Wilderness emergency medicine services (WEMS) is a specialized branch of EMS where practitioners systematically prepare for and deliver medical care in situations limited by environmental considerations, prolonged extrication, or resource availability. WEMS differs significantly from traditional EMS in terms of scope of practice, equipment used, resource availability, communications, and availability of direct medical oversight, among other differences. Significant potential protocol and scope of practice differences in WEMS versus traditional EMS include differences in wound care, termination of resuscitation, joint reductions, spinal cord protection, and treatment of anaphylaxis. Although it may seem counterintuitive, WEMS protocols and preparations are important for all regions, not just those with fixed and significant remote call areas. A current challenge facing WEMS is its lack of standardization relative to other medical specialties and branches of EMS.