You and a friend are descending a fairly steep, single track trail on your mountain bikes when you round a corner and see a middle-aged man crouching over a teenager who appears to have fallen off his bike. You stop to render assistance. A young man—his father says Jeff just turned 19—is lying on his back with his shoulders and head against rock roughly fifteen feet downhill from the trail; is bike is slightly uphill and on top of him. His father reports that he ran off the edge of the trail and fell head first off his bike into the rock; he says he hasn’t moved him. On exam, Jeff is pain responsive and breathing easily; his helmet is shattered where it hit the rock. Jeff groans as you palpate his shoulders and neck, and his right knee. You have no bars on your cell phone; the trail head and your vehicle is roughly four miles away; the nearest hospital is another two hours further. It’s mid-afternoon and the sun sets at five o’clock. The temperature is in the low 60’s now and is forecast to drop into the upper 30’s this evening. You have camping gear in your truck.
What is wrong with Jeff 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.
Our public YouTube channel has educational and reference videos for many of the skills taught during our courses. Check it out!