- Joined
- Apr 3, 2018
- Messages
- 3
- Reaction score
- 20
- Location
- portland, or
- Website
- nombunny.neocities.org
hey, so these are some of my notes from a wilderness medicine certification I did years ago.
this kinda knowledge is especially good for travelers as it emphasizes improvisation and lack of resources.
the patient assessment system is the smallest "chunk" of knowledge that is useful in this field (other than maybe first aid/CPR) and could easily be taught in a two hour workshop.
please let me know if you have any questions! im thinking of writing a zine on this subject, so it would be helpful to know which parts are confusing
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Wilderness - time away from definitive medical care (1hr or more)
Urban -> 911 -> ambulance -> ER -> stay or home
Time: long term care
Environment- safety, temp
Gear: improv
Communication
Prevention
Evac
No war stories
Patient assessment system:
Identify method of injury (MOI)
Body substance isolation (BSI)
Number of patients
General impression
1 - im number 1
2 - what happened to you
3 - dont get it on me
4 - any more?
5 - dead or alive
--------------
Approach patient - introduce : ‘hi my name is …, I have some medical training? Can I help you out?’
(consent)
Stabilize c-spine (cervical/neck)
Initital assessment -
A - airways 1) open 2) empty
Is there anything in your mouth?
Stop+fix
B- breathing
Is it happening?
Does it hurt?
Stop+fix
C - circulation -> pulse, blood sweep
Stop+fix
D - decision ->
Was there a MOI for possible spine injury?
“Tell us what happened”
E - environment -> protect
“Is there anything we could add to make you more comfortable?”
Expose- look at injury
Head to toe exam
C - circulation
S - sensation
M - movement
L - look
A - ask
F - feel
Vital signs - looking for trends
Time: take regular vitals
LOR - level of responsiveness
HR - heart rate - 72 strong and reg
RR - respiratory rate
SCTM - skin color temp moisture
BP - blood pressure
Pupils - PERRL
Temp - thermometer
LOR - A - awake and oriented
4. Event
3. Time
2. Place
1.person
Not awake
Response to:
Verbal stimuli
Painful stimuli - pinch back of arm
Unresponsive
Heart rate(HR)
Rate - normal - 50-100 beats per min
Rhythm - regular, irregular
Quality - strong, weak
Respiratory rate - dont tell what you are doing
Rate - 12- 20 breath/min
Depth - shallow/deep
Effort - easy/labored
SCTM - skin color, temp, moisture
Normal - pink, warm, dry
Stressed - pale, cool, damp, clammy
Blood pressure
Systolic/diastolic
Listen for first and last beat
Oscaltation - bp cuff plus stethescope
Palpation - pluse/bp cuff
Estimation - pluse
Pupils-
Equal, round, reactive to light
Let patients do things they can for themselves
History - dont ask leading questions
(nausea, headache, dizzy)
S - symptoms, how do you feel?
A - allergies - do you have any?
M - meds
P- past history - is there anything else I should know?
L - last in/out
E - events prior
No matter what you think the diagnosis may be, never forget the history
Symptoms (things you need to be told) vs signs (visible)
SOAPA - legal issues are a good reason to document
S - summary - age, sex, chief complaint, MOI, LOR
O - observation - patient found __________ + LOR
Head to toe, vitals, sample
A - assessment list - problem list
Request backboard
Shock secondary to dehydration
CPR
this kinda knowledge is especially good for travelers as it emphasizes improvisation and lack of resources.
the patient assessment system is the smallest "chunk" of knowledge that is useful in this field (other than maybe first aid/CPR) and could easily be taught in a two hour workshop.
please let me know if you have any questions! im thinking of writing a zine on this subject, so it would be helpful to know which parts are confusing
---------------------------------------
Wilderness - time away from definitive medical care (1hr or more)
Urban -> 911 -> ambulance -> ER -> stay or home
Time: long term care
Environment- safety, temp
Gear: improv
Communication
Prevention
Evac
No war stories
Patient assessment system:
- Scene size up
- Life threats - abcde
- Head to toe, vital signs, history
- Problem list + plan
- Monitor
Identify method of injury (MOI)
Body substance isolation (BSI)
- Gloves, b) sunglasses, c) cover nose and mouth
Number of patients
General impression
1 - im number 1
2 - what happened to you
3 - dont get it on me
4 - any more?
5 - dead or alive
--------------
Approach patient - introduce : ‘hi my name is …, I have some medical training? Can I help you out?’
(consent)
Stabilize c-spine (cervical/neck)
Initital assessment -
A - airways 1) open 2) empty
Is there anything in your mouth?
Stop+fix
B- breathing
Is it happening?
Does it hurt?
Stop+fix
C - circulation -> pulse, blood sweep
Stop+fix
D - decision ->
Was there a MOI for possible spine injury?
- Yes -> maintain
- No -> let go
“Tell us what happened”
E - environment -> protect
“Is there anything we could add to make you more comfortable?”
Expose- look at injury
Head to toe exam
C - circulation
S - sensation
M - movement
L - look
A - ask
F - feel
Vital signs - looking for trends
Time: take regular vitals
LOR - level of responsiveness
HR - heart rate - 72 strong and reg
RR - respiratory rate
SCTM - skin color temp moisture
BP - blood pressure
Pupils - PERRL
Temp - thermometer
LOR - A - awake and oriented
4. Event
3. Time
2. Place
1.person
Not awake
Response to:
Verbal stimuli
Painful stimuli - pinch back of arm
Unresponsive
Heart rate(HR)
Rate - normal - 50-100 beats per min
Rhythm - regular, irregular
Quality - strong, weak
Respiratory rate - dont tell what you are doing
Rate - 12- 20 breath/min
Depth - shallow/deep
Effort - easy/labored
SCTM - skin color, temp, moisture
Normal - pink, warm, dry
Stressed - pale, cool, damp, clammy
Blood pressure
Systolic/diastolic
Listen for first and last beat
Oscaltation - bp cuff plus stethescope
Palpation - pluse/bp cuff
Estimation - pluse
Pupils-
Equal, round, reactive to light
Let patients do things they can for themselves
History - dont ask leading questions
(nausea, headache, dizzy)
S - symptoms, how do you feel?
A - allergies - do you have any?
M - meds
P- past history - is there anything else I should know?
L - last in/out
E - events prior
No matter what you think the diagnosis may be, never forget the history
Symptoms (things you need to be told) vs signs (visible)
SOAPA - legal issues are a good reason to document
S - summary - age, sex, chief complaint, MOI, LOR
O - observation - patient found __________ + LOR
Head to toe, vitals, sample
A - assessment list - problem list
- MOI for spsine
- Ankle pain
- dehydration
- Maintain c-spine
- RICE + support
- hydrate
Request backboard
Shock secondary to dehydration
CPR
