First Haf Flashcards
What are the Main Three ost important umbrella concepts we go over in this course.
- Patient Assesment System
- Mcguyvering
- Communication
IN terms of the Wilderness context there is always a _____ range of medical protocols
Greater
In the wildereness context there is always a _____ of _____ ____
Variety of common injuries
When doing PAS and trying to provide treatment who are the two people at risk?
Patient and Responder
In the Wildereness context you usually have a ____ of equipment and communication
Lack
In the Wilderness context simple injuries may become?
Life threartening
Explain the difference between real v ideal
No matter what you learn in class or in a textbook, the ideal situation, the real situation is always much different and may require different action. This class i s a foundation for you to build upon
You should always Go Slow to?
Go Fast
S.T.O.P. Means?
Stop, think observe Plan
What is Macguyveryig?
Turning the items and the equipment you have on you and using it in multiple ways,. Making multi use out of items you already have
What is the first thing you do with the PAS?
Scene Size up? is the Scene Safe?
What is the Second step you do regarding PAS?
LTC’S AND ABCDE’S
What is ABCDE?
Airways, Breathing, Circulation (Chunk Check), Disability, Exposure
What is the Third step in the PAS?
Head to toe exam, Vital Signs, and Sample
What is the fourth step in PAS?
Documentation
What is the fifth step in PAS?
Ongoing observation
What is the difference between prone v supine?
Prone on stomach v Supine = on back
What does AVUP stand for?
Alert and Oriented (4 level scale), Verbal, Pain, Unresponsive
Whats the difference between level
4 3 2 1 of the Alert and Oriented ness scale
- who, where, when, what
- who where, when
- who, where
- who
- unresponsivce
Brain survives off of what tewo things?
Oxygen and sugar (and blood)
Prone and Supine are what kind of positions?
Anatomical
What are the Top reasons for an altered level of responsiveness (ALor)?
STOPEATS
What is Stop EATS?
Sugar, Temperature, Oxygen,, Pressure, Electricity, Altitude, Toxins, Salt
What is SAMPLE?
S- Signs and Symptoms A- Allergies M- Medication P= Patient Histoy L- Last ins and Outs E- Events
What should you always do after scene size up and BOI’S? (Gloves, Eyeware, Cover, Washed Hands,Mask)
Ask for Consent and Participate in Constantr Communication.
What is MOst common Alor reason on STOP EATS?
Sugar and least common is Salt
What are the three main elements of the Scene size up?
What do you see- scene safe? MOI- C-SPINE
What do you have - Numbers and resources
What can you do?
Scene saftey. who’s saftey comes first?
Your saftey
When you decide to DO somethong you now ____ your patient
Own
What do you do when your are planning what to do?
Use all available resources and information to make a plan
What is the Multiple Casualty Incidents Triage?
Immidiate- immidiete intervention
Delayed- serious but not immidiately life threatening
Minor
Morgue
What are the two main types of evacuation?
Assisted and Self
What Type of evacuation is used 90% of the time?
Assisted
What type of vaxcuation is used 10% of the tiem?
Self evacuation
Assisted evacuation means?
Outside help is required
Evacuations provide skills and equipment pros have
Self Evacuation means?
NO outside help required
Group manages entire
What are the three levels of evacuation?
Level 3- Oh Shit- LTC Needs immediate help
Level 2 - Load and Go Needs help within 4-6 hours
Level 1 stay and Play- Minor, evac within 24 hours
What are the top 4 major reasons to evacuate for Level 3 Oh shit?
Chest Pain
Dyspenea (Trouble Bleeding)
Prolonged ALOR
Debilitating Pain
A STABLE Patient might have what three things?
Non LTC
No Moi
Consistent Vital Signs
An UNSTABLE Person might have?
A life threatening injury
MOI
Inconsistent or tanking vitals
What are SOAP Notes?
Subjective
Objective
Assespent
Plan
What are the Purposes of Documentation?
Tracking Patient History
Legal Recors
Helps determine course of action
Providing infor for EMS
IN SOAP Notes what does S mean?
Subjective (what they tell you)
age-sex-race-moi-cc-sample
IN SOAP Notes what does O Stand for?
Objective (What you see)
Vital signs
Physical
IN SOAP Notes what does A Stand for?
Assesment
Pt’s problem list
Interventions
IN SOAP Notes what does P stand for?
Plan
What is an important thing to remember with Paitent confidentiality and SOAP Notes?
Names & Info can only be written for documentatrion
NOT FOR RADIO COMMUNICATION
What are Verbal soap notes?
Location Situation Scene
Requested resources
In regards to soap notes if its not written down?
It never happened
How long do you legallly keep soap notes for?
4-7 years
What are three main reasons injusries occur?
Bad Human Juddgement
-Por or unintended use of equipment and alck of kjnoweldge / skills
- Environmental conditions
- terrain weather - Equipment failure
In terms of basic risk management what are the things you should ask yourself?
What are the hazards
What happened
Who is at risk, why? How?
Can we reduce or elimnate risk
how do we deal with it
how likely is an occurance
How severe are its consequences
In relation to Injury and Ilness statistics how many outdoor participants became injured or Ill?
10%
Out of that 10% injured or ill what percentage was injured v. ill?
Injured- 54%
Ill- 46%
In relation to 54% injured what injury happened 43% of the time??
Ankle sprain
39%soft tissue injuries
6% fracftures
What four MAJOR things should first aid kits provide?
Multi Use
Watar tight compartments
First aid and rescue instructions
Paper and Pencil
You should consider heavily PEOPLE-DURATION-WEIGHT when putting together what?
First aid kit
What is one major thing to consider when constructing a first aid kit to bring?
OTC’S
What are OT’CS?
Over the counter Medications
What are Common OTC Medications?
Asprin Ibruprophen Acetaminophen Disphendramamine Alamag Glucose Electrolytes Wipes
Analgescis meds are usually used to treat?
Pain
Antihistamine are meds used to treat?
Allergies
Antipyretics are used to treat?
Fevers
Antimetics are used to treat?
Vomit
Asprin is usually used for ?
Chest Pain
Tylenoal is used for?
Muscle Pain?
Whata re good glucose things to carry to stabalize sugar?
Cake icing
Jello packets
Honey
What are good items to carry for prophylactic Electrolytes?
electrolyte tabs, camelback elir
What should ou carry fror reactive electrolytes?
Pedialyte
What are the three major types of wipes you should carry?
Alchol, Iodide, atiseptic
What are three items that expire?
Gloves
Medication
Sterile Items
What is ASR?
Acute Stress Reation
Acute Stress reaction is a form of ?
Shock
ASR Is common as for of shock as it happens
95% of time
What are two common types of (real) shock?
Volume and Vasogenic
Whatr are some initial signs of shock?
Anxiety and restlessness
Nausea
Flushed Skin
Confusion
Dry Mouth’
Disorentarion
Later signs of shock?
Umbles
Altered Lor
Rpaid and shallow radial pulse
What are the three most common reason of volume shock?
Bleeding
Dehydration
Burns
What is shock exacerbated by?
VHOAS
With shock Duck syndrome is crucial, what is it?
Maintaining compsure, half of all treatment is psychological
You must find and treat underlying cause
Shock treatment priciples are?
Lay patient Supine
Elevate legs
Insulate
Turn head
In relation to shick if the evacuation is within 4- 6hours you shoud?
Withold food and water
6 hours, sips of water
What should you avoid giving to a patient wit shick?
Caffiene,
Alcohil,
Sugars
Salt
When should you stop CPR In the wilderness?
More than 30 minutes
resusitaton sucess
exahustion
Rescuer placed in danager
What is a TBI?
Traumatic Brain Injury
What are the three common forms of TBI’S?
Blunt force trauna (85%)
skull fracture
Unresponsiveness
Goose egg
With a TBI any period of unresponsiveness requires what?
Immediate evacuation
How do you know if it’s head tauma v TBI
Head Trauma = No loss of consiousness and No Amenisa
TBI Opposite
As time passes the more likely we are to see signs of ICP Which is?
Intrcrainial pressure
early signs of intracrainial pressure are?
Persistent vomitting
ALOR
Sever headache
Late signs of ICP Are?
DIC Head
Battle signs
Rccoon eyes
Unequal Pupils
Vommiting
Antrograde Amnesia
CSF
Excessive sleepiness
What should you remember for treating a tbi v shock?
Face is pale raise the tale
Face is red raise the head
REVERSE SHOCK POSTIONS
What should you do in cas you need to perform extended care for a TBI?
Let patient sleep
watch breath
wake up every 2-3 hours
give them info to remember
Take and use
What are the three main components of the spine?
C- SPINE
Upper back
Lower back
What is the C-spine Equation?
A + B = C-SPINE
What does A stand for?
Cause and MOI
what are some causes?
Falling on a jagged rock
3 ft above ground
hit head
loss of consiousness
landing on buttocks
What does B stand for?
Effect (signs and symptoms)
What are some symtpoms of a spinal injury?
Unsusual warmth in hands
Numbness
Inability to move extremties
trouble Breathing
seizure
Obvious injury to the spine
In relation to C-Spine immobilization do NOT
Move head or spinal colum
Cover ears or speak negatively
In the case of C-SPINE IMMOBILIZATION DO
Gently support neck and head
Once you shold C-spine what happens?
Thats your only job
Who is in charge of rolling patient?
C spine holder
IN relation to moving a c spine patient what do you do?
ABC’S Move head slowly first if its to the side
reallign body with slow gentle traction one body part at a time
What should you do if someone with a spinal injury is stuck on a tree?
Work as a team to elevate the body and move to aflat surace
When do you stop holding cspine?
When it is immobilized
Even though a new study came out whhich says that 98% of all spinal injuries happen initially and not adfter fact we should be cautious about two things?
Trouble breathing and a positive moi to take precautions
In relation to Backcountry ILLNESSES What are the signs and symptoms of the cold and flu?
Fever over 101
Headache
Nasal Congestion
Coughing
Vomitting
Diaareaa
In relation to Backcountry ILLNESSES What are treatments of cold and flu?
Hydration
Hygiene
Rest and Otcs (Antipyrectic
In relation to Backcountry ILLNESSES what are signs and symotms of cnstipation?
Infrequent of difficulty with bowell movement
In relation to Backcountry ILLNESSES what are treatments for constioapation
Lots of liquids
no fatty foods
sorbitol
In relation to Backcountry ILLNESSES wat is the cause of diarrhea?
Reaction to baxcteria based infection within intestinal walls
Dehydration could lead to volume shock
What is the treatment to Diarrhea?
Eat a bratty diet
What does BRATTY stand for?
Bananas, Rice, Applesauce, toast, tea yogurt
In relation to Backcountry ILLNESSES What are the sins and symtpoms of Gastrointenstinal Illnesses
Abdominal discomfort
Nausea and Vommiting
Diarrhea
In relation to Backcountry ILLNESSES How do you treat Gatrointenstenial Illness?
Hydration with electrolytes
OTC ANTIMETHIC
Bland diet
Hygenie
In relation to the cold or flu, what are some evacuation considerations to keep in mind?
Fever over 102 shortness of breath
weakness
What are evacuations to keep in mind for gastrointenstinal illness?
Bloddy or coffee ground vomit bloddy or stool urine
sever dehydration
persistent abdminal pain
fever greater than 102
unable to tolerate fluids
In relation to Backcountry ILLNESSES Whata re seizures?
Bodies normal response to extreme or sudden injury disease fever poisioning
What are signs of seizures?
loss of mobility
Numbness or shaking
Unconscuous
Muscle contractions
chage in emotion
U
Confusion
Loss of basic senses
How long do seizures usually last
Rarely over 2 minutes
During a seizure do NOT ?
Srtick anything in mouth
What should tyou do during seizure?
Take notes:
Protect head
Soft skills
What should you take notes on during a seizure?
What happened
how many they had
any triggers how long it was
Most seuzures are non ltc but may indicate?
Underlying problem
Seizures are usually followed by?
Postical phase
A postical phase is denoted by?
confusion, disorintation, drowsiness, fatigue
During a seizure, Evacuate immediately if?
Fisrt time seizure occurance
seizure occured for unknown reasons
Multiple seizures in short period of time
In a diabetic emergency what is Diabetes Mellitus?
Body;s inabiity to maintain insulin levels
Insulin helps metabolize sugards and fats
Insulin made in pancreas
What is Type 1 diabetes v type 2 ?
1- lack of unsulin
2-inability to use insulin (sugar substitute)
What is Hypoglycemia?
Low blood sugar
can occure by skipping meal
What are signs and symptoms of Hypoglycemia?
Alor Rapid hr rr normal or shallow bp slightly elevated normal breath odor
Hyperlycemia is?
High blood sugar
Rare
Long time to develop
Symptoms of Hyperglycemia?
alor
increased hunger or appetitie
increaed urine
HR weak
Breath or odor may be sweet
What are treatments for Diabetic emergencies?
SUGAR
GLUCOSE KIT
ORAGNE JUICE
Are wildlife first aiders allowed to administer insulin?
No
Whata re the three types of strokes?
Ischemic
Hemoragic
Mini sroke
schemic is blood clots and happens?
87%
Hemoragic is internal bleeding and happens 13%
t
Whata re stroke symptoms?
Numbess or weakness on 1 side of body
confusion
trouble seeing
walking
sever headaches
What are three major signs of a stroke in women?
Hiccuos
Chest pain
shortness of breath
How do you go about recognizing a stroke?
FAST
FAST Stands for?
FACE ARMS SPEECH TIME
What should you do for stroke management?
Evacuate for definitive care?
Administer aspriin as long as there is not visual disturbances
In relation to heat illnesses what i8s the common progressio of heat illnesses?
Sweating
heat cramps
Heat exahustion
Hyperthermia
Whagt are heat exhaustion symptoms?
Sweating Pale
Headache
nAUSEAS
mUSCLE cRAMPS
Dark yellow urine
elevated hr rr
Heat exahustion treatent looks like?
water and electrolytes
dont use salt tablets
fabn
allow lethargic patients to sleep
Heat strike can be a ltc, how?
Red hot dry skin
classic shock
core temp above 1-4
headache
elevated hr rr
Heat strike treatment for sever looks like
Reduce body core temp
If consious give smalll amounts of ICE
No antipyrectics
What does dehydration look like?
thirst
dry mouth
rapid breathe
rapid heartbeat
fatigue
headache
sever dizinessunconscious
What is dehydration caused by/
LOss of fluid
not drinking enough
vommiting or diarrhea
Treatment for deydration
Oral rehydration salts
electrolytes
water
AOID SUGAR DRINKS
Ways to prevent dehdraton
Drink 3-4 qts a day
Prevention is key
What is Hypotremia?
Loss of fluids and electrolytes through sweat
Signs of hyponatremia?
Swelling of ingers and joint
alor
nauseaus vomit
Possible seizures
How do your treat hypinatremia
Eating salty foods
resting in a cool place
Restor electrolytes
monitor
What is the progression for cold injuries?
Goosebups
shivering
frostbite
Hypothermisa?
What is Frostbite?
Vasoconstriction A generally occurs on extremities
Measured same as burns
Frostbite treatment is?
End exposure to cold
Re warm slowly i warm water
DO NOT RUB EXTREIIRES
UTILIZE OTHER WARM BODIES
Give 400 mg ibruprohen ev six hours
Frostbte prevention =
Wear adequate clothing
Avoid tight constricting clothing
wear mittens
Avoid contact with metals
stay well hudrated
maintain high caloris diet
In terms of frostbit what is better than numb?
Tingling anf Pain
In relation to mild hypothermia you should loo for similar signs and symptoms to?
Shock
In relation to hyopthermia you should look for the?
Umbles
Extremities may be numb
Fast and slow breathing
tired
stimach ache
Sever hypothermia looks like?
Loss of mscle cordination
skin pale
dosporentation
sivering ma stop
orratinal behavior
How do you treat hypothermia?
Food is they key
Mild hypothermia treatement is best treated by?
An ice cold coke
Mild hypothermia treatment looks like/
end exposure to cold
remove wet clothing
DEPLOY HUMAN BURRITO
re warm SLOWLY BODY CORE FIRST
Wht is the hyuman burrito?
1 tarp, sleeping bad, padding, patient
How do you evacuate a hypthermic patient?
Pckage witgh added heat source
Gentle with Horicontal position at all times
NO CPR IF CHEST FROZEN
What should you never wear in cold and wet environments?
Cotton
How o you prevent altitude illness?
Dont exert yourself
Avoid respiratory surpressents
stay fit
hydrate
CLIMB HIGH SLEP LOW
What two OTC’s have been proven to help prevent altitude sickenss by 30%
Ibeprofufen and Aceteminophen
How much should you take a day? 600mg
600 mg
You should tyake how many?
1 a day prior and during
what is acute mnt sickness?
Most common altititude related
Where does AMS Occure?
6-8,000 ftq
What are the signs and symptoms of AMS
Secere persistent headache
nausea and or vommiting
lastitude
nosebleeds
dizziness
peripheral
Whagt is High altitude cerebral edema?
Fatal LTC]
Brain tissue swells causing pressure
Signs and Symptoms of High altittude cerebral edema
AMS PLUS
Alor
mood swings
headache
seizure or coma
atacialack of muscle cord
How do your trat ams and HACE?
Descened immediately
Rehydrate
Ibrprophen
light exercise
If aigns persist?
Evac now
What is High altitutde Pulmonafry edema?
Occurs between day 2-4
accumulation of fluids in lungs
Signs and symptoms of HAPE?
Difficutl breathe
Pink sptum
chest tightness
fast shallow
increased heart rate
How to treat HAPE?
DESCEND IMMIDIATELY
SUPP OXUGEN
ASTHMA INHALER 2-4 PUFFS HOUR
TADLAFIL
What are some evacuation guidlines to keep in mind with altittude?
Any patirent must descend immideatey
Many patients who descnd and recover may climb back up