Slipstream First Aid - Group Training Quote Request Form
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1.
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1
. Contact Information
Contact Information
Your Name:
Company/Organization:
Email Address:
Phone Number:
2
. Please give us some background information about the people in your group. You can select one or more of the options below, and/or write in the comment field.
Please give us some background information about the people in your group. You can select one or more of the options below, and/or write in the comment field.
Scientists
Ski patrollers
Prior first aid training (please describe below)
Age 16-19
Volunteers
High-school graduation
Age 20 and up
Post-secondary education (10 or more years ago)
Post-secondary education (recent or currently attending)
Aboriginal peoples
Age 12-15
Medical professionals (RN/MD/etc.)
Less than high-school
English as a second language
Comments
3
. What type of training would you like to provide for your group?
What type of training would you like to provide for your group?
90-hour Advanced Wilderness First Aid (Slipstream's most popular course for educators, guides, and leaders)
50-hour Essential Wilderness First Aid (Slipstream's most popular course for recreationists and other outdoor professionals)
40-hour Search and Rescue Medic
Build my own course (select topics below)
I don't know
Other (please specify)
4
. Would you like to add any of these fun topics to your 90-hour, 50-hour, or 40-hour course? (Skip this question if you selected "Build my own course" above.)
Would you like to add any of these fun topics to your 90-hour, 50-hour, or 40-hour course? (Skip this question if you selected "Build my own course" above.)
Yes, add CPR Level A (adult patients only)
Yes, add CPR Level C (adults, infants, children, and 2-rescuer CPR)
Yes, add "Hot Fudge Sundae" topics (Altitude Illness, Oxygen Therapy, Electronic Thermometers, Metered Dose Inhalers, Glucometers, Spine Boards, Robertson Orthopedic "Clamshell" Stretcher, Commercial Collars, Sager Splints, Stethoscopes, and Sphygmomanometers)
I don't know
5
. Select topics for "Build my own course" option. (Skip this question if you did not select "Build my own course" above.)
The number in front of each topic indicates instruction time in minutes. For every 10 hours of class time, we suggest that you select approximately 5 hours worth of topics, and leave 3 hours open for practice (recommended outdoors) to help "Make It Stick" plus 2 hours open for breaks and questions. (We usually run courses 10 hours per day, but this is flexible depending on your scheduling requirements.)
You can also opt to let one of Slipstream's expert instructors select the best topics for your group, or you can choose your topics at a later date.
Select topics for "Build my own course" option. (Skip this question if you did not select "Build my own course" above.) The number in front of each topic indicates instruction time in minutes. For every 10 hours of class time, we suggest that you select approximately 5 hours worth of topics, and leave 3 hours open for practice (recommended outdoors) to help "Make It Stick" plus 2 hours open for breaks and questions. (We usually run courses 10 hours per day, but this is flexible depending on your scheduling requirements.) You can also opt to let one of Slipstream's expert instructors select the best topics for your group, or you can choose your topics at a later date.
30 - Introduction
10 - Scope of Practice
15 - Good Samaritan Law vs. Duty to Care
10 - Negligence
10 - Critical Incident Stress Debriefing
50 - Patient History and Vitals
10 - Infection Risk Management
30 - Water Disinfection
45 - Dressings and Bandaging
10 - Deadly Bleeding
10 - Nosebleeds (Epistaxis)
45 - General Principles of Immobilization
45 - Arm Splints
45 - Neck Collars (improvised)
30 - Pelvic Injury Packaging
45 - Abdominal Injury Packaging
20 - Ankle Sprains (Tincture of Benzoine, Tape)
70 - Leg Splints (improvised)
30 - Evacuation Planning
20 - Electronic Communication Devices
30 - Air Evacuation
10 - Shock - Hypovolemia
10 - Scene Assessment
10 - Triage
65 - Primary Survey
10 - Primary Survey Problems
80 - Secondary Survey
15 - Head Injuries
15 - Spine Injuries
15 - Rib Injuries
15 - Abdominal/Pelvic Injuries
15 - Orthopedic Injuries
15 - Wilderness Considerations for CPR
20 - Dehydration and Electrolyte Imbalance
15 - Drowning and Near Drowning
25 - Hypothermia
20 - Hyperthermia
10 - CO Poisoning
10 - Wound Care Supplies
20 - General Small Wound Care
15 - Frostbite
5 - Wound Closure Demo
20 - Burns
20 - Sun Damage (Skin & Eyes)
15 - Blister Prevention and Care
15 - Eye Trauma (Foreign Body Removal Demo)
15 - Heart Attack (MI)
10 - Stroke (CVA)
20 - Long Term Care
90 - Risk Management
30 - Med Forms/Participant Screening
30 - Medication in the Wilderness
30 - Orthopedic Re-alignment
60 - Dislocations
60 - Clearing the Spine
60 - Anaphylaxis
15 - First Aid Kits
60 - Rolls, Slides and Lifts (different ways to move your patients around)
20 - Burrito (Heat Loss Prevention)
90 - Patient Evacuation
45 - Life Threatening Injuries (flail chest, pnuemothorax, hemothorax, tension pneumothorax)
10 - Lightning
10 - Illness and History Documentation
60 - Detailed Patient Exams - Illness (CNS exam, chest exam, abdominal exam)
70 - Chronic Illness (seizure, asthma, angina, diabetes)
15 - Chronic Medical Problems (nausea and vomiting, diarrhea, constipation, fecal impaction, peptic ulcers)
20 - Severe Abdominal Illness (appendicitis, pancreatitis, cholecystitis, pylonephritis, peritonitis, kidney stones)
10 - Genitourinary Conditions
10 - Female Specific Problems (vaginal infections, toxic shock syndrome, pregnancy complications)
10 - Male Specific Problems (epididymitis, testicular torsion)
60 - Zooinosis, Envenomation, Poisoning
10 - Trenchfoot
20 - Eye Injuries/Disorders
20 - Dental Injuries/Disorders
15 - Overuse Injuries
20 - Wound Closure Practical
30 - Altitude Illness
65 - Oxygen Therapy - Delivery and Monitoring
10 - Electronic Thermometers Including Tympanic
5 - Metered Dose Inhalers
15 - Glucometers
120 - Advanced Spinal Management (spine boards, Robertson Orthopedic "clamshell" Stretcher, commercial collars)
45 - Sager Splints
60 - Differential Diagnosis and Advanced Exam Skills (stethoscopes and sphygmomanometers)
240 - CPR Level A (adult patients only)
360 - CPR Level C (adults, infants, children, and 2-rescuer CPR)
I want Slipstream to design my 1-day course
I want Slipstream to design my 2-day course
I want Slipstream to design my 3-day course
I'll choose my topics later for a 1-day course
I'll choose my topics later for a 2-day course
I'll choose my topics later for a 3-day course
Comments
6
. What are you planning to use this training for?
What are you planning to use this training for?
Continuing Medical Education (CME) credits
Recreation (multi-day)
Field research
Community outreach
Park warden service
Ski patrol
Fisheries work
Guiding (day trips)
Recreation (day trips)
Guiding (multi-day)
Outdoor Leadership Training
Other (please specify)
7
. Approximately how many people in your group are:
Approximately how many people in your group are:
Taking Wilderness First Aid for the first time?
Recertifying, with previous training from a complimentary agency?
Recertifying, with previous training from Slipstream?
8
. When would you like to do this training? Price may vary depending on season.
MM
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Earliest start date:
When would you like to do this training? Price may vary depending on season. Earliest start date: Month
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Day
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Year
Latest end date:
Latest end date: Month
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Day
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Year
9
. Where would you like to do this training?
Where would you like to do this training?
City/Town:
State/Province:
Country:
10
. What budget do you have in mind for this training?
What budget do you have in mind for this training?
Less than $100 per student
$100-199 per student
$200-299 per student
$300-399 per student
$400-499 per student
$500-599 per student
$600-699 per student
$700-799 per student
$800-899 per student
$900-999 per student
$1000 or more per student
Less than $1000 for the course
$1000-1999 for the course
$2000-2999 for the course
$3000-3999 for the course
$4000-4999 for the course
$5000-5999 for the course
$6000-6999 for the course
$7000-7999 for the course
$8000-8999 for the course
$9000-9999 for the course
$10,000 or more for the course
Comments
11
. Would you like to open your course to public registrants through Slipstream's website? This can reduce your cost to run the program, and enrich the learning experience and networking opportunities for your students by introducing individuals from a variety of backgrounds. (Note: This option is only available if you selected the 90-hour or 50-hour course above.)
Would you like to open your course to public registrants through Slipstream's website? This can reduce your cost to run the program, and enrich the learning experience and networking opportunities for your students by introducing individuals from a variety of backgrounds. (Note: This option is only available if you selected the 90-hour or 50-hour course above.)
Yes, please include public registrants in my course
No, I would like my course to be private, for my group only
I don't know
12
. Do you have any other comments or questions for us?
Do you have any other comments or questions for us?
Thank you for completing our Group Training Quote Request Form!
Once you click the "Done" button below, you can expect to receive a response by phone or email from Slipstream Headquarters within 2 business days. If you do not hear anything within this time frame, please contact us at 1-800-760-3188 or email info@wildernessfirstaid.ca.
Slipstream First Aid
www.wildernessfirstaid.ca
© 2011 Solid Medical & Safety Systems Ltd.
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