Okay, winter IS cold. That's why we call it winter. Cold injuries—hypothermia, frostnip, frostbite, chilblains—are all potential problems. Fortunately with a bit of thought and practice, it's possible to stay warm, even in extreme cold. If you are a seasoned winter traveler, you're probably familiar with everything listed here. If you are new to playing outside in the winter, I trust you'll find a few things of value.
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You are trip leader for a week-long backpacking trip in North Cascades National Park. While hanging a food bag to protect it from wandering bears, one of the participants is hit sharply on the head with a four-inch thick tree branch. The branch broke while hauling the bear bag up into a tree and fell roughly 22 feet before hitting the young woman squarely on the top of her head. She was knocked immediately to the ground by the impact. She appeared stunned for a moment or two before becoming fully awake. Forty minutes later, she is awake and tired with complete memory of the event, and responds to questions slowly. She has a three inch laceration and "goose egg" on the top of her head, a mild headache (3/10), and says she "feels a little slow." She has no spine pain or tenderness and normal sensor and motor exams. The bleeding from her head wound has stopped and the wound cleaned.
What do you think is wrong and what can you do about it? Click here to find out. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. You are hunkered down in your 4-season tent waiting out a severe early winter storm. The high winds, wet snow, and freezing rain have forced you to cook in the vestibule of your tent. You and your partner wake the second morning of the storm with headaches and sense of general fatigue.
What's wrong and what should you do? Click here to find out. Want more information on this and other wilderness medicine topics? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. A 35 year-old climber is hit by falling rock as she belays you on the sixth pitch of a 12-pitch climb. While Joanne was unresponsive for a few minutes immediately after the event, she is awake and groggy by the time you descend and reach her belay station. Her helmet is chipped and cracked, and she is complaining of severe pain (8) in her neck. During your focused spine assessment (FSA) she complains of mid-line tenderness between C-1 and C-3, and stiff; she has no neurological deficit. Her remaining injuries are compatible with self-evacuation; she thinks she is capable of setting rappel anchors. From the base of the climb it is an hour hike over third class terrain to your vehicle and another three hours to the hospital. There is no cell coverage. A front is moving in and high winds, rain, and possibly snow are predicted for the next day. You have no bivy gear with you; however, sleeping bags, shelter, food and water are in your vehicle.
What should you do? Click here to find out. Refer to this blog article for context. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. A 66 year-old man is swept away in a medium sized soft snow avalanche while skiing in the backcountry. He travels approximately 800 feet and is recovered partially buried. He is awake, alert, and reliable with cervical spine pain (5) and tenderness. He reports a tingling, electric-like pain in his right arm when his neck moves; he cannot distinguish between pinprick pain and light touch on his right hand; and, there is noticeable weakness on his right side when executing the motor exams on his hands. His remaining injuries are compatible with self-evacuation. Help is roughly eight hours away.
What should you do? Click here to find out. Click here to read an article about about assessing and managing spine and spinal cord injuries. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. You are on ten-day late summer kayaking trip on the Green River through Desolation Canyon with three other paddlers and one support raft. The river is a bit muddy from a recent flash flood; the water, cool; the sun, bright and hot; and the wind gusty and blowing upstream. All the paddlers are wearing pogies. By day four, all the paddler's hands and lips are dry and starting to chap. One paddler's fingers are starting to crack.
What can you do about it? Click here for answers. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. You are paddling with some friends on a the Jarbidge River in Idaho when Dan missed his line in a challenging rapid and pinned under water still in his kayak on one of the numerous log jams in the river. It takes roughly five to ten minutes to free him. Once on shore he is unresponsive, with no pulse or respirations. You begin CPR. During chest compressions, copious amounts of foam issue from his mouth and nose quickly covering his face. Breathing forcefully through the foam, you continue CPR. A few minutes later, his pulse and respirations spontaneously return; he remains unresponsive. Putting your ear to his chest you hear crackling noises.
What is wrong with Dan and what should you do? What is Dan's prognosis? Click here to find out. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. You and your partner are avid Nordic skiers and live close to a large groomed trail system. Your parents bought you a ski sled so you can ski with your one year old daughter.
What are your concerns? Click here to find out. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. You are on the 5th pitch of a new route on Elephant's Perch in the Sawtooth Wilderness in Idaho when you climbing partner, Jonna, takes a forty-foot lead fall. During the fall, she made contact with the rock a couple of times. Hanging from her harness immediately after the fall, she is awake and alert, complaining of severe pain in her left arm near her elbow. There is enough rope for you to lower her to your belay stance on a micro-ledge. Once on the ledge, you examine her arm and find it tender, slightly deformed, with no range-of-motion, and painful (6 out of 10) with good distal CSM. Her right knee also hurts (2 out of 10) and is slightly tender with some minor abrasions, but has complete range-of-motion and she is able to bear weight. Jonna reports that she did not hit her head or trunk during the fall; however, her helmet is scratched, her neck is sore (2 out of 10), and she has a mild headache (3 out of 10).
What do you think is wrong and what can you do about it? Click here for answers. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. You are at a friend’s cabin cutting firewood for the upcoming winter, when the chainsaw slips and cuts deeply into your Ron’s right leg just above his knee. The saw stalls on the canvas of his pants and his tissue; dark blood immediately begins to well out of the wound quickly saturating the material and flowing down his leg. You quickly grab his sweatshirt and attempt to stop the bleeding with direct pressure as you yell to your brother to grab the first aid kit. Blood is seeping from under the shirt when the first aid kit arrives. Opening it, your brother finds two CAT tourniquets, 3-4 rolls of sterile gauze, two Chito-SAM dressings, Trauma shears, and a couple of 2-inch elastic wraps. You are at least six hours from the nearest hospital.
What should you do? Click here to find out. Don't know where to begin or what to do? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course. Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available. |
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