You are trip leader for a week-long backpacking trip in North Cascades National Park. While hanging a food bag to protect it from wandering bears, one of the participants is hit sharply on the head with a four-inch thick tree branch. The branch broke while hauling the bear bag up into a tree and fell roughly 22 feet before hitting the young woman squarely on the top of her head. She was knocked immediately to the ground by the impact. She appeared stunned for a moment or two before becoming fully awake. Forty minutes later, she is awake and tired with complete memory of the event, and responds to questions slowly. She has a three inch laceration and "goose egg" on the top of her head, a mild headache (3/10), and says she "feels a little slow." She has no spine pain or tenderness and normal sensor and motor exams. The bleeding from her head wound has stopped and the wound cleaned.
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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.
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