While paddling a Class V section on the Wind River in WA, a 35 year-old intermediate kayaker turned over in a rocky rapid. While upside down, Jamie hit his face and head against a boulder before being scraped out of his boat. He was rescued by his friends unresponsive and with a pulse, but not breathing. He started breathing spontaneously after one of his friends delivered a few rescue breaths. Five minutes later he awakened with a severe headache (7) and no memory of the event. Jamie's neck is stiff and painful (4) with mid-line spinal tenderness at C-3 and a tingling, electric-like pain shooting down his right arm whenever he moves his head. He appears somewhat stunned or dazed and reports numbness in his upper lip and gums and difficulty breathing through his nose. His nose is both painful (4) and tender. He is able to stand but has difficulty with his balance and walking. What is wrong with Jamie 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.
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You and your partner are planning a two or three day backpacking trip near your home in Boone, NC with your seven year-old daughter and six year-old son. They have been car camping with you for the past three years, taken short day hikes, and enjoyed both. Your daughter is severely allergic to wasps and poison oak; she was hospitalized at four after being stung by a yellow jacket in your backyard. How should you plan your trip? 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 paddling with two friends on the Farmlands section (Class VI-V) of the White Salmon River in Washington state. The day is sunny and 65 degrees F but the water temperature is quite cold at 45 degrees. Most of the river is behind you when one of your friends Jessie, gets offline and runs the slot. Her kayak completely disappears for a few seconds before popping up downstream upside down. There is no sign of Jessie. Chasing her, you see her get scraped out of her boat as it drags over a submerged rock. It takes another 3-5 minutes (?) to rescue her. Once on shore, she is unresponsive, not breathing, and does not have a pulse. You pull her onto a flattish rock and begin CPR. During the second round of chest compressions, a small amount of foam issues from her mouth and nose. You breathe through it. Roughly three minutes later she spontaneously begins breathing. Ten minutes later she is awake and confused with no memory of the event. Her helmet is cracked and her physical exam is unremarkable. She is shivering even though the rock she is on is in the sun; she is wearing a drysuit. Her pulse rate is 52 and regular; her respiratory rate is 16 and easy; her lungs appear dry with no rales, gurgling, or coughing. The Green Truss bridge take out is just downstream and requires ropes to haul your kayaks to the rim. Once at the rim, a clinic is about an hour away and a small hospital an hour further. Jessie wants to get off the water and go home. You have cell coverage. What is wrong with Jessie and what should you do? 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 and two friends are riding an old mountain bike race course when you reach a gnarly downhill section. You elect to slide down the section with your bike and take photos. One of your friends manages to successfully ride down. Unfortunately Jack hits his front breaks too hard, flies over the handlebars landing on his head, neck, and shoulders, then slides with his bike another 50 feet to an open, dry wash at the bottom of the slope. When you reach him, he is sitting up holding his side and having difficulty catching his breath. After a few minutes, he calms down and is able to breath as long as he doesn't try to take a deep breath and breathes with his diaphragm. Jack's helmet is intact and he is able to recall his entire fall. He says he landed hard on his handlebars and thinks he broke a rib low on his left side. Road rash covers most of his back where his jacket slid up during his slide and small pieces of gravel is embedded under portions of his skin; it looks nasty but Jack said it doesn't really hurt. Jack's pulse rate is 88 and regular; his respiratory rate is 22 and easy; he reports that his normal pulse rate is in the low 50s. It's 3 pm, overcast and cool, about 50 degrees F; the sun sets about 7:30 pm. You have a small first aid kit, some water, food bars, but no additional clothing. Nighttime temperatures have been in the low 40s. You are roughly six miles from your vehicles over challenging terrain and another two hours to the nearest clinic. You have cell phone reception. What is wrong with Jack 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 and one of your friends are thinning trees on a remote piece of property you hope to build on some day. While cutting a leaning tree in some thick brush, Jeep's chainsaw jumped cutting deeply into his left leg. In seconds, his jeans were soaked with blood. You have a couple of tourniquets in your first aid kit along with two hemostatic dressings, gauze, and elastic wraps courtesy of your grandfather. (Too bad you didn't take his advice and purchase protective gear....) Tearing open Jeep's jeans all you see is blood welling up from what appears to be a deep wound. Wiping away the blood with a trauma dressing from the kit, you can see the wound is deep. It quickly filled with dark blood again and direct pressure didn't seem to help very much. Your truck is close by but it's a good four hours to the nearest clinic with no cell reception. What should you do? Click here to find out. Click here to read a blog article on the field management of severe bleeding. 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 skiing in the backcountry when one of your friends, Jane, catches an edge and crashes into a tree hitting her head—she is wearing a helmet—and upper chest. She is awake, struggling to breathe, and holding her head when you reach her. Her helmet is cracked. After catching her breath, she is confused, has a throbbing headache (6), and doesn't remember her fall, hitting the tree, or the events immediately preceding it. While the left side of her upper chest hurts as you examine her, she is able to take a deep breath without pain. While it is difficult for her to focus during your spinal assessment, she has no spine pain, no mid-line spine tenderness, and normal motor and sensory exams. The rest of her physical exam is unremarkable. Jane plays lacrosse for her college and was hospitalized for a brief period after a concussion three years ago. Her pulse roughly fifteen minutes after the accident was 58 and regular; her respiratory rate 16 and easy; she reports her normal pulse rate is 56. It's a few hours ski to your vehicles, the nearest hospital or clinic is another two hours beyond that, and your cell phone has no bars. There are a total of three people in your party, including Jane. What is wrong with Jane 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 and your partner are planning a three day canoe trip with your five year-old son. He has been car camping multiple times over the past two years and enjoys sleeping in a tent and playing outside. He has also been in a canoe on a small lake near your home in northern Florida multiple times last summer and enjoyed it. You are considering taking the trip on 30 mile stretch of river with moving water and some Class I rapids. You and your wife are proficient expedition canoe paddlers with a number of 2-3 week trips in your resume and are comfortable paddling a loaded canoe in easy Class III whitewater. What should you keep in mind as you prepare for the trip? Click here to find out. Click here to read a blog article about keeping children safe in the outdoors. 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 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. 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 a Forest Service wildland firefighter supervisor and trainer. You have a strenuous field exercise planned for tomorrow for a new cadre. Unfortunately, an unseasonable heat wave is in place and the high temperature predicted for the day is in excess of 110 degrees F. What are your concerns and how should you address them? 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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Our public YouTube channel has educational and reference videos for many of the skills taught during our courses. Check it out!
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