Wilderness First Responder: A glimpse into a backcountry medicine course in Costa Rica

Written by: Mikaela Ferguson

I’ve written about the importance of getting wilderness medicine training before, but committing to a course can be a bit daunting. What will it be like? What should you expect before, during and after? Today I’m going through my experience with Wilderness First Responder, a course I did in 2017 with the Canadian company Boreal River Rescue in Costa Rica.


Wilderness First Responder, or WFR (pronounced WOOF-er) is about the highest wilderness medicine designation you can get before you’re an EMT. It requires at least 70 hours (80 in Canada) of training and is an extremely comprehensive course. If you work in the outdoors or trip in remote areas, this course is great for you. If you’re a little less intense in your outdoor recreation, this may be more training than is necessary for you (meaning more $$$), so take a look at this post to figure out which course is best for you.

In Class or in the Field

At least part of this course has to be done in the field – you need to be able to run simulations in an outdoor environment for the training to be meaningful. If you do a traditional 5 or 7 day course, it can be an exhausting couple of days if you aren’t used to spending so much time in a classroom. When I did my Wilderness Advanced First Aid three years ago, half the course was in a dark lecture room and the other half was in a cold field in Hamilton, ON. This is how most courses are organized.

When I began looking for a WFR course this was something I tried to avoid. Being a student, I was already spending 30 hours a week in a lecture theatre and couldn’t bare the thought of using my mid-semester break to do even more lectures.

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Our “classroom”. (Costa Rica, 2017)

This led me to do the course in Costa Rica. Our “classroom” was the second floor of an open bamboo tree house with natural sunlight beaming in. We took breaks to swim in the Pacuare River or walk around the off-the-grid camp. We did emergency rescue simulations while whitewater rafting. It was much easier to stay engaged this time.

Pre-Departure Work

If your course is 5 days long, you’re expected to do some studying prior to the course starting (as was the case with my course). I think this is the better option – you get the course material a few weeks early and can begin studying it on your own time. There are a few short assignments corresponding to each section of the material that you’ll hand in at the start of the course. When you begin the course, you’ll already have a basic understanding and will be ready with questions about any material you don’t quite get.

The Material

Regardless of where or how you take the course, the material is standardized. Some things you’ll learn (though far from an exhaustive list):

  • Conduct Primary Assessments – Airways, Breathing, Circulation
  • Diagnose and treat problems like angina and heart attack, partial and complete choking, asthma, allergic reactions, seizures, altered mental status, deadly bleeding
  • Learn to splint broken bones like femurs and wrists, relocate dislocated shoulders, perform litter carriers
  • Evaluate a potential spinal injury and determine if you can clear the spine for mobility
  • Diagnose and treat many illnesses found in the backcountry, like those resulting in diarrhea and vomiting
  • Treat hypothermia, heat exhaustion and heat stroke
  • Understand how to classify an emergency as a high-risk or low-risk evacuation

Basically the most useful information to have when you’re in the backcountry! The quantity of content can feel a bit overwhelming, especially if you’ve been out of school for a while and aren’t in the habit of studying material. The instructors are all very accommodating though; they use their personal experiences and plenty of emergency simulations so you’ll get lot’s of practise.


We’re transporting a patient with a broken femur using a litter carry (taken by Boreal River in Costa Rica, 2017)

The Delivery

The delivery is very important – all of the instructors I’ve ever encountered have been friendly and engaging, as well as experienced and very qualified. Before committing to a course provider, ask them who your instructor is likely to be. You might be able to find information or reviews about them and their style. This is what I did with Boreal River. I knew my instructor was likely to be the owner of the company, Danny; everything I read online said he was easy to listen to and conducted versatile simulations that related to your own experiences (consequently, I had a lot of canoeing related simulations).


Whitewater Rafting and Boreal River Rescue 

I want to take a moment to include a few more details of the specific course I took because I thought it was such an amazing experience. We met on Sunday morning and drove two hours to the put in of the Pacuare River. This day was spent rafting and swimming as we made our way to camp. Sunday evening we ate dinner and did some introductions and a little course material.

Monday through Wednesday we worked on course material, taking breaks to swim and hike. We spent Thursday whitewater rafting to travel to our second campsite, where we stayed until Saturday morning. Here we did our final simulations and did a short written exam before getting out certifications.

We stayed in semi-permanent tents and all of our meals were prepared by a lovely Costa Rican women. I cannot recommend this course enough! Follow this link to Boreal River Rescue’s course page.

So there you have it! A little glimpse into the world of wilderness medicine courses. As always, please feel free to get in touch and share your own experiences and questions.

– Mikaela

Note: I have received absolutely no compensation from Boreal River Rescue for writing reviews. I have taken three courses with them and loved every single one. I write these reviews to share the importance of getting wilderness medicine training and showcase a company that is doing a lot of good work!

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