medical support. The National Outdoor Leadership School and the Wilderness Medical Institute have sterling reputations for their rigor and integrity. I seemed to be the least versed in NOLS culture among the students. Everyone else there glowed with respect and admiration for the organization. After going through the WEMT program, I can see why.

What We Studied

In addition to classroom time, we practiced hands on practical skills, outdoor scenarios, and did emergency room rotations in local hospitals.

Patient Assessment

The core skill is the patient assessment system, a series of steps to determine the condition of a patient. Breathing, circulation, and consciousness are the big picture components to life, and checking those out first offers signs to underlying issues. Obvious bloody, painful traumas might not actually be the biggest life threat in an accident. Following the patient assessment system increases the likelihood that you will catch life threats immediately.

Practical Skills

You wouldn’t think that putting a splint on someone would be so hard, but there are plenty of ways to do it wrong. We practiced skills like splinting, administering oxygen, and CPR until they sunk in on the muscle memory level. By the end of the course, I could backboard a patient in under 5 minutes.


Scenarios ranged from one patient / one rescuer situations on the lawn outside the classroom to whole class endeavors in the woods at night. Problem-solving a traumatic injury was curiously stressful if the patient was in pain or passed out, even though we knew they were pretending. Acting as a patient was as insightful as acting as a rescuer because you experience what good and bad treatment feels like. In the more involved scenarios, being a patient could be scary and disorienting. I felt empathy for patients in real world traumatic situations, which will make me a better rescuer in the future. The game designer in me recognized these scenarios as light weight live-action role-playing. I wonder if pushing the role-playing would add to the educational experience.

Emergency Room

The emergency room environment was alternately boring and enthralling. Either nothing was happening or there was a flurry. Helping with real medical emergencies burned those particular issues indelibly into my brain. I prepped a man with a gangrenous foot for amputation, watched a woman have a transient ischemic attack, and helped a doctor insert a chest tube into a man with tension pneumothorax.


Leadership skills were not an overt part of the course, but they were expertly modeled by our instructors. Tate, Daniel, and Atila worked together seamlessly, delivering a wealth of expertise and support while still putting enough fear of God in us so we excel.

Happy Ending

In the end, I passed both the course and the national EMT exam. I am a certified Wilderness EMT! Here’s to ever more enriching and responsible endangerment together through Sextantworks.

All photos by Tate Higgins.