Sarah Sarfaty, AEMT, WFR, FAWM, is a MedTreks Wilderness Medicine Instructor who teaches International Wilderness Life Support (IWLS). She is also a nursing student with more than a decade of experience in outdoor education, EMS and wilderness medicine.

Ask Sarah what clinicians underestimate outside, and her answer comes quickly: almost everything is harder. She also has strong opinions about knots and why Nerds Gummy Clusters absolutely count as trail food. “It might be simple, but it isn’t easy,” she shared with me.

Sarah Sarfaty at a glance

• Current roles: MedTreks Wilderness Medicine Instructor and nursing student
• Credentials: AEMT, WFR, FAWM
• Additional training: AIARE Level 2 and Advanced Open Water certification
• Teaching experience: Outdoor education since 2014 and wilderness medicine education since 2019
• International teaching experience: India, Chile and the Galápagos Islands in Ecuador
• Favorite subjects: Evacuation decisions, low-resource care, knots and diabetes management outdoors

How Sarah found wilderness medicine

Sarah began as an outdoor professional. She completed her Wilderness First Responder training because it was required for more advanced outdoor jobs. Then a medical emergency made her want to know more…

While leading a remote winter course in Colorado, a participant experienced several seizures. The group was far from immediate care, and the situation led to an evacuation. Sarah remembers not feeling like she had enough information to make confident decisions.

So, she became an EMT and kept studying! The more she learned, the more interested she became in the decisions surrounding the medical algorithm: how long an evacuation might take, what the environment was doing and what the group could realistically manage.

Cold hands lose dexterity, and rescuers get hungry or tired. Even moving a patient across uneven ground is very different from moving one down a hospital hallway.

“People really underestimate the additional burden the environment places on almost everything that happens outside,” Sarah says.

What low-resource thinking looks like

For Sarah, it starts with looking around. What do you actually have? If there is not enough padding for a splint, could the patient’s coat help? Does someone in the group know the route or have a useful piece of equipment?

Teaching in India challenged one of her own assumptions. During a lesson about anaphylaxis, Sarah learned that the epinephrine autoinjector she considered standard was not available to the people in that setting. The class worked through how to administer epinephrine using supplies they could access.

“You can’t be scared by the absence of tools,” she says. “You need to think, ‘What can I make? What do I have? What is the most effective way to use it?’”

Small skills that make a big difference

Ask Sarah which practical skill clinicians should feel more confident using outside the hospital, and she will tell you to learn a knot or two.

Knots can help secure a splint or put up a shelter. They have also followed her into nursing school. During a recent lab, her class had to use a quick-release knot. The only other student at her table who already knew it was a climber.

There is also the cool factor! “When somebody pulls out a knot and does it correctly, I think, ‘Wow, that person is prepared. They’re so in control.’”

Sarah learned another small but important lesson while hiking the W Trek in Patagonia after teaching in Chile. She ignored a hot spot on her foot until it became two painful blisters. Then she spent the next several days hiking through snow and rain while taping her feet every morning.

Now she stops early, even if it means standing barefoot in the snow beside her backcountry skis to apply athletic tape. “Prevention feels boring because nothing bad happens,” she says. “But that’s the whole point.”

What Sarah enjoys teaching in IWLS

One of Sarah’s favorite subjects is diabetes management in the wilderness. She has worked with young adults and teenagers and has seen how concerns about medical complexity can keep people out of outdoor programs.

Sarah wants instructors to have enough knowledge to say yes when an outdoor program can safely include someone, rather than excluding them because their care seems complicated. For her, wilderness medicine is not only about emergencies. It can also help more people get outside in the first place.

IWLS gives healthcare professionals time to practice these kinds of decisions in realistic scenarios. If you know Sarah from an earlier MedTreks WLS course, the current course is International Wilderness Life Support (IWLS).

Sarah’s favorite part of teaching with MedTreks is the students. “MedTreks has attracted some incredible healthcare professionals from such diverse backgrounds,” she says. “It’s amazing to share in their experiences, and I’m honored to get to be part of their experience.”

Her advice to first-time participants is to “lean into everything.” In the Galápagos Islands, Sarah watched a guest who was afraid to snorkel decide to try it. She came back saying it was one of the best things she had ever done. 

Sarah has also written about her own experience teaching wilderness medicine in the Galápagos.

What comes next for Sarah Sarfaty

Sarah recently began nursing school because she wanted to expand her medical training and have more options in the future. She was drawn to the versatility of nursing. Sarah says the wilderness is where she first learned to feel capable. Now she is taking that confidence with her into nursing.

Outside of school and teaching, she explores Utah’s desert country with her dog and is learning how to care for a growing collection of indoor plants. On the trail, she carries athletic tape and does not apologize for bringing candy.

Learn with Sarah and the MedTreks faculty

Explore International Wilderness Life Support and meet the rest of the MedTreks faculty.