WFR Course Study Guide Flashcards
What considerations should you make when evaluating a scene?
Don’t approach the patient immediately
Make sure the scene is safe
- snow, ice, rocks, fire, animals
Determine how many people are injured and how
- Mechanism of injury or nature of illness
- Ask them if there were others involved
What are the 5 components of the primary assessment?
M - Massive hemorrhage
A - Airway (with C-spine precautions)
R - Respiration
C - CIrculation
H - Hypothermia/Hyperthermia or Hike vs. Helicopter
What is the top priority for CPR?
Circulation first - emphasizing the importance of early, uninterrupted chest compressions
Why do we place patients in the recovery position?
Reduces risk of aspiration - tongue won’t occlude airway, drainage of vomit
If you’re giving rescue breaths, how can you tell if you’re doing it effectively?
Adequate chest rise and fall
How do you assess circulation?
Look at skin color and assess capillary refill in all extremities
Check for pulse
Assess neck veins if absent pulses or prolonged capillary refill - distended or flattened
What three things are assessed in the Glasgow Coma Scale?
Eye-opening Response
Verbal Response
Motor Response
What are the six components of the secondary survey?
S - Symptoms/Subjective
A - Allergies
M - Medicine
P - Prior medical history
L - Last oral intake
E - Events leading up to illness/injury
What does it mean to say someone is Alert and Oriented x 4 (A&O x 4)?
Do they know person, place, time, situation
- their name
- where they are
- what time it is or day
- what happened
What are some of the ways we characterize pain?
C - Character (type of pain)
O - Onset
L - Location
D - Duration
E - Exacerbation
R - Relief
R - Radiation
What do you include in each of the 4 parts of the SOAP note?
Demographics of the patient
S - Subjective - patient’s chief complaint or injury
O - Objective - state what you found on your exam of patient, including vitals, injuries, or medical problems
A - Assessment - What you think is wrong
P - Plan - Treatments performed and what you think should be done next
What are at least five conditions that always need evacuation?
suspected spine injury
suspected pelvic injury
open fracture
suspected compartment syndrome
hip or knee dislocation
vascular compromise to an extremity
laceration with tendon or nerve injury
uncertainty of severity of injury
What is meant by the term “shock”?
Inadequate delivery of oxygenated blood (perfusion) to the tissues and organs of the body
What are the three types of shock?
Cardiogenic
Hypovolemic
Vasogenic
What is cardiogenic shock?
failure of the heart to pump blood effectively throughout the body. Heart attack.
What is hypovolemic shock?
Results from low fluid volume within the system and is typically preventable with early recognition and management. Causes include fluid loss such as from bleeding, diarrhea, vomiting, or lack of oral fluid intake
What is vasogenic shock?
loss of tone in the blood vessels and thus increased space and decreased pressure within the system. This type can be caused by a spinal cord injury, severe allergic reaction, or a system-wide infection.
How can you tell if someone may be in shock?
Look for causes
Changes in vital signs
Rapid/weak pulse
Rapid/shallow breathing
Pale, cool, clammy skin
Anxiety or restlessness
Nausea, thirst
How can you use the radial pulse and mental status to know which stage of shock someone may be in?
Early/compensated shock: increased heart rate, stable pulse; anxious/restless mental status
Late/decompensated shock: disorientation, decreased alertness, drowsiness; pulse weakens
Late/irreversible shock: unresponsive mental status; pulse disappears
Treating shock in the wilderness is very difficult, especially without medical training or equipment. However, what are some things you can do to help the patient?
Treat the underlying cause:
-basic life support including CPR
-control bleeding; replace fluids
-spinal immobilization; epinephrine; antibiotics
Lay them flat, elevate legs
Keep them warm
Monitor vital signs
Fluids and oxygen
Evacuate
When should you evacuate someone who’s in shock?
When their condition does not improve
Worsening shock, deterioration of mental status, circulatory system collapsing (blood pressure falling or pulse becoming weak)
What is another name for a heart attack?
acute coronary syndrome
What are the signs of acute coronary syndrome?
Is the pain always directly above the heart?
chest pain or discomfort, tightness or fullness
Pain in one or both arms, jaw, neck, back, stomach
Shortness of breath
Feeling dizzy or lightheaded
Nausea
Sweating
No
How do you treat a heart attack in the wilderness?
Stop all activity - don’t hike out
Give adult-strength aspirin
Give nitroglycerin if prescribed
Evacuate
Someone has a bleeding injury. What should you be regularly testing downstream of the injury?
A pulse - to tell if any arteries are compromised or blood flow cut off
How can you tell the difference between someone who is experiencing sinus tachycardia from a more concerning arrhythmia?
ST: rapid but regular heart rate; appropriate response to physical or emotional stress; has a clear cause
More concerning: heart rate racing starts suddenly when at rest or exertion; no clear cause; fails to resolve with stopping the activity; lightheadedness, palpitations, chest discomfort
What are the signs that someone has experienced syncope?
Loss of consciousness/fainting
Preceded by feelings of warmth, sweating, lightheadedness
Most people recover quickly
What should you do to help someone who has experienced syncope?
Do they always need to be evacuated?
Remove them from dangerous conditions
Monitor breathing and heart rate
Elevate legs
Treat underlying cause: hydration, cooling, stop activities
No
What is the difference between respiratory distress, respiratory failure, and respiratory arrest?
RD: unable to regulate gas exchange, too little oxygen in or too little carbon dioxide out
RF: unable to provide adequate ventilation for body’s requirements
RA: complete stopping of breathing
