You are a trip leader for a 21 day winter ski trip. On day 13 one of your students, a 17 y/o male, approaches you before breakfast and tells you his belly hurts and he is not hungry. After questioning him further you find that he has generalized achy pain in his abdomen that prevented him from sleeping well the night before. He said he first noticed the pain yesterday after lunch and it slowly worsened through the day from a one to a four on the ten scale. An abdominal exam reveals mild tenderness in all quadrants. He has no relevant personal or family history. No one else in the group is feeling poorly. His pulse is 72 & regular, his respirations are 18 and easy, his skin is pink, and warm, & dry, his oral temperature is 99.4º F. A "heel drop" test is negative. You prudently decide to remain at the hut for the day to see if he gets better and to examine your evacuation options.
Three hours later he reports that he is nauseous and the pain is still getting worse and is now six on the ten pain scale. The pain has also localized to his lower right quadrant. Another abdominal exam reveals slight tenderness in his lower right quadrant. He reports a sharp pain when asked to stand on his toes and drop suddenly to his heels. His pulse is 80 & regular, his respirations are 20 and easy, his skin is pink, warm, & dry, and his oral temperature is 100.6º F. 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.
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You are a leading a snow mobile tour outside of Glacier Park in northwestern Montana when one of your clients, a 62 y/o man in apparently good health, tells you in a worried tone that he has a deep pulsing sensation with mild pain (a 3 on the ten scale) in his upper abdomen. He says it started suddenly a few moments ago during the break. On exam, his upper abdomen is slightly tender. He reports that he is current with Rx medication prescribed to lower his blood pressure. His pulse is 88 & regular, his respirations are 20 and easy, his skin is pink, warm, & dry, and his oral temperature is 97.6º F; his blood pressure and O2 Sat were not taken.
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. While backcountry skiing you see a party of two caught in a soft slab avalanche. It takes you about 15 minutes to reach the site. One person, a 26 y/o female was only partially buried and was able to dig herself out. By the time you arrive, she has turned her beacon to receive and started to look for her partner who is completely buried. It takes you another twenty minutes to locate and uncover the second victim. He does not appear to be breathing and has has a weak pulse. He is wearing an AvaLung and the mouthpiece is in his mouth upon recovery.
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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