Wilderness First Responder exam

Neuro

refers to the nervous system

Lymphatic

picks up fluid leaked from blood vessels and returns it to the blood/immune system

Pulmonary

pertaining to the lungs and their blood supply

Cerebral

pertaining to the brain

Ischemia

Local and temporary deficiency of blood supply due to circulatory obstruction

Hematoma

collection of blood that has escaped from the blood vessels into tissue = bruise

A,B,C,D,E

Approach and Assess
Airway
Breathing
Breathing- how well
Circulation- feel for pulse
Circulatio- chunk check
Deformities- broken bones in chunk check
Disabilities/ decision- hold c spine?
Environment - keep them safe
Everyone else- delegate/ how is group

What is the primary goal of an initial assessment?

1. Do not create a 2nd victim
2. Treat what will kill = prioritize the patient

How to preform a proper head to toe?

palpate = arms, wrist/hands, lower back, above knee, calf, feet
Check CSMs in all 4 extremities

What are the 5 vital signs we can assess?

pulse
PERRL eyes
A&O
respiration rate
skin= SCTM = skin, color, temp. and moisture

O,P,Q,R,S,T

O = onset = how was the onset of signs/symptoms = how fast/slow did the pain hurt/feel
P = palpate (touch) = touch the signs and ask how it feels (arms, wrist/hands, lower back, above knee, calf, feet)
Q = quality of pain = ask if pain came on sharp/dull
R = radius = determine the area of the pain
S = severity = ask on a scale 1-10 how much it hurts
T = time = do assessment again over time and log any changes

S,A,M,P,L,E

S = signs (visual) and symptoms (internal) = ask how they feel/what hurts
A = allergic reactions = ask if any
M = medication = ask if taking any
P = pertinent/prior medical history = ask
L = last oral intake = what did they eat/drink last?
E = events of incident = ask what happened in their perspective

What is shock and how is it treated?

shock = trauma
treatment = if face is pale > raise tail

What are the signs of internal bleeding?

bruised,swollen, tender or rigid abdomen
bruises on chest or signs of fractured ribs
blood in vomit
wounds that have penetrated the chest or abdomen
bleeding from the rectum or vagina
abnormal pulse and difficulty breathing
cool, moist skin

How do you stop external bleeding?

1. ELEVATE the wound above the level of the heart and continue to apply direct pressure
2. apply PRESSURE AT A PRESSURE POINT
3. apply a PRESSURE BANDAGE over the wound

Avulsion

tissue forcibly torn away or separated from the body

Laceration

a cut, tear or wound

Puncture

a pierced/punctured pointed object into the body

Abrasion

Scraping or wearing away of the skin by friction; irritation

HAPE High Altitude Pulminary Edina

Alititude related. fluid leaks into the lungs and potentially fatal

HACE High Altitude Cerebral Edema -

Altitude. fluid leaks into the cerebral/head and potentially fatal, rarely occurs<10,000 ft
increase brain cell volume leads to visual disturbances, paralysis, seizures, hallucinations, coma
MGT: immediate descent, O2 supplement or portable hyperbaric bag/chamber

AMS Acute Mountain Sickness

body responds to quick movement to high altitude; symptoms include dizziness, headache, shortness of breath and nausea; can cause lethal pulmonary cerebral edema

How do you recognize an airway obstruction?

1. head tilt chin lift
2. Open the casualty's mouth by grasping both his tongue and lower jaw between your thumb and fingers and lifting (tongue-jaw lift)

Heimlich

a maneuver performed when someone is choking to dislodge the food using force of air back throught the trachea forcing thumbs into phera plex area

Flail Chest

a life-threatening medical condition that occurs when a segment of the chest wall bones breaks under extreme stress and becomes detached from the rest of the chest wall. It occurs when multiple adjacent ribs are broken in multiple places, separating a segment, so a part of the chest wall moves independently

Pneumothorax

the accumulation of air in the pleural space causing a pressure imbalance that prevents the lung from fully expanding or can cause it to collapse

Hemothorax

condition wherein blood accumulates in the pleural space of the lungs

How do you recognize a head injury?

1. Headache that progressively worsens.
2. Consciousness gradually deteriorates from alertness to drowsiness or disorientation; A&O of at least 3. Persistent or projectile (shoots out under pressure) vomiting.
4. One pupil becomes significantly larger than the other.
5. Bleeding from an ear or nose without direct injury to those areas, or a clear watery fluid draining from the nose.
6. Bruising behind the ears or around the eyes, when there is no direct injury to those areas.
7. Seizures.

What are common sources of a neurotoxin and how do you treat it?

A poison that attacks the nervous system, causing blindness, paralysis, or suffocation.
common sources = Brown Recluse spider
Treatment = Wash the affected area with a mild soap.
Apply a cold compress to the wound site for ten minutes on followed by ten minutes off.
If possible elevate the wound site above the heart. This aids in slowing the spread of the venom.
Take an anti-inflammatory to ease the pain.
Remain calm at all costs. Panicking will raise the blood pressure speeding up the flow of venom throughout the body.

Anaphylaxis

Severe allergic reaction, possiblly fatal, to a drug that occurs a short time after a drug has been administered to a person who is hypersensitive to it

How many chest compressions per minute do you provide during CPR?

30 beats per minute

How do you treat hypothermia?

Remove from the cold.
Get them dry and keep them dry.
Insulate from the ground.
Hypothermia wrap:
Re-insulate with dry insulation.
Cover and protect the head from further heat loss.
Cover and protect the hands and feet from frostbite.
Surround with a windproof and waterproof layer.
If conscious, feed warm, sweet liquids.
If unconscious, evacuate and handle very gently to prevent ventricular fibrillation.

Trench foot

Infection of the foot caused by wet, cold, and unsanitary conditions.

Frostbite

the freezing of body parts exposed to the cold; can cause the loss of fingers, hands, arms, toes, feet and legs

Heat Stroke

A medical emergency consisting of a fever of at least 105 F, hot dry skin, rapid heartbeat, rapid and shallow breathing, and elevated or lowered blood pressure caused by the breakdown of the body's cooling mecanism.

Heat Exhaustion

an overheating of the body that can result from dehydration

Can you perform proper splinting/immobilization techniques?

keep neck straight and splint where necessary and do not let equipment touch damaged area of patient

A&O x1234

Alert & Orientated
X1 name
X2 where you are
X3 time
X4 what happened

The three things the human person needs

Thermotegulation
Nutrition
Hydration

TIA transient ischemia attack

Insufficient blood flow to the brain that spontaneously resolved w/in 24 hr

Cerebral Vascular Accident (CVA)

caused by interruption in blood flow to the brain due to a blockage or bleeding in a cerebral artery

hypoblemic shock

Caused from a decrease in blood supply

cardiogenic shock

Shock caused by inadequate function of the heart, or pump failure.

neurogenic shock

Caused by vasodilation, a loss of vascular tine.

compensatory shock

Body tries to keep bp up by increasing pulse, rests, pallor

decompensatory shock

stage of shock in which he body's compensatory mechanisms are no longer able to maintain a blood pressure and perfusion of the vital organs.

Necessities of a Splint

Immobilize the joint above and below
Can check CSMs
Rigid
Padded
Adjustable

heat cramps

muscle pain and spasm resulting from inadequate fluid and electrolyte depletion

heat exhaustion

condition resulting from exposure to heat and excessive loss of water and salt through sweating
Relieved by rest hydration and replacing electrolyte

heat stroke

a dangerous condition in which the body loses its ability to cool itself through perspiration. Pt is red hot and mad and has change in LOC and ^ HR/RR

Hyponatremia

deficient sodium in the blood caused by too much water stripping the body