In Response to “Wilderness First Aid and the Law”

To the Editor:

Mr James H. Moss' response to “Wilderness First Aid: Is There an Industry Standard?” makes some interesting legal points, especially on the implications of setting standards of care. ¹ One of his statements, however, is puzzling: “There are 3 agencies chartered by the Federal Government to provide first aid training: the Boy Scouts of America, the American Red Cross, and the National Ski Patrol.” None of their charters include any mention of teaching first aid. While the American Red Cross (ARC) has been teaching first aid for over a century, its charter mandates just 2 missions: Services to military personnel and their families, which includes “to provide aid in time of war to the sick and wounded of the armed forces …” and “to act as a medium of communication between the peoples of the United States and the armed forces of the United States …”; and disaster relief.^2,3 According to the National Ski Patrol (NSP) charter, its purposes are “to promote, in every way, patriotic, scientific, educational, and civic improvement activities and public safety in skiing, by such means as the dissemination of information and the formation of volunteer local patrols consisting of competent skiers trained in first aid for the purpose of preventing accidents and rendering speedy assistance to individuals sustaining accidents.” ⁴ Until the NSP developed its Winter Emergency Care course in 1988 (now called Outdoor Emergency Care), however, they did not even teach first aid or emergency care. Patrollers were required to be certified in American Red Cross Advanced First Aid (which the ARC phased out in 1993), or a higher level of training. And according to the Boy Scouts of America (BSA) charter, “The purpose of the corporation shall be to promote, through organization, and cooperation with other agencies, the ability of boys to do things for themselves and others, to train them in Scoutcraft, and to teach them patriotism, courage, self-reliance, and kindred virtues, using the methods which were in common use by Boy Scouts on June 15, 1916.” ⁵ Again, there is no mention of teaching first aid. So there are no agencies whose first aid courses enjoy any recognition from the Federal Government in their charters.

Mr Moss also discusses Good Samaritan laws. In California, a bill to amend and strengthen its law was unanimously passed, and signed by the Governor on August 5, 2009. Assembly Bill No. 83 amends Section 1799.102 of the California Health & Safety Code, so that it now reads “any person … who in good faith, and not for compensation, renders emergency medical or non-medical [my emphasis] care or assistance at the scene of an emergency shall not be liable for any civil damages resulting from any act or omission, as long as that act or omission does not constitute gross negligence or willful or wanton misconduct.”^5,6 This amendment was proposed and passed in reaction to a decision of the California Supreme Court, which ruled that pulling an accident victim out of a wrecked car was not covered by the Good Samaritan Act because it was not medical care. But the amended law makes it clear that any prudent assistance (medical or non-medical), by someone who does not have a duty to act, is covered. Those of us who teach emergency care, and encourage our students to use their skills in emergencies, can only hope that other states follow this example, to strengthen their Good Samaritan laws.

Paul Nicolazzo, in his letter, rightly says that instructors should have relevant wilderness experience; and that the usual 1-day instructor course is too short. ⁷ Several factors, however, are more important than the length of the course for instructor training. As an instructor trainer for four national organizations that provide emergency care courses (including the ARC, NSP, and AHA), I taught and observed many instructor classes. With most of the classes I observed, the main problem was lack of realistic instructor training. Teaching is like any other skill—the only way to learn it is to practice and get good corrective feedback. Few of the instructor classes that I observed included any practice teaching and evaluation. Instead, participants spent most of their time listening to lectures on the courses and administrative procedures. Not surprisingly, the people conducting these instructor classes had never been trained as instructor trainers. Several organizations for which I have taught simply appoint instructor trainers based on an administrator's recommendation.

As WFA instructors, we must live with the fact that most of our students (especially those who lead wilderness activities as volunteers) have limited time for emergency care training. We need to plan and teach our courses so that we use the time effectively, and train our students to prevent or cope with the emergencies they are likely to encounter. And we should take every opportunity to improve our own teaching skills. ⁸