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The Part of Wilderness Medicine We Don’t Talk About Enough: Psychosocial First Aid
When most people think about wilderness medicine, they think about injuries.
Broken bones. Hypothermia. Head injuries. Severe bleeding. Allergic reactions. Medical emergencies hours away from an ambulance or hospital.
And yes, those are absolutely part of wilderness medicine.
But anyone who has spent enough time working with people in remote environments knows something else:
The medical problem is not always the only problem.
Sometimes your patient is medically stable, but terrified.
Sometimes a group member completely shuts down.
Sometimes fear spreads through a team faster than the actual emergency.
Sometimes people become angry, withdrawn, confused, overwhelmed, or unable to make decisions.
Sometimes you have delivered devastating news, but you still have six hours of evacuation ahead of you.
And sometimes you are the responder trying to care for everyone else while managing your own stress at the same time.
That side of an emergency matters.
Wilderness Medicine Is About the Whole Person
One of the things I love about wilderness medicine is that we have to think beyond the injury.
In a hospital, there are entire teams and systems available to help manage a patient.
In the wilderness, we may be working with a handful of people, limited equipment, changing weather, difficult terrain, communication problems, exhaustion, and an evacuation that could take hours or even days.
That changes everything.
We have to think about the patient's physical condition, but we also have to consider their ability to cope, communicate, participate in their own care, and tolerate what is happening around them.
We also have to consider the rest of the group.
A frightened teammate can affect decision making.
Conflict can interfere with patient care.
Exhaustion can make communication deteriorate.
Uncertainty can cause people to panic or disengage.
A technically excellent medical plan can become much harder to execute when the people involved are no longer functioning well.
That is where psychosocial first aid becomes incredibly important.
What Is Psychosocial First Aid?
Psychosocial first aid is not about becoming someone's therapist in the field.
It is about recognizing distress and responding in a way that helps create safety, stability, communication, and connection.
It means understanding that a person can be physically injured and emotionally overwhelmed at the same time.
It means noticing when someone's behavior changes.
It means knowing how to communicate when a person is frightened, angry, grieving, confused, or shutting down.
It means helping a group continue to function during a stressful event.
And it means recognizing that responders are human too.
In prolonged incidents, those skills can become just as important as knowing how to splint an injury or perform a patient assessment.
A New Resource for People Working in Remote Environments
This is why I am so excited to announce a new book written by my husband, A.M. LaMouria, PhD:
Psychosocial First Aid in Austere Environments: A Whole-Person Guide to Assessment, Stabilization, Communication, and Recovery
The book was written specifically for people who work with people in environments where resources may be limited and higher-level help may be delayed.
That includes:
Wilderness medicine providers
Guides and outdoor educators
Search and rescue personnel
Expedition leaders
First responders
Remote teams
Camp staff
Outdoor professionals
Anyone responsible for the well-being of others in challenging environments
The book draws from psychological first aid, trauma-informed care, wilderness medicine, communication, and field experience to create a practical approach to caring for the whole person.
It addresses how to recognize distress, communicate effectively, stabilize difficult situations, support individuals and groups, and make thoughtful decisions when circumstances become complicated.
Why I Think This Matters
I teach people how to respond when something goes wrong far from immediate medical care.
We spend a lot of time learning how to recognize life threats, perform patient assessments, make treatment decisions, and determine when someone needs to be evacuated.
Those skills matter enormously.
But the longer I work in this field, the more I believe that good responders also need to understand people.
You can have the perfect medical kit and still struggle with a terrified patient.
You can know exactly how to treat an injury and still have a team falling apart around you.
You can make the correct evacuation decision and still need to help someone cope with what may be the worst day of their life.
That does not make psychosocial care separate from good wilderness medicine.
In many situations, it is part of good wilderness medicine.
Caring for More Than the Injury
Remote medicine asks us to do more with less.
Sometimes that means improvising equipment.
Sometimes it means caring for someone much longer than we would in a traditional EMS system.
And sometimes it means recognizing that our patient needs more than a bandage, splint, medication, or evacuation plan.
They need someone who can remain steady.
Someone who can communicate clearly.
Someone who can recognize what is happening beyond the obvious injury.
Someone who understands that the goal is not simply to treat a body.
It is to care for a person.
Psychosocial First Aid in Austere Environments is now available on Amazon.
You can find the book here:
I am incredibly proud of the work that went into this book, and I am excited to see this part of remote and wilderness care receiving more attention.
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