Outdoor emergency care (OEC) was first developed by the National Ski Patrol in the 1980s for certification in first aid, and other pre-hospital care and treatment for possible injuries in non-urban settings. Outdoor emergency care technicians provide care at ski resorts, wilderness settings, white-water excursions, mountain bike events, and in many other outdoor environments.
Basic emergency skills taught include using airway adjuncts, assisting patients with medications, splinting and bandaging, providing emergency care for environmental illnesses and injuries, using special equipment and techniques particular to non-urban rescuers, and managing prolonged transport.
Training
The standard of training and actual procedures and requirements for OEC meet and exceed those of the first responder basic course and the curriculum contains many of the skills identified in the US Department of Transportation (DOT) 1994 EMT-Basic National Standard Curriculum, although training is specific to needs in outdoor scenarios, such as self-reliance and individual skills. This instead of the EMT curriculum focusing on urban environments with immediate access to additional resources such as EMT partners and an ambulance. While the OEC curriculum includes a skill set and fund of knowledge that exceeds those of the emergency medical responder (EMR) program, it does not include all the knowledge needed for an EMT program since it emphasizes caring for patients in the wilderness, with a focus on snow-sports pathology. Because of this, OEC technicians typically have a similar standards of training compared to EMT-basic responders, albeit several different focuses of the training: with OEC devoting a larger portion of the curriculum to musculoskeletal injuries, splinting, bandaging, and environmental emergencies and devoting comparatively less time on patients with a medical based issue. OEC technicians are first responders, not definitive medical care, and have the knowledge to care for, transport, and treat patients, but not to diagnose them or provide terminal support or invasive therapies.
OEC technician training focuses primarily on assessing and treating immediate life threats to the patients' airway, breathing and circulation; stabilizing the patient; and transporting them (if necessary) to rendezvous with equal or higher levels of medical care, especially an ambulance. Based on severity, the OEC technician will often manage secondary concerns either before transporting (most common), or while waiting for rendezvous. These typically include fractures, sprains, bleeding, head injuries, and medical concerns including anaphylaxis, acute myocardial infarction, and hypoglycemia (diabetes).
The scope of practice of the OEC technician is entirely basic life support and non-invasive. It is determined for each operating agency (most often a local ski patrol) by a local medical director, most typically a physician, and effected through protocols, standing orders, and off-line medical direction. Most often, the OEC technician is unable to consult with a physician medical director to receive on-line instructions, unlike an EMT, so they follow already established local protocols. Protocols and standing orders may differ slightly from the OEC standards of training, but maximally, may include the following: