You are part of a Search & Rescue team looking for a missing fisherman, Jim Hicks, on a Moosehead Lake in northern Maine. You find him roughly a half mile from his upside down skiff floating unresponsive with his face out of the water in three-foot waves roughly 500 yards from open shore on Mt. Kineo. You estimate he has been in the water more than an hour. The water temperature is 74ºF and he is wearing lightweight cotton pants and a insulated shell under his lifejacket. He has no pulse or respirations. Once on board, you begin CPR. A small amount of foam appears in his mouth as you compress his chest. HIs pulse and respirations spontaneously return after a few minutes and you place him in a full hypothermia package. Twentyfive minutes later, as you are in the process of transferring him to a waiting ambulance, Jim awakens with no memory of getting in his skiff or leaving the Rockwood dock. Aside from still being quite cold and some lingering but mild respiratory distress, his history, physical exam, and vital signs are unremarkable and he passes a focused spine assessment. He thanks you profusely for rescuing him, says he doesn't want to go to the hospital, and asks you to drop him off at his vehicle so he can go home and rest.
What is wrong with Jim and what should you do? What is Jim's prognosis? Click here top 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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