About This Book
Survival and Austere Medicine: An Introduction (3rd Edition, 2018) is a 620-page reference written by the moderators of the Remote, Austere, Wilderness and Third World Medicine (RAWTWM) discussion group. The author team spans three continents and includes two physicians, a remote-practice registered nurse, a physician assistant, a biomedical technician, a veterinarian, and a paramedic/RN. The book is distributed freely as a PDF, and print copies are sold at production cost with no author compensation.
The book addresses a question that most first aid courses do not touch: how do you manage common and serious medical problems when modern healthcare facilities are not available, not for hours but for weeks, months, or longer? It was written specifically for large-scale, prolonged grid-down scenarios and builds from basic assessment and stabilization through long-term patient management, improvised equipment, medication sourcing, and austere surgical considerations.
This is not a substitute for formal medical education, and the authors make that clear throughout the text. It is a reference for people who have already pursued structured training and want a deeper resource for scenarios where professional care is not coming.
How This Ties into LFHI
Medical is one of LFHI’s nine functional pillars. The Foundation establishes the progression: every member completes Stop the Bleed and CPR/AED as baseline requirements, then moves into wilderness first aid, tactical emergency casualty care, and eventually EMT certification or wilderness medicine coursework.
This book fills the space between those structured courses. Most first aid and trauma programs teach you to stabilize a patient until EMS arrives, which assumes EMS is coming. This book starts where that assumption ends. It is the reference your chapter reaches for when training shifts from “stabilize and hand off” to “stabilize and manage,” which is exactly the gap chapters need to prepare for.
Recommended Training Alongside This Book
This book is most useful when paired with hands-on training. Reading about wound closure or airway management without practicing it under instruction builds false confidence. The following programs give chapters the structured, supervised skill-building that turns this reference into something members can actually apply.
Stop the Bleed. This is where every chapter starts. Free, 60 to 90 minutes, available nationwide through the American College of Surgeons. Teaches tourniquet application, wound packing, and direct pressure. Schedule a session for the entire chapter through your local hospital or fire department. No member should open this book without having completed Stop the Bleed first.
AHA BLS Provider. CPR, AED use, and basic life support for adults, children, and infants. Every member should hold a current BLS card. This course and Stop the Bleed together form the non-negotiable medical baseline for every LFHI member.
Wilderness First Aid (NOLS/WMI). A 16-hour course that teaches patient assessment, musculoskeletal injuries, wound management, and environmental emergencies in settings where evacuation is delayed. This is the natural next step after the baselines and the point where this book starts becoming a useful companion reference.
TECC (NAEMT). Tactical Emergency Casualty Care, the civilian adaptation of military TCCC protocols. Covers hemorrhage control, airway management, and casualty movement under threat. Designed for first responders but open to civilians. Chapters with members who have military medical backgrounds should consider hosting a TECC session.
D.A.R.T. (Dark Angel Medical). Direct Action Response Training. Practical trauma medicine focused on the first few minutes of a critical injury. Shorter and more focused than TECC, making it a good fit for a chapter training day.
Wilderness First Responder (NOLS/WMI). An 80-hour course that is the gold standard for non-professional wilderness medicine providers. Covers prolonged patient care, improvised splinting and litter construction, medication administration, and complex decision-making when evacuation is hours or days away. Members at the Practitioner tier who are mentoring others on medical skills should pursue this certification. The scenarios in this book become significantly more actionable once a member has completed WFR.
EMT Certification. Available through local community colleges and fire academies. A full EMT course (typically 120 to 150 hours) gives members clinical assessment skills, pharmacology basics, and patient management experience that no short course can replicate. Members pursuing the Cadre tier in Emergency Medical Response should consider EMT certification as the foundation for everything else they will teach.
The events calendar lists upcoming medical training events, including Stop the Bleed, Wilderness First Aid, TECC, and D.A.R.T. courses across the country.