Upon exam, his right forearm is tender and while he can move the fingers of his right hand, it hurts quite a lot and he is unable to hold onto a one liter water bottle due to the pain in his forearm. The laceration on his forehead has stopped bleeding and upon close inspection is more a scratch than a serious wound. His right shoulder is sore but he can move it without pain.
By now, twenty minutes have passed and his arm, although throbbing, doesn't hurt quite a much (3 on the 10 scale) as long as he supports it against his chest. He also says his nausea is gone and he feels better. His pulse is 68 and regular, his respirations 16 and easy, the skin on his face and hands is a bit pale and cool (it is cold out after all), and he is able to easily carry on a discussion with you regarding his injuries. He says his back doesn't hurt. While he is able to resist pressure applied to his ring and index finger equally on both hands, the fingers of his right hand are significantly weaker than those on his left even with his hand supported. His feet show no weakness when asked to push down or pull up. He has a no spine tenderness and no shooting or electric-like pain.
What are his current problems, anticipated problems, and your treatment plan? You and Joe are about two miles from your vehicle. 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.