Risk Management : Our Prolonged Field Care courses feature in outdoor/expedition industry publications.
Whilst already well known in Search and Rescue, disaster response, NGO, outdoor and expedition circles, it’s always great to see our civilian expedition/fieldwork specific Prolonged Field Care training feature in the press.
Previously, our specialist PFC courses have appeared in Search and Rescue publications, highlighting the importance of PFC (mirroring the experience of some of our delegates from Mountain Rescue who have had to care for casualties for very extended periods in very poor weather), through to Jungle, desert and mountain emphasis articles, to featuring in the Adventure Medic, in articles relating to training we had provided to Analogue Space Missions.
This time, the article is in relation to Polar climes in the winter edition of outdoor/expedition emphasis, industry body publication: ‘The Professional Mountaineer’, in the very specific context of PFC training forming one element of the medical aspects of risk management.
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We weren’t involved in writing the article but were asked if we could contribute a couple of images we’d taken on our various Arctic circle expeditions. In the circumstances, we’ve broken this piece (below) up with pictures from our training in the Arctic Circle. Very timely given the weather in the frozen UK over the last week or so and that we’re sitting down this week to plan our 2026 and 2027 Arctic Circle expeditions.
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The Professional Mountaineer article is hugely well timed article as it coincides with our April 2 day Prolonged Field Care course having just gone live for bookings. It follows directly on from our 7 day Remote Medical Responder: A Wilderness First Responder course™️ making a 9 day remote austere and wilderness medicine masterclass for non health care professionals or those early in their medical education. Additional modular courses to complete the programme for non HCP’s include 1 day wound care, 1 day dentistry, 2 day remote area emphasis Pre Hospital Trauma Life Support and a 2 day risk management/planning/incident response course.
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For qualified Health Care Professionals, we have our unique 7 module, c380 hour, 15 days face to face, R/EMO:TE Medic Programme. The PFC module is an entirely stage alone module but forms one module on the programme.
2 day Prolonged Field Care
1 day Wound Care
1 day Dentistry
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Demonstrating signalling options in addition to tracking & sat phones.
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The Professional Mountaineer article was written by Assistant Professor, Dr. Myles Harris RN of the Institute for Disaster Risk Reduction at the world famous University College London.
(UCL). Dr Harris is also the National Expeditions Advisor to a branch of the RAF and the founder of Space Health Research as well as an expedition medic.
Last year, after many years of research, Dr. Harris published a world first PhD into Prolonged Field Care. The PhD was in association with Remote Area Risk International and the UK Ministry of Defence, Royal Centre for Defence Medicine.
Harris. M. (2024) Prolonged Field Care a grounded theory of mitigating risks to heaith in remote environments. PhD thesis, University College London [Online) Available at https//discovery ucloc.uk/id/
eprint/10187416/
The article follows others in the same series (earlier articles focused on desert, jungle and mountain expeditions).
The article considers the impact on risk management by way of suitable preparation in this space - embedding suitable training including Prolonged Field Care into the exped teams in the build up to the expedition itself along with other necessary field skills relevant to the expedition.
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Our training delivers exactly that. The concept has also been put to the harsh test of reality with trained groups having encountered situations, in very remote extremis, where they had to utilise the training. Subsequent investigations have praised their pre deployment training.
It’s a small world and so, by happy coincidence, we find that the control expedition featured in the article was the 2022 ‘Heroes of Telemark expedition’ undertaken by Forces Wives Challenge (we’ve trained their ops team members in risk management over about half a decade), a military charity.
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Risk Management… prepping for the possibility of falling through the ice.
The article highlight the importance and value of pre departure training, relevant to the expedition environment and in as high fidelity a setting/context as possible. This can be built on by further training in country.
A well tried and tested model that is used for many deployments including eg Arctic prep expeditions prior to Antarctic expeditions (mirroring training we’ve delivered).
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Dr. Harris states;
‘Training for prolonged field care (prehospital care with limited resources and a delayed evacuation) is vitally important because mountain professionals are (thankfully) not required to do it very often. Most expedition medic training focuses on responding to major injuries but nevertheless, the harshness of polar, winter, and sub arctic environments may demand prolonged field care capability. It is important to note that prolonged field care includes physical and psychosocial health care. Being in extreme remote environments such as the polar regions can be a psychological stressor that may appear small at first (disturbed sleep, loss of appetite, anxiety), but these minor influences on health can increase vulnerability to natural hazards and poor decision making.’
‘High-fidelity training in prolonged field care involves experiencing healthcare provision over a long duration, so mountain professionals can learn to develop their own strategies to mitigate and manage risk. The research that informs this article series was in collaboration with the Ministry of Defence, Royal Centre for Defence Medicine, and a civilian organisation called Remote Area Risk International (RRi). R2Ri have developed a prolonged field care course specifically for civilian expeditions that involves experiential learning through casualty simulation. This training can equip participants with a mindset that helps them to develop risk mitigation strategies, including how to train for mountain expeditions.’
‘To prepare for any expedition in polar, winter, or sub-arctic environments, bespoke training relative to the risk and hazard landscape of where you are going is paramount. A key takeaway from this article is health risk mitigation begins at home and capability to manage the risks during an expedition is increased through high-fidelity training. Researching tools. learning from case studies, and practising during training can inform your decisions about how to mitigate risks to health while out on expedition.’
Our training is carefully designed to inform, develop and to provide knowledge, skills and reduce mental stress load burden by providing bandwidth by way of a framework. In other words, if it happens for real, the delegates know what the process looks like. It’s not an unprepared ‘rabbits in the headlights’ moment
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Our programme assumes and indeed has a pre requisite of prior medical training. It’s designed for those who have been through our programmes but we’ll also accept from 2 day outdoor first aid holders to Pre Hospital Consultant with extensive remote area experience.
In the UK, the vast, vast (numerically) majority of outdoor professionals - including those leading expeditions overseas, will have no more than a 2 day outdoor or expedition emphasis first aid course.
Over many years, we’ve been very vocal in our views as to how appropriate (or not) we believe a 2 day course to be, for the context of more remote expeditions.
In our humble opinion, if you need to utilise health care professional level skills, take a suitably trained HCP. If a lower level is needed… well, that’s why we developed our 7 day Remote Medical Responder: A Wilderness First Responder course ™️ and progression modules.
The RMR:WFR course, with our profrsssion modules, plus our health care professional level programme - R/EMO:TE Medic Programme are designed to align with existing good practice guidance.
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The point is that groups aren’t made up solely of remote area health care professionals. There may be a doctor, paramedic or nurse on the team. There may not be. Whatever the case, individuals can only operate effectively for a finite period before rest is needed and then someone else has to take over. Those trained to a lower level still need to know what they can and should do, within the remit of their current training . A whole group approach is needed and delegates can only operate up to the level of their skill, knowledge and competence.
We’ve tested ‘whole’ group approaches in the field, during high fidelity training - training teams made up of both health care professionals and non health care professionals about to deploy to very remote locations, to maximise outcomes. This training formed part of the PhD referenced above. One test team ultimately then had to operate for real, in a very very remote, very austere location overseas, when a PFC situation arose . The post incident feedback from health care professionals involved, was very supportive of the training. Subsequent reports congratulated the team on the quality of the medical training undertaken prior to departure.
Above: different shelter options. From time consuming snow holes (super cosy) to much swifter options … including expeditioner testing sleeping bag and blizzard bag combinations.
Continuity of treatment, quality of observations, consistency in care and high quality hand overs. Team work, personal admin and keeping the team operationally effective.
On top of their existing medical knowledge foundation, we develop delegates further, taking them through kit, a mnemonic framework, nursing skills, comms, telemedicine, procedures and more.
Importantly, the Faculty is made up of appropriate members with experience of Prolonged Field Care in both civilian and military settings, in very remote environments. They’ve been there, then we’ve worked to develop the training that Faculty members would have liked to have been in place when they encountered the situations they did. We’ve involved civilian and specialist military medics, academics, specialist risk managers and many more. We’ve encouraged and supported others in undertaking research in such fields as pushing the boundaries of affordable telemedicine solutions.
If you want to know further about why we developed this course, check out the course page. Long story short, our Director, a non health care professional- was undertaking remote expeditions and none of the mainstream training covered what to do when evacuation wasn’t immediate. Lots of digging and research later and we decided to address the civilian training gap to make training affordable and accessible to civilians operating in remote areas, based out of a back pack.
One of our Faculty was asked by the Royal Geographical Society to introduce PFC to the latest edition of the Oxford Handbook for Expedition and Wilderness Medicine.
Prolonged Field Care is necessary and should be mainstream. In fact, it IS mainstream in as much as it is now firmly established good practice. It’s reflected in the texts and research. It’s part of your Duty of Care. There are some excellent courses around the globe. Search them out. Get trained. Fill training and knowledge gaps.
Our raison d’etre is to raise awareness and standards and fill knowledge gaps. Wherever you go for training, make sure your training covers all the eventualities of where you go and what you’ll be doing.
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Kai Muller, alumni of our R/EMO:TE Medic Programme, leading his cutting edge telemedicine initiative in Antarctica with one of our Faculty Doctors, Hannah Evans. An initiative testing affordable, small sized integrated telemedicine solutions (integrating comms, monitors, ultrasound) beaming back data to be received by another of our Faculty Dr. Kat Ganly.
We developed the course due to very obvious training gaps in traditional training courses. Lots of courses train delegates how to deal with immediate life threatening problems but then cut to external help arriving on scene very quickly. 🚁.
Where our clients operate, this isn’t the reality, so longer term strategies are needed - and those strategies have to be put in place well in advance - planning, comms, telemedicine, training.
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After a day of lectures and skill stations, the delegates prep full expedition kit - backpacks replete with food, cookers, tents, sleeping bags and med kit split amongst the group - med kit they’ve chosen after an exercise covering exped med kits.
Delegates then head up on to the mountain for 12 hours. They treat what they find and react to appropriate, realistic, purposeful, well thought out and designed injects.
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The following day, delegates extract out to a helicopter landing zone.
The training has been tried and tested and it works. Delegates have also gone on to use the training in a Prolonged Casualty Care setting - in rural, urban and ambulance (immediately outside hospitals) in context of many many hours waiting.
Proper prior planning prevents poor performance.
Get in touch to undertake high quality, professional training, trusted by leading expedition companies, NGO’s, UK military, fieldworkers, NGO’s, SAR and many more.
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