MEDS 465 Wilderness and Survival Medicine
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Schedule TBA
PRE-REQUISITES: BISC 220L, or 221L; and BISC 307 and MEDS 320
INSTRUCTORS: This course will be taught by a team of Emergency Medicine physicians from the
Keck School of Medicine
Course Coordinator:
Matthieu DeClerk, MD, Emergency Medicine,
Health Sciences Campus
GNH 1011
mpdeclerck@gmail.com
Team Members:
Stuart Swadron, MD, Associate Professor, Emergency Medicine, swadron@usc.edu
Bob Paquette, MD, Assistant Professor, Emergency Medicine, rpaquett@usc.edu
Billy Mallon, MD, Associate Professor, Emergency Medicine, wkmallon@yahoo.com
Sanjay Bhatt, MD, Assistant Professor, Emergency Medicine, sbhatt3@gmail.com
Mel Herbert, MD, (video), Associate Professor, Emergency Medicine, mel.herbert@yahoo.com
Sean Nordt, MD, Assistant Professor , Emergency Medicine, SPNORDT@HOTMAIL.COM
Emergency Medicine Residents participating in Wilderness Medicine elective
Introduction and Purpose
There are a wide variety of definitions out there for wilderness medicine, ranging from broad to
specific. The specific definition is the practice of medicine where definitive care is more than an hour
away. The broad definition includes any medical care given when there are limited resources or
environmental extremes.
We believe this real world application will provide an exciting and enjoyable way to retain major
principles in physiology. Drawing from a wide range of wilderness medicine and expedition medicine
topics, the course attempts to strike a balance between some didactic lectures and outdoor skills, small
groups, and hands-on instruction to most effectively train learners in thinking and managing
environmental situations. There is a very strong emphasis on practical scenarios run in conjunction
with our own local highly experienced faculty team and aided by local mountain rescue teams. One
will cover essential skills and knowledge required to be an invaluable member of any expedition in
different environments.
Objectives
 Introduction to “extreme” physiology of various medical problems that are unique to the
wilderness setting including high altitude illness, environmental exposure, lightning injuries,
and toxic plant ingestions. A sort of “Physiology Gone Wild” theme.
 A wilderness medicine curriculum designed for a novice but medicine-focused undergraduate
learner.
 Identify some life threatening environmental hazards and consider prevention techniques.
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Improve necessary skills for remote medical care including patient assessment, trauma care,
orthopedic manipulation, wilderness improvisation, and pearls of basic survival;
Incorporate leadership and teamwork skills in the wilderness setting to affect improved patient
outcomes.
GRADING: Letter grade
Midterm (40%) :
Final (60%):
Written exam (multiple choice) 30%
OSCE (Objective Structural Clinical Exam) with a clinical case/simulator 10%
Written exam (multiple choice) 50%
OSCE (Objective Structural Clinical Exam) with a clinical case/simulator 10%
Grading Scale
90-100 (A)
80-89 (B)
70-79 (C)
65-69 (D)
<65 (F)
REFERENCE/ASSIGNED READING MATERIAL:
Chapters (or sections from various chapters): Wilderness Medicine by Paul S. Auerbach 4 or 5th
Edition
FORMAT: 1 topic per week:. Divided into a Didactic portion (1-2 hours) and a Experiential portion
(2-3 hour outdoor workshop/small group format).
Topics to be covered include:
WEEK 1: Introduction &Patient Assessment and improvised treatment in the Wild.
This week will state expectations of the course and review initial approach to patients in the wilderness
setting. Chapter 14
WEEK 2: Moving an Injured Patient/Patient Packaging & Evacuation
Cover basic principles of appropriate transport of an injured patient. Indications to transport and the
various forms of transportation available (i.e., litter, carries, aero-medical) Chapter 24, 26, 27
WEEK 3: Principles of Avalanches- Review of survival, safety, and rescue
Review basic principles of avalanches and the classic injuries related to this natural disaster. This
week will also review rescue principles for this type of rescue. Chapter 2
WEEK 4: Physiology in high altitude- Altitude medicine
Review principles of higher altitude and the physiological effects on the human body at high altitude.
Review basics of the various types of Acute Mountain Sickness and treatment options. Chapter 2
WEEK 5: Physiological principles of lightning injuries and assessment
Review concepts of lightening and physiological effects when stuck by lightening. A review of basic
principles of management and how this differs from other mass casualty scenarios. Chapter 3
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WEEK 6: Physiology of Hypothermia and cold related illnesses
Review physiology in of hypothermia at various stages. We will cover various presentations of cold
related illnesses including frostbite, frost nip and basic management. Chapter 4,5,7
WEEK 7: Physiology of Diving- Dive related injuries
Discuss concept of SCUBA and how this affects our bodies. Review illnesses specifically related to
diving like Air embolism, Decompression illness, and submersion. Review treatment options.
Chapters 56, 57, 58, 59
WEEK 8: Physiology of heat related illness and heat related illnesses
Review physiology in the setting of extreme heat conditions. We will review presentations such as heat
stroke and heat exhaustion and review basic management principles. Chapter 10, 11
WEEK 9: Physiology of Wound infections- Will review principles of Management and
wilderness/remote access wound care options.
WEEK 10: Patho-physiology of water-borne illnesses/diarrhea. Will discuss various causes of
infectious diarrhea and the effects on the body in severe dehydration. A review of treatment and
prevention with tips on basic water purification techniques. Chapter 51, 52, 53
WEEK 11 Anatomy: Fractures and Dislocations Management: Review practical splinting techniques
in the remote setting. Chapter 21
WEEK 12: Patho-physiology of various animal, insect, arthropod, marine bites and stings. Review key
concepts and treatment for common ones. Chapter 60, 61
WEEK 13: Plant medicine and toxins. Review key concepts and treatment for common ones. Chapter
47, 48, 49, 50
WEEK 14: Basic survival skills and navigation.
A review of basic navigation principles, practicing with navigation and some tips on surviving if
“Johnny gets lost.” Chapter 28, 70, 71, 73
WEEK 15: Wilderness medicine preparation
We will build a Medical Kit, taking into consideration the location, feasibility to carry items, high
yield usage, etc. Chapter 65, 69,
Statement for Students with Disabilities
Any student requesting academic accommodations based on a disability is required to register with
Disability Services and Programs (DSP) each semester. A letter of verification for approved
accommodations can be obtained from DSP. Please be sure the letter is delivered to me (or to TA) as
early in the semester as possible. DSP is located in STU 301 and is open 8:30 a.m.–5:00 p.m., Monday
through Friday. The phone number for DSP is (213) 740-0776.
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Statement on Academic Integrity
USC seeks to maintain an optimal learning environment. General principles of academic honesty
include the concept of respect for the intellectual property of others, the expectation that individual
work will be submitted unless otherwise allowed by an instructor, and the obligations both to protect
one’s own academic work from misuse by others as well as to avoid using another’s work as one’s
own. All students are expected to understand and abide by these principles. Scampus, the Student
Guidebook, contains the Student Conduct Code in Section 11.00, while the recommended sanctions are
located in Appendix A: http://www.usc.edu/dept/publications/SCAMPUS/gov/. Students will be
referred to the Office of Student Judicial Affairs and Community Standards for further review, should
there be any suspicion of academic dishonesty. The Review process can be found at:
http://www.usc.edu/student-affairs/SJACS/..
Emergency Preparedness/Course Continuity:
In case of emergency, and travel to campus is difficult, USC executive leadership will announce an
electronic way for instructors to teach students in their residence halls or homes using a combination of
Blackboard, teleconferencing, and other technologies. Instructors should be prepared to assign students
a "Plan B" project that can be completed at a distance. For additional information about maintaining
your classes in an emergency please access: http://cst.usc.edu/services/emergencyprep.html
Please activate your course in Blackboard with access to the course syllabus. Whether or not you use
Blackboard regularly these preparations will be crucial in an emergency. USC's Blackboard learning
management system and support information is available at blackboard.usc.edu.
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