You are part of a mountain rescue team responding to an out of bounds avalanche that reputedly buried three skiers. Two victims have been recovered; one is alive, awake, and curled in a fetal position in a sleeping bag, moaning. Aside from low back pain Jim's SAMPLE history is unremarkable. He reports that any movement sends a severe, shooting pain down his right leg. A physical exam reveals tenderness at L-3 and L-4. His pulse is 68 and regular, his respiratory rate is 18 and easy, and his skin is normal. Jim's blood pressure and O2 sat were not taken.
What is wrong with Jim and what should 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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