You are leading a two-week canoe trip in the Boundary waters of northern Minnesota. On day seven of the trip, one of your female students, Jane, suddenly sits down next to her canoe just prior to entering it after lunch. When you reach her she complains of abdominal pain (4 out of 10). She tells you her menstrual period started yesterday with bloating, cramping, and mild abdominal pain and, although it is slightly worse right now, it's pretty normal for her. She adds that she is unusually tired today and while she had a normal bowel movement this morning, she found it difficult to urinate. An abdominal exam reveals tenderness in both her lower quadrants; her lower back is non-tender. She reports that ibuprofen and rest usually help. What do you think is wrong with Jane and what should 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.
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You are the trip leader on a day rafting trip on the Penobscot River in Northern Maine. One of the rafts in your trip flips in Exterminator hole at the top of the Staircase rapid (Class IV) shortly after putting-in at the power station. One of the guests, a 52 year-old man, was trapped under the raft and only released at the bottom of the rapid. James was pulled onto the top of his raft by the guide weak and coughing. After a few minutes, the coughing subsided and, aside from numerous scrapes on his lower legs from contact with the rocks in the rapid, your physical xam is normal and he says he feels okay. He is currently alert with no spine pain or tenderness and normal motor and sensory exams. His history is also unremarkable and after resting for ten minutes, he wants continue with the trip. What do you think is wrong with James and what should you do about it? Click here to find out. Click here to read a blog article on drowning. 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 a private, mid-summer river trip when one of your friends, Adam, is stung by a wasp on the back of his throat as he was drinking a can of Coke. Adam immediately coughed and spewed soda and the wasp onto the sand. Apparently the wasp had entered the open can while it was sitting next to his camp chair when he went to get a second sandwich during lunch. Roughly fifteen minutes later Adam is hoarse and tells you in a mild panic that his throat is swelling and it is becoming difficult for him to breathe. There are two expired EpiPens in the first aid kit and no oral antihistamines. One of the EpiPens is ten years old and the epinephrine is cloudy with a reddish hue. One of the group members has asthma and carries an albuterol multi-dose inhaler (MDI) that is also out of date by a few years. What is wrong with Adam and 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. You are backpacking on the Appalachian Trail through the Great Smoky Mountains National Park when one of the members of your group disturbs a yellowjacket nest and is stung numerous times on both her lower legs. While she has no history of allergies, roughly five minutes after being stung, she developed hives in her groin that quickly spread to her flanks and back. Retrieving the group first aid kit you see that the EpiPens—there are two—expired four years ago. The epinephrine appears clear with no particulate matter. The kit does not contain an oral antihistamine; however, one of the group members has hayfever, is taking Claritin daily, and has a small vial with five caplets. What is wrong with Laura and 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. 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. |
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