Wilderness Medicine Case Study 68

You are a trip leader for a week-long snowshoe trip over winter break. You are responsible for a coed group of high school juniors and seniors; your assistant, Steve Hall, is a 38-year-old math teacher from the school with some outdoor experience. As you are setting up camp on the third day of the trip, you notice that Steve stops what he is doing to stretch and rub the left side of his lower back. When you ask him what's wrong, he says he thinks he strained it earlier in the day when helping one of the students put their pack on after a break. 

Forty-five minutes later as you are beginning to assist the students with dinner preparation, Steve says his back is hurting more and he needs to lie down. Roughly an hour later, dinner is ready and you send one of the students to get Steve. After a few minutes, the student comes running back saying Steve is curled on his side in his sleeping bag moaning in pain. You tell the students to start eating while you go and check on Steve.

You find Steve in curled his sleeping bag as reported by the student. He can barely talk through the pain. Gradually you come to understand that the pain started slowly on the left side of his lower back and, over time, began to move down into his groin and scrotal area. He has never experienced pain like this before; changing his position does nothing to relieve it. His history is unremarkable. At 5:48 p.m. Steve's vital signs are: pulse rate: 92 and regular, respiratory rate: not taken due to pain, blood pressure: not taken, skin: pale, cool, & slightly moist, core temperature, 98.4º F, AVPU: awake, alert, and in extreme pain.

What is wrong with Steve 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.

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