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You and six other friends are on a 5-day high water trip on the Middle Fork of the Salmon River in Idaho. You have one paddle raft with five paddlers and some gear, a kayak, and a gear boat. It's the afternoon of day two when the paddle raft slams into a large hole and flips. Everyone is recovered safely with the next half mile. One of your friends managed to punch himself in the left eye with the T-grip of his paddle when the raft folded in the hole just before it flipped. He says his eye doesn't hurt (see photo).

What's wrong with your friend's eye? What do you need to do? Can he stay on the trip or do you need to fly him out at the next ranch with an airstrip? Click here to find out.

Don't know where to begin or what to do? Take one of our wilderness medicine courses.
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You and a three kayaking friends are taking turns playing in a rather large hole on a popular day run. The take out is four miles downstream. The day is sunny and 74º F and the clean blue-green water is a cool 52º F and every one is wearing a dry top if not a full dry suit. It's a weekend so there is some raft traffic on the river. You are keeping an eye out for approaching rafts as they sometimes run the hole you are playing in and can't see a kayaker in the hole until it's too late. You have been at the play spot for a while and everyone is getting a bit
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You and a small group of friends are on a late May rafting trip on the Main Salmon River in Idaho. The day time temperatures have been in the 40s and 50s with less sun than expected, lots of clouds, and occasional rain. The past few nights have been below freezing with a heavy layer of frost covering everything upon awakening. The water temperature is in the low 40s. Upon arrival at camp on day three of the five day trip one member, a 26 y/o male complains of cold, numbness, and achy pain in his feet. On examination you see (refer to photo). He says the pain started yesterday and has
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Spring came early and warm temperatures precipitated an early run-off. Streams and rivers in the program area rose quickly. An instructor team with 10 college-age students were en route to their course end pick-up and were unexpectedly stopped by a flooded stream. The instructors were new to the course area and had no training in Swiftwater Rescue or high-water stream crossings; no emergency communication is available. After spending the night next to the swollen stream, they noticed that, although still quite high, the water level had fallen somewhat during the night and elected to attempt a crossing. During the attempt, one student was swept off her
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You are boarding in the backcountry with one of your close friends, Joe, in roughly two feet of new powder on a 35º timbered slope. The trees are Lodgepole Pines with trunk diameters varying between six and ten inches. Some are closely spaced. Your friend chooses a rather tight line and takes off. Unfortunately it's a bit too tight, and he crashes into an eight-inch tree hitting his head — he's not wearing a helmet — and injuring his arm. When you finally reach him, he is partially buried in a tree well and struggling to release his bindings with his left arm. He has a two inch gash across his forehead over his left eye that, while not deep, is bleeding freely.
 
 
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
 
 
You and and a friend are on a week-log hut trip in British Columbia. You have been backcountry skiing; it has been bitterly cold all day. On the way back to the hut your friend starts to complain of cold hands. Back at the
 
 
_ 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
 
 
_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
 
 
_A friend of yours from Florida and you have just flown to an Alpine ski area in Colorado for vacation. You are both beginning skiers and it's the fourth day of your vacation. You started skiing the beginner trails from the top of the mountain yesterday. The temperature has been in the upper twenties since you arrived; however, a cold