Power-Outage Points

Patient Assessment System

It looks complicated, but break it down into sections and you've totally got this!

🎵 🎶 A is for Airway, Approach, and Assess

B, for Breathing quality "is it adequate?"

C for Circulation Squared: check for Pulse & andy gross, lifethreatening Bleeds

D, Deformity- Chunk Check, Disability- log roll & check their Back

E for Environment, place that Pad! 🎵🎶

Then roll them back, *deep breath*, their not dead yet ... WooHoo! 🙃

TAKE OFF THE @#$%ING BOOT!!!!!!

For reals, though. If you leave shoes/restrictive clothing on under a splint, you not only lose the ability to assess skin signs, you risk that boot turning into a crappy tourniquet as swelling increases, leading to compartment syndrome and potential life-long repercussions for your patient.

Principles of Splinting

Spinal Clearing

Process

If the patient has 1 of these 6 Mechanism Of Injuries, be suspicious of a Spinal Injury.

Hold C-Spine as you go through your Primary and Secondary Assessments.

If there has been no evidence of ANY signs or symptoms of Spinal injuries, then you can follow the Clearing process. Make sure you take care of any other injuries first, your Pt is sober, your Pt has + CSMs in all extremities, and you've re-assessed the spine a 3rd time.

Then, you can take your Pt through the Range Of Motion test you learned in class.

In Wilderness Medicine, we have a different set of protocols for possible spine injuries for a few different reasons. We have a MUCH longer transport time to Difinitive care (hours to days), we need to worry about the environment posing a threat to our patient's health, and we have limited resources. For these reasons, and the research on spinal immobilization from the past 15 years, our Wilderness protocols involve full spinal assessments and the ability to confirm the absence of injury. This allows our patients to be moved off of cold, wet ground, wrapped in warm layers, supported in positions of function and comfort, and to walk out of the woods under there own power.

Fueling Your Body

and

Maintaining your Temperature

Hypothermia

The most dangerous thing about Hypothermia is that it is almost impossible to recognize in oneself, even in the earliest of stages. This is due to the effect low body temperature has on our brains.

If you are solo hiking, focus on prevention:

Pack high calorie snacks and don't skip out on sugar
Stay hydrated, dehydration compounds Hypothermia
Layer up every single time you stop to take snack & water breaks
Dress in moisture wicking layers, such as wool, with waterproof shells on top to keep them dry. You want to avoid Cold, Wet, Windy conditions
Pack extra warm layers, even if you don't think you will need them. Remember that weather is different above tree line
Recognize if you are moving slower than planned or there are changes in the weather you hadn't prepared for. It's not quitting to turn back. It's better to turn around and make it home than to try to push through and get stuck

If you are hiking with others:

Do everything listed above
Having a Responsibili-buddy can save a life. Having someone who can recognize the early signs of Hypothermia and intervene is priceless
Speak up if members in your group are not being taken care of. It's hard to stand up against the pressure to reach a summit, and it could be the reason your group avoids a tragedy
Say no to "slinky breaks"

Signs/Symptos:

Mild

Moody/Grumpy
Tired
Poor Judgement
Shivering
Trouble with Fine Motor Skills

Moderate

Lower level of Orientation (A&Ox2 or 1)

The UMBLES (stumble, mumble, crumble...)
Loss of Gross Motor Skills (can't walk)
Violent Shivering

Severe

Not shivering
Low level consciousness: V, P, or U on AVPU
Low HR, RR, and BP

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