NOLS Wilderness EMS Educator Looks Back on 48-Year Career

In 1970 Tod Schimelpfenig, AEMT, WEMT, FAWM, saw 30 Days to Survival, a film chronicling 30 days of a National Outdoor Leadership School (NOLS) course in Wyoming’s Wind River Mountains.

In the next year he took an NOLS course.

Two years later Schimelpfenig took a NOLS field instructor training course and began leading wilderness educational expeditions for NOLS while also serving on a rescue squad at college.

“The two tracts—wilderness and medicine—came together when people working as guides and educators on wilderness trips asked me, because of my EMS background, to provide first aid training,” he says. “Looking back it seems a matter of luck or serendipity that this evolved into a lifetime.”

Schimelpfenig—one of the nation’s few nationally recognized and honored wilderness medicine education experts—recently retired after 48 years of service to NOLS staff and more than 285,700 EMS students his education impacted.

Schimelpfenig points out the need for wilderness EMS is stronger now than ever.

“The popularity of outdoor recreation continues to grow,” he says. “Any SAR team will tell you about an increased mission tempo in recent years fueled by people seeking solace outdoors,” particularly during the COVID pandemic. “There also seems to be more severe weather and other natural disaster events that can quickly turn the controlled urban environment into a wilderness.”

Delayed Access to Care

Wilderness medicine is practiced during outdoor recreation, on expeditions, in remote clinics, during search and rescue, during wilderness event support, and as part of humanitarian relief and disaster response.

“Wilderness medicine is practiced in the context of delayed access to care, in challenging environments, often with the need to improvise gear, with limited communication and independent decision-making on the need for and urgency of evacuation,” says Schimelpfenig. “The contextual differences have implications for patient care differences between wilderness and urban medicine. In wilderness medicine you tend to be with your patient for longer prehospital time than in traditional EMS.”

Often without medical technology support, assessments rely on careful hands-on observation and patient rapport to understand complaints and patient history.

“You may have to create equipment—litters and splints, for example—understanding the principles of the tool you are building and that you may be seeking not what is ideal but what is practical,” Schimelpfenig notes.

Those in wilderness EMS need to know more about environmental problems, especially in terms of prevention of hypothermia, frostbite, heat illness, dehydration, and altitude illness, says Schimelpfenig.

“Your greatest challenge is not providing first aid—it’s keeping yourself, your teammates, and your patient protected in adverse environments. There also is a different suite of risks to assess in the wilderness context. The environment can’t be controlled as easily as we can in the back of the ambulance. There may be evaluations of rockfall or avalanche danger, dangerous animals, adverse weather, and transport through technical terrain.

“Time-sensitive emergencies such as life-threatening bleeding and anaphylaxis need to be managed on scene,” he says. “Wilderness medicine promotes self-sufficiency.”

Schimelpfenig applies his wilderness EMS skills in any setting each time he engages with a patient. “My assessments are thorough,” he says. “I’m trained to be aware of the trap of focusing on the technology, not the patient. I can more easily cope with unforeseen difficulties by seeking creative solutions based on principles or simply by slowing the mission tempo. My wilderness training makes me comfortable in adverse weather, darkness, and challenging terrain.”

Career Achievements

During his NOLS administrative career beginning in 1978, Schimelpfenig served as a program supervisor, purchasing agent, and field staffing director.

He developed and filled the role of NOLS’ first risk management director, creating the first NOLS risk management incident database. Schimelpfenig was the Rocky Mountain branch director before ultimately serving as the NOLS wilderness medicine curriculum director.

His contributions to the field encompass authoring or coauthoring several textbooks as well as articles addressing wilderness EMS topics. Schimelpfenig is the only person who has been twice recognized (2001 and 2008) with the Wilderness Medical Society’s Warren Bowman Award for outstanding contributions in support services for wilderness medicine.

The WMS recognized him in 2012 with its Matterhorn Award for continuing medical education.

In 2014 he was recognized with an Award for Excellence in Peer Reviews from the Wilderness & Environmental Medicine journal.

A founder of the Wilderness Risk Managers Committee and coauthor of the text Risk Management for Outdoor Leaders, Schimelpfenig was honored in 2010 with NOLS’ Charles (Reb) Gregg Award for his lifelong wilderness risk management contributions.

The state of Wyoming—for which he served in various EMS and SAR roles—honored him with a 2017 Lifetime Achievement Award.

Schimelpfenig says his greatest challenges have been “being comfortable in adverse weather, challenging environmental conditions, long, arduous missions while caring for the patient, and working through the stress injuries we suffer.

“Many people seek training in wilderness medicine skills, but the training is incomplete if they do not also master the skills of being comfortable and able to operate in adverse conditions,” he adds.

While saves in difficult conditions are among his most memorable moments, Schimelpfenig says what triggers emotions are “those we never found, those we could not rescue but only recover, and those long hours until we knew the entire team had returned safe.”

Schimelpfenig says his greatest joy in wilderness EMS has been the opportunity to “work with really wonderful people” not only at NOLS, but with other teams as well. “There is a theme of lifelong learning, cooperation, and collegiality that is an embedded culture in the practice,” he adds.

Melissa Gray, NOLS wilderness medicine director, credits Schimelpfenig for providing responsive, prompt, and thoughtful updates enabling NOLS to stay on the cutting edge.

“His patient and nonjudgmental style is key to our faculty feeling valued, appreciated, and connected to the school,” she says.

Schimelpfenig will continue with NOLS as an itinerant wilderness medicine instructor, edit the seventh edition of NOLS Wilderness Medicine, and collaborate on “what the next evolution of wilderness medicine education will look like at NOLS,” says Gray.

Carol Brzozowski is a freelance journalist and former daily newspaper reporter based in South Florida. Her work has been published in more than 200 media outlets.