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FROM THE DESK
Two readers asked me the same question last month: "If I can only take one medical training course, which one?" Stop the Bleed (2 hours, free) or Wilderness First Aid (16 hours, $200 to $300). To keep it simple, WFA if you can afford it, Stop the Bleed if you can’t.
Here's what I've got this morning.
THE BRIEF
Choosing the Right Medical Training for Your Situation
We've covered first aid throughout this newsletter: basics (Issue 7), medical kit (Issue 38), and austere first aid (Issue 53). This week compares the two most impactful medical training courses available to civilians and helps you decide where to invest your time.
Stop the Bleed is the highest-impact single training session you can take. In 2 hours, you learn to control severe hemorrhage using direct pressure, wound packing, and tourniquets. Severe bleeding is the leading cause of preventable death in trauma. The skills learned in Stop the Bleed can keep someone alive for the 10 to 30 minutes it takes for EMS to arrive. It's free, widely available, and the skills are usable immediately.
Wilderness First Aid (WFA) is a 16-hour course that covers a much broader scope: patient assessment, wound management, fracture stabilization, environmental emergencies (hypothermia, heat stroke, altitude), allergic reactions, and medical decision-making when evacuation is delayed. It teaches you to be the first responder for hours, not minutes, and to make decisions about when to evacuate and when to treat in place.
For most suburban and urban households, Stop the Bleed addresses the most statistically likely life-threatening scenario: someone bleeding severely from an accident, injury, or violence. The skills are simple, the training is free, and the impact is immediate.
For anyone who spends time outdoors (hiking, camping, rural living), or who wants to be prepared for extended disruptions where medical help may be delayed by hours or days, WFA provides the broader decision-making framework that Stop the Bleed doesn't cover.
The ideal path: take Stop the Bleed first (free, 2 hours, learn the most critical skill), then take WFA when time and budget allow (16 hours, $200 to $300, learn the broader framework). CPR/AED certification ($50 to $100, 4 hours) fits between them in priority.
All three courses require periodic refresher practice. Skills degrade without use. Issue 79 covered how to maintain competence through regular practice.
ONE THING THIS WEEK
Register for a Stop the Bleed class at stopthebleed.org.
Find a class near you and sign up. It's free, it's 2 hours, and it teaches the single most impactful medical skill a civilian can learn. Do this before anything else on this page.
ON THE RADAR
57 Minutes to the ER. 5 Minutes to Bleed Out.
Median time from severe trauma to definitive care at a North American trauma center is 57 minutes — with a range of 12 to 232 minutes. Median EMS response to reach the scene: 6 minutes. A person with life-threatening hemorrhage can lose their entire blood volume in under 5 minutes. In a study of 680 critical trauma patients at 12 major trauma centers, 81% of 24-hour deaths were caused by exsanguination. Separate trauma research puts 35% of pre-hospital fatalities in the same category — uncontrolled bleeding, most of it preventable with direct pressure, wound packing, or a tourniquet applied in the first minutes.
LESSON FROM: DR. JOE ALTON AND AMY ALTON
The Altons address medical training priorities directly in The Survival Medicine Handbook. Their recommended learning sequence for civilians is: bleeding control first, CPR/AED second, wound management third, and then increasingly specialized skills like splinting, burn care, and environmental emergencies.
Their reasoning mirrors the trauma priority model used in emergency medicine: airway, breathing, circulation. If you can maintain these three, the patient survives long enough for everything else to matter. Stop the Bleed addresses circulation (the C in ABC). CPR addresses airway and breathing. Everything else builds on that foundation.
The Survival Medicine Handbook by Dr. Joseph Alton and Amy Alton
WHAT'S HAPPENING
Philippines Earthquake Kills 47, Displaces 350,000 in Mindanao
A 7.8-magnitude earthquake struck the southern Philippines on June 8, with its epicenter 13 km south of General Santos City. At least 47 people were killed and 688 were injured. More than 346,000 people across 75,000 families were displaced. At least 18,600 homes were damaged, 3,330 of them destroyed. Tsunami warnings were issued across the Pacific; more than 3,000 aftershocks were recorded through June 11, including three magnitude 6.0 or greater events. Power grids, cellular networks, roads, and bridges were disrupted across the Soccsksargen and Davao regions. Relief operations remain ongoing.
Source: NPR, Al Jazeera
WHAT I'M TESTING
NOLS Wilderness First Aid Course
I completed the 16-hour NOLS WFA course over a weekend. The course covers patient assessment (a systematic head-to-toe check), wound management, fracture stabilization, environmental emergencies, allergic reactions, and the critical skill of evacuation decision-making: do you treat in place or get the patient to help?
The patient assessment system (the "SOAP note") alone was worth the course. It gives you a repeatable framework for evaluating any injured or ill person, determining what's wrong, and deciding what to do. Under stress, having a framework prevents the "frozen by uncertainty" response that stops most untrained people.
The hands-on practice is extensive. Simulated patients, scenario-based learning, and peer practice under time pressure. About $250 for the weekend course.
Budget alternative: Stop the Bleed (free) plus Red Cross First Aid/CPR/AED ($80). These two courses cover the most critical skills for about $80 total. Not as comprehensive as WFA, but a strong foundation.
OVERRATED / UNDERRATED
Overrated: Online-only medical training. You can learn the theory online, but medical skills require hands-on practice. A tourniquet you've only seen applied on video is a tourniquet you'll fumble with in real life. Take an in-person course.
Underrated: Regular practice after the course. Taking a Stop the Bleed class once doesn't mean you can apply a tourniquet in 15 seconds a year later. Monthly practice for 5 minutes maintains the skill. Without practice, you'll revert to your pre-training baseline.
THE LINK DUMP
StopTheBleed.org — Find free bleeding control classes. The highest-priority medical training.
NOLS Wilderness Medicine — Gold standard Wilderness First Aid and Wilderness First Responder courses.
Red Cross: First Aid/CPR/AED — In-person and blended learning certification courses.
Where There Is No Doctor (free PDF) — Austere medical reference. Download to complement your training.
Grokipedia: First Aid — Background on first aid history, methods, and training standards.
NEXT ISSUE
Reading NOAA forecasts like a meteorologist. How to interpret the technical forecasts that professionals use, instead of relying on simplified app summaries.
PS: I've taken both courses. If I could go back and take only one, I'd take Stop the Bleed first. The skills are more immediately applicable, more frequently needed, and more likely to save a life in the first critical minutes. WFA builds beautifully on that foundation when you're ready.
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