Wilderness Medicine Case Study 77

You and a couple of friends rented a backcountry yurt and are out on a day tour. As one friend, Tyler, triggers a soft-snow sluff that carries him 75 feet into the trees where he stops, partially buried against a large Ponderosa pine. He is unresponsive and bleeding slightly from a small cut above his left eyebrow and from abrasions below his left eye. He slowly awakens and is fully alert as you finish digging him out of the snow. Tyler is a healthy 26-year-old male with a history of multiple mild concussions. He is complaining of a mild headache (3) and a sore neck (2). He exhibits limited movement in his left eye when asked to follow your finger as you move it upward (refer to photo); the remainder of his physical exam is unremarkable. During the focused spine assessment his spine is non-tender with normal motor and sensory exams; his neck is still sore. His resting pulse and respiratory rates are normal; his oxygen saturation level, blood pressure, and core temperature were not taken. You have no cell reception and are about two miles from the yurt where there is an emergency satellite phone.

What is wrong with Tyler and what should you do? Click here to find out.

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