Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergencies, 7th Edition

Interview with Dr. Tate Higgins and Dr. Ali Arastu

How has Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergencies, 7th Edition evolved since the previous edition? How has it evolved since the first edition?

This is really Paul Auerbach’s book and vision. Now in the 7^th edition, the book has grown over the years and has been carefully updated as the field of wilderness medicine has evolved. This new edition has a completely reorganized and updated opening chapter to offer a foundation on how to approach a sick or injured patient. This chapter, “Patient Assessment – A Structured Approach to Emergencies in the Outdoors”, lays out a foundational approach to emergencies. The rest of the book offers specific approaches to medical and environmental emergencies.  

Unlike other first aid books, we try to offer specific tools for when you may be the only help that a patient has. We try to avoid just saying, “call for help” and instead offer specifics on treatment for those situations when calling for help may not be an option. There is an extensive drug reference section with medications and dosages. There are also step-by-step guides with illustrations on procedures like suturing, advanced splinting, and shoulder reduction techniques.  

This edition is particularly special because it was the last edition Paul worked on before he died. Ali and I were honored to know and work with Paul, and this is really his book. We talk about his impact on us and our careers in the intro and each section opens with a photo tribute to Paul, his adventures, and his family who were so important to him.  

What is the most exciting aspect of the new edition? What chapter or topic covered in the new edition are you most excited about? 

The chapter, “Patient Assessment – A Structured Approach to Emergencies in the Outdoors”, opens the book and lays out the approach to emergencies. A hands-on training program will build first on this type of approach before getting into the specifics of the field. I also love the section on splinting, shoulder reductions, and use of SAM splints. From this section you can stabilize and splint any broken bone or musculoskeletal injury imaginable.  

Who will find the greatest value from Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergencies, 7th Edition, and why? Has the audience changed since the book was first published? 

This book is for anyone wanting to help when someone is hurt or injured. It is specifically written for the moments when calling for help is not an option. Wilderness medicine is practiced in the most remote corners of the world, at high altitude base camps, and on mountain trails and wild rivers. Wilderness medicine also applies to any situation where you do not have access to 911. This could be a natural disaster, a power outage, or any situation where you have to step in to help until backup comes. We wrote this book to empower people to act so that they may help others.  

This book is for those that want to be useful in places beyond the reach of Wi-Fi and cell service. It is your complete wilderness medicine reference that never needs batteries or the internet. This book belongs in the expedition medical kit, disaster kit, glove box, and backpack of anyone venturing into the backcountry or anyone who wants to be prepared for disasters. It is small enough to be portable while still being as comprehensive as possible.  

What new ideas, practices, or procedures would you like to highlight for the new edition?  

Lots of new figures and updated techniques including patient assessment, Narcan administration for opiate overdose, tourniquet use and wound packing for control of severe bleeds, and splinting techniques.  

This book is written by practicing physicians and offers a depth of understanding and advanced techniques not often found in first aid texts.  

This edition is a great bookshelf reference and more importantly designed as a take-along manual to go with you into the backcountry.  

Is there anything else about the book you’d like to say?  

We would like to highlight that this book represents the life work of Paul Auerbach, and we are honored and humbled to carry it forward. As Paul says in the preface, “Good fortune favors the well prepared, and there are no more important considerations for a successful outdoor experience than safety and first aid.”  

About the Authors

Tate Higgins: I’m an emergency medicine physician in California. Before becoming an emergency medicine doctor, I spent a decade as a whitewater river guide, backcountry expedition leader, international tour guide, EMT, and instructor of wilderness and pre-hospital medicine.  

I grew up in South Carolina. I studied English at Clemson University and then completed a Master of Fine Arts in creative writing at Colorado State University. In Colorado, I started working as a professional river guide.   

As I began to guide longer expeditions deeper into the backcountry, I decided that I needed good medical training to take care of emergencies in the wilderness. One of my best friends and mentors at the time, Brett Venable, told me about a skills-intensive wilderness EMT training at NOLS. This was a month-long immersive, scenario-based training in prehospital medicine for austere environments that was geared toward those responsible for keeping others safe in the backcountry. I went up to Wyoming, completed the training, and became interested in not only learning but applying medicine. I started working as an EMT and slowly built my skills and experience.  

I have always been interested in teaching. I had experience teaching English classes, and I had grown up watching my mom really excel and love being a math teacher. My training at NOLS was highlighted by the absolute best team of educators and the delivery of the curriculum that I had seen. I knew that I wanted to teach like that someday. After I gained some medical experience on my own, I applied and was hired as an instructor at NOLS Wilderness Medicine. I spent the next ten years teaching wilderness medicine courses to students all over the country. I’ve taught wilderness medicine to thousands of students. I love the empowering aspect of this field. We are arming students with the capacity to problem-solve in emergencies when there is no option to call 911.  

Medicine for the Outdoors contains this empowering curriculum to take care of medical problems in austere environments whether that means deep in the wilderness or during a natural disaster in your own community. If you don’t have electricity, a cell phone signal, or access to a hospital then you’re going to want to have some training and some reference material. Our book is an extensive and portable reference source for medical emergencies. I recommend that everyone who wants to be able to help others in an emergency seek out some hands-on training. There are lots of amazing groups out there offering wilderness medicine training. Get training and get this book.  

Ali Arastu: I was born in Southern California, spent my childhood internationally, returned to California as a teenager, and now consider this amazing state home. I studied Marine Biology at the University of Southern California and stayed at the same institution for medical school. I completed my General Pediatrics residency at Children’s Hospital Los Angeles and a fellowship in Pediatric Critical Care at Stanford University.  

My medical interests, apart from Pediatric Critical Care, extend to wilderness medicine, global health, and health disparities. I am especially passionate about using the wilderness as a platform to empower vulnerable youth to care for their own health, as well as the health of the environment. To this end, I am honored to be heavily involved in several non-profit organizations, including Big City Mountaineers (Medical Director) and New Earth Los Angeles (Board Member).  

I am also passionate about advocating for the system involved and homeless youth. On a chance detour, while hiking the Pacific Crest Trail, I had a conversation with a homeless man that would inspire me to live on the streets in Skid Row with the highest concentration of homeless persons in the country.  For the first two years of medical school, I forged relationships with homeless individuals which deeply planted the seed for the desire to care for the most vulnerable of patients. I tell the story, and more, in a TED talk (https://www.youtube.com/watch?v=zcNL1casj7o).  

Purchase your copy of Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergencies, 7th Edition here!