Wilderness First Response Flashcards
1
Q
What is the primary role of a Wilderness First Responder (WFR)?
A
To provide emergency medical care in remote settings.
2
Q
True or False: A Wilderness First Responder is trained to perform advanced medical procedures.
A
False.
3
Q
What does the acronym WFR stand for?
A
Wilderness First Responder.
4
Q
Fill in the blank: A WFR is trained to assess _____ in a wilderness setting.
A
medical emergencies.
5
Q
What is the first step in the WFR patient assessment process?
A
Scene safety.
6
Q
True or False: WFRs can only operate in groups.
A
False.
7
Q
What should you do if a mountain biker is unconscious?
A
Check for responsiveness and call for help.
8
Q
What is the most common injury in mountain biking?
A
Fractures.
9
Q
Multiple choice: What is the best way to manage a bleeding wound?
A
Apply direct pressure.
10
Q
What is the recommended position for a patient who is in shock?
A
Lay them flat and elevate their legs.
11
Q
True or False: Mountain biking injuries require immediate evacuation regardless of severity.
A
False.
12
Q
What is the primary concern when treating a head injury?
A
Monitoring for signs of concussion or increased intracranial pressure.
13
Q
Fill in the blank: A WFR should always have a _____ kit while biking.
A
first aid.
14
Q
What is a common sign of a fracture?
A
Swelling and deformity.
15
Q
Multiple choice: Which of the following is NOT a sign of hypothermia?
A
Increased heart rate.
16
Q
What is the priority of care for a patient with a suspected spinal injury?
A
Stabilization of the spine.
17
Q
True or False: You should remove a helmet from an injured mountain biker immediately.
A
False.
18
Q
What does the acronym SAMPLE stand for in patient history taking?
A
Signs, Allergies, Medications, Past medical history, Last oral intake, Events leading up to injury.
19
Q
What is the recommended treatment for heat exhaustion?
A
Move the person to a cooler place and provide fluids.
20
Q
Fill in the blank: Always perform a _____ check before assisting an injured person.
A
scene safety.
21
Q
What is the first aid response for a sprained ankle?
A
Rest, Ice, Compression, Elevation (RICE).
22
Q
True or False: A WFR can administer medications.
A
True, within their training limits.
23
Q
What is the best way to prevent mountain biking injuries?
A
Wearing proper gear and following safety guidelines.
24
Q
Multiple choice: Which of the following is a symptom of a concussion?
A
Confusion.
25
What is the purpose of a triage system?
To prioritize patients based on the severity of their condition.
26
Fill in the blank: In a wilderness setting, _____ is crucial for effective communication.
signaling.
27
What should you do if you suspect a spinal injury?
Keep the person still and avoid movement.
28
True or False: Mountain biking injuries are always life-threatening.
False.
29
What does the term 'evacuation' refer to in wilderness first response?
Transporting an injured person to a location where they can receive advanced medical care.
30
What is a common method for treating a burn?
Cool the burn with running water.
31
Multiple choice: What is the best way to carry a patient in a remote area?
Use a stretcher or improvised carrying device.
32
What should you assess first in a patient with multiple injuries?
Airway, Breathing, Circulation (ABC).
33
Fill in the blank: Always have a _____ with you when mountain biking.
buddy.
34
What is the primary goal of wilderness first aid?
To stabilize the patient until professional help arrives.
35
True or False: A WFR can perform CPR.
True.
36
What is the importance of hydration during mountain biking?
To prevent dehydration and heat-related illnesses.
37
What should you do if a patient is bleeding heavily?
Apply direct pressure and elevate the injury if possible.
38
Multiple choice: Which of the following is a sign of dehydration?
Dark urine.
39
What is the best way to treat a dislocated joint?
Immobilize the joint and seek medical help.
40
Fill in the blank: Always assess _____ before providing care.
the environment.
41
What is a critical factor in managing an emergency in the wilderness?
Effective communication.
42
True or False: You should encourage a person with a suspected fracture to move the injured limb.
False.
43
What is the typical duration of a WFR course?
Approximately 70-80 hours.
44
What should be included in a basic first aid kit for mountain biking?
Bandages, antiseptic wipes, and a splint.
45
Multiple choice: What is the most effective way to prevent hypothermia?
Dress in layers.
46
What is the recommended response for a person experiencing an asthma attack?
Help them use their inhaler and find a calm position.
47
Fill in the blank: A WFR must be able to _____ their own limitations.
recognize.
48
What is the purpose of a safety plan in mountain biking?
To outline procedures for emergencies.
49
True or False: You need special certification to be a WFR.
True.
50
What is the first step in treating a snake bite?
Keep the patient calm and immobilize the affected limb.
51
Multiple choice: Which of the following is a common sign of a heart attack?
Chest pain.
52
What should you do if a mountain biker is having a seizure?
Clear the area and protect their head.
53
Fill in the blank: Always have a _____ plan when biking in remote areas.
rescue.
54
What is the best way to treat a sprained wrist?
Rest, Ice, Compression, Elevation (RICE).
55
True or False: You should give food or drink to an unconscious patient.
False.
56
What is a key component of wilderness first aid training?
Scenario-based practice.
57
Multiple choice: Which of the following is NOT a sign of stroke?
Rapid breathing.
58
What is the primary concern for a patient with a broken leg?
Pain management and stabilization.
59
Fill in the blank: A WFR should always carry a _____ for communication.
whistle.
60
What should you assess in a patient with a suspected concussion?
Cognitive function and balance.
61
True or False: A WFR can provide emotional support to patients.
True.
62
What is the best method for treating a minor cut?
Clean the wound and apply a sterile bandage.
63
Multiple choice: Which of the following is a risk factor for mountain biking injuries?
Inexperience.
64
What should you do if a patient is allergic to a medication?
Avoid administering that medication and seek alternatives.
65
Fill in the blank: It is important to _____ your first aid kit regularly.
check.
66
What is the role of a spotter in mountain biking?
To assist and ensure safety while riding difficult terrain.
67
True or False: You should always use a helmet while mountain biking.
True.
68
What is the first action to take if someone is choking?
Encourage them to cough if they can.
69
Multiple choice: What is the best way to treat a bee sting?
Remove the stinger and apply a cold pack.
70
What should you do if you encounter a wild animal while biking?
Stay calm and slowly back away.
71
Fill in the blank: Always inform someone about your _____ before going mountain biking.
route.
72
What is one of the main goals of wilderness first aid?
To preserve life.
73
True or False: It's acceptable to move an injured person without assessing the situation.
False.
74
What is a common sign of a broken bone?
Inability to move the affected area.
75
Multiple choice: Which of the following is the best way to treat frostbite?
Gradually rewarm the affected area.
76
What should you do if a patient is experiencing severe anxiety?
Provide reassurance and help them focus on their breathing.
77
Fill in the blank: Maintaining _____ is crucial for a WFR.
skills.
78
What is the primary focus during a wilderness rescue?
Safety of the rescuer and the patient.
79
True or False: A WFR can work independently in the wilderness.
True, but should follow protocols.
80
What should be included in a rescue plan?
Evacuation routes and communication methods.
81
Multiple choice: What is a common treatment for a sprained ankle?
RICE method.
82
What should you do if you encounter a medical emergency while biking?
Assess the scene and provide care as needed.
83
What is the most important topic in sports outdoor medicine?
The management of someone injured
84
What are the four effective survey techniques used in initial assessment?
* Scene survey
* Primary survey
* Secondary survey
* Ongoing survey
85
What is the first survey technique when assessing an injured patient?
Scene survey
86
What should you ensure before entering a scene to assess a victim?
The scene is safe
87
What is the primary purpose of the primary survey?
To keep the victim alive
88
What acronym is used to prioritize treatment during the primary survey?
MARCH
89
What does the 'M' in the MARCH acronym stand for?
Massive hemorrhage
90
What does the 'A' in the MARCH acronym represent?
Airway (with C-spine precautions)
91
What is the third priority in the MARCH acronym?
Respiration
92
What should be prioritized even before managing the airway?
Preventing major hemorrhage
93
What steps should be taken to stop heavy bleeding?
Direct pressure or a tourniquet
94
What should you assume if a victim is unresponsive?
There is a C-spine injury
95
What precaution should be taken for Airway during the primary assessment?
Hold the C-spine
96
What should you check for after assessing the airway?
Respiration
97
What falls under Circulation when using the MARCH acronym?
Checking the pulse
98
What action should be taken if the victim is not breathing or has no pulse?
Initiate CPR
99
Fill in the blank: The second survey technique is the _______.
Primary survey
100
True or False: The scene survey should take a long time to complete.
False
101
What is the primary focus of Hypothermia/Hyperthermia management?
Ensure the patient is warm and dry and assess the need for evacuation (Hike vs. Helicopter)
## Footnote
This highlights the importance of environmental factors in patient care.
102
What does MARCH stand for in the primary survey?
MARCH prioritization ensures patient stability
## Footnote
MARCH is a mnemonic used in trauma assessment.
103
What does the acronym SAMPLE represent in the secondary survey?
* Symptoms/Sübjective
* Allergies
* Medications
* Prior medical history
* Last oral intake
* Events leading up to illness/injury
## Footnote
SAMPLE helps gather comprehensive patient history.
104
What should you do if a patient cannot answer questions during the secondary survey?
Ask family, friends, or bystanders for information
## Footnote
This approach ensures critical information is obtained.
105
What is the purpose of the ongoing survey?
Repeat the assessment as often as needed, especially if the patient is unstable
## Footnote
Continuous monitoring is vital until medical help arrives.
106
What does the acronym AVPU stand for in the ongoing survey?
* Alert
* Verbal
* Pain
* Unresponsive
## Footnote
AVPU is used to assess a patient's responsiveness.
107
When should you move a patient to a safer location?
If the scene is not safe for the victim
## Footnote
Ensuring safety is paramount, but careful consideration of potential spinal injuries is necessary.
108
What is the risk-to-benefit ratio in scene safety?
Weighing the risks of moving the victim against the dangers of staying in the current location
## Footnote
This assessment is crucial in emergency situations.
109
What is the blood sweep?
A quick assessment to identify major bleeding and deformities
## Footnote
Effective for detecting both external and potential internal injuries.
110
Why is it important to look under layers of clothing during a blood sweep?
Blood can collect between layers, indicating hidden injuries
## Footnote
Comprehensive assessment includes examining all areas of the body.
111
What should you do if a patient is bleeding internally?
Evacuate them as quickly as possible
## Footnote
Internal bleeding is a critical condition that requires immediate medical attention.
112
True or False: You should not check the ground or street for blood during the blood sweep.
False
## Footnote
Checking the surroundings can provide additional information about the patient's condition.
113
What is a significant difference between wound management in the wilderness and urban settings?
Backcountry wounds are often dirty or may become dirty, and there is often a lack of first aid materials.
114
What is the first step in managing a wound after the primary survey?
Gain exposure to the injured area.
115
What is hemostasis?
Stopping the bleeding.
116
What does 'M' stand for in the MARCH protocol?
Massive hemorrhage.
117
What is the first step in stopping any blood loss?
Application of direct pressure.
118
What should you do if direct pressure does not stop the bleeding?
Use a tourniquet.
119
True or False: Elevation of the limb above the heart is often sufficient to stop bleeding.
False.
120
Where should a tourniquet be placed?
About two to four inches above the wound.
121
What should you mark on the patient's forehead after placing a tourniquet?
The time that you placed the tourniquet.
122
What is the most important intervention to prevent infection in wound management?
High-pressure irrigation.
123
What should be used to create a high-pressure stream of water for irrigation?
A catheter tip or a plastic bag with a small hole.
124
What should be done to visible foreign matter in a wound?
Remove it to minimize infection, inflammation, and discomfort.
125
What is the purpose of dressing a wound?
To protect wounds from the environment and help prevent infection.
126
Fill in the blank: If a commercial pad or dressing is not available, improvise using a _______.
4 x 4 pad covered in an antibiotic ointment.
127
What types of injuries require consideration for evacuation?
* Complex or mutilating wounds
* Grossly contaminated with penetrating debris
* Laceration of eyelid, ear or cartilage
* Penetration of bone, joint or tendon
* Bites of hands, legs or feet
* Amputations
128
What recent studies suggest about wound scabbing?
Keeping the wound environment moist promotes healing and reduces scar formation.
129
What should be done daily to keep a wound moist?
Apply Vaseline, honey, or a clean and moist dressing.
130
True or False: Wounds should be kept exposed to the air to promote healing.
False.
131
What should be done to wounds to minimize scab formation?
Rinse daily and inspect dressings.
132
What are the three rules for wound healing?
Keep them clean, keep them moist, keep them covered
133
What are the two courses of action for closing a laceration in the wilderness?
* Primary closure
* Delayed primary closure
134
What methods can be used for primary closure of a laceration?
* Sutures
* Staples
* Tape
* Skin glue
135
What is the advantage of primary closure compared to delayed primary closure?
Immediate treatment with better mobility and less pain
136
What is the main disadvantage of primary closure?
Higher risk of infection
137
What is used to achieve closure with steri-strips or tape?
Place steri-strips or tape over the wound and pull the wound together
138
Where are staples appropriate for use when closing wounds?
Anywhere except the face
139
What is skin glue used for?
Closing small and uncomplicated lacerations
140
What must be done to flexible parts of the body after applying skin glue?
Immobilize the joint with a splint
141
How are burn injuries classified?
* By Depth
* By Area
* Location on the body
142
What are the three depths of burns?
* Superficial
* Partial thickness
* Full thickness
143
What is a characteristic of superficial burns?
Skin can become red and painful
144
What treatment is recommended for superficial burns?
Aloe-vera gel and cool damp cloths
145
What should be avoided to prevent increased scar formation in superficial burns?
Leaving the wound to dry
146
What is the treatment for partial and full-thickness burns?
* Gently clean with cool water
* Trim away loose skin
* Apply antibacterial ointment
* Cover with a non-adhesive sterile dressing
147
What should not be applied directly to burns for more than 15 minutes?
Ice
148
What is the Rule of Nines used for?
To aid in decision making for evacuation based on total body surface area affected by burns
149
What percentage of body surface area does each arm represent in the Rule of Nines?
9%
150
What percentage of body surface area does each leg represent in the Rule of Nines?
18%
151
When should a burn victim be evacuated?
* Partial thickness burns greater than 10% body surface area
* Full thickness burns greater than 1% body surface area
* Burns involving the face, hands, feet, or genitals
* Electrical burns
* If the burn victim is medically ill
* Uncontrolled pain
* Burns complicated by smoke or heat inhalation
152
What is a blister?
A pocket of fluid between the upper layers of skin
## Footnote
Commonly develops from friction, freezing, or burns.
153
What are the common causes of blisters?
* Friction (e.g., from poorly fitting shoes)
* Freezing of the skin (frostbite)
* Burns
154
What is the purpose of a blister?
To protect and cushion the layers underneath the skin
155
What can blisters be filled with?
* Serum
* Plasma
* Blood
* Pus
156
What is a 'hot spot' in relation to blisters?
A sore spot that usually forms before a blister
157
What should you do if a small blister or hot spot forms?
Place a dual-layer pad over that area
158
What is Blist-o-ban?
A material used to address friction and shear forces on the skin
159
How does a dual-layer pad prevent blisters?
It allows the bandage to glide smoothly, deflecting friction and shear forces away from the skin
160
What is the key to preventing friction blisters on feet?
Reducing hot spots by properly breaking in boots and reducing moisture by wearing wool socks
161
How can you treat a blister that has already formed?
Cut a hole in the moleskin and place the ring around the blister
162
When should a blister be opened?
If it is 2 cm in diameter or larger, or if it has already ruptured
163
What is Medihoney?
A honey-based treatment used in wound care to prevent infection and speed healing
164
What are the benefits of using Manuka honey in wound care?
Contains methylglyoxal which helps fight a broader range of bacteria strains
165
What are some over-the-counter topical first aid antibiotics?
* Bacitracin
* Neomycin
* Polymyxin B sulfate
166
What is Silvadene Cream 1% used for?
As a topical antimicrobial drug for prevention and treatment of wounds and burns
167
What are the four components of a tooth?
* Enamel
* Dentin
* Cementum
* Pulp
168
What is the hardest substance in the body?
Enamel
169
What is the function of dentin?
Lies beneath enamel and cementum; makes up a significant portion of the tooth
170
What happens if the dentin tubules become exposed?
Teeth become very sensitive to cold and air
171
What is the function of cementum?
Covers the root of the tooth and is similar in hardness to bone
172
What does the pulp of a tooth contain?
Nerves and blood vessels that supply the tooth
173
What is pulpitis?
Inflammation of the pulp, primary cause of toothaches
174
What can cause inflammation of the pulp?
* Bacterial entry from tooth decay
* Trauma
* Fillings placed near the pulp
175
What symptoms indicate pulpitis?
* Sensitivity to heat or cold
* Pain after removal of stimulus
176
What are common symptoms of pulpitis?
Sensitivity or pain to stimuli such as cold, hot, sweets, or tapping
177
What initial treatment should be done for pulpitis?
Remove irritants or debris, usually by swishing the mouth with warm water
178
What medication can be given to reduce pain from pulpitis?
Ibuprofen
179
What should patients with pulpitis do after initial treatment?
See a dentist upon returning home
180
What should you do when a filling or crown falls out?
Remove debris and fill the hole with temporary filling material
181
What are the two products you can use for temporary fillings?
* Cavit
* IRM
182
What is a characteristic of Cavit?
Comes pre-mixed and hardens once placed in the mouth
183
What is the advantage of IRM?
Can be mixed to any desired consistency
184
What types of activities commonly lead to dental trauma?
* Mountain biking
* Skiing
* Climbing
* Rafting
185
What is a common symptom of a chipped tooth?
An obvious chip in the tooth, usually without pulp exposure
186
What is the treatment for a chipped tooth?
Pain management and smoothing sharp edges with temporary filling
187
What defines a tooth fracture?
A very large part of the tooth is broken with loose fragments present
188
What should be done for a fractured tooth?
Remove loose fragments and cover the tooth with a temporary filling
189
What happens when a tooth is knocked loose?
The tooth can reattach and become secure again over time
190
What should patients do if their tooth is knocked loose?
Eat soft foods and take Ibuprofen
191
What is the best immediate action if a tooth is knocked out?
Try to put the tooth back in its socket
192
What is the success rate of a replanted tooth if done within 20 minutes?
High rate of success
193
What should you not do when handling a knocked-out tooth?
* Scrub
* Scrape
* Disinfect
* Let the root surface dry out
194
What is the best solution to store a knocked-out tooth?
* Hank's Balanced Salt Solution
* Milk
195
How long can a tooth last in Hank's Balanced Salt Solution?
24 hours
196
How long can a tooth last in milk?
About 6 hours
197
What are some not so great solutions for tooth storage?
* Salt water
* Saliva
198
What is a poor solution for tooth storage?
* Water
* Sports drinks
199
Why is water not a good storage medium for a tooth?
Destroys the cells on the tooth
200
What is a common limitation of saliva as a storage medium?
Contains enzymes and bacteria that can damage a tooth over time
201
What types of injuries are most commonly associated with mountain biking?
Wounds and bruises
## Footnote
Wounds and bruises account for the highest percentage of injuries sustained while biking.
202
What percentage of mountain biking injuries are fractures?
4%
## Footnote
Fractures are among the less common types of injuries in mountain biking.
203
Which body parts are most commonly injured in mountain biking?
* Neck
* Knees
* Buttocks/Groin
* Upper Extremities
## Footnote
These areas are where bikers most frequently seek medical care.
204
What is the recommended safety gear for mountain bikers to prevent head injuries?
Helmet
## Footnote
Bikers should always wear a helmet, which should be checked for integrity after any impact.
205
What are the clinical findings that may indicate a skull fracture in head injury cases?
Clear liquid leaking from the ears or nose
## Footnote
This symptom constitutes a medical emergency.
206
What are the common signs of a concussion?
* Headache
* Slurred speech
* Vomiting
* Delayed speech
* Disorientation
* Memory deficits
* Intense emotions
* Vertigo
* Nausea
* Vacant stare
* Delayed motor responses
* Confusion
* Loss of consciousness
* Dizziness
## Footnote
These symptoms may vary based on the severity and location of the concussion.
207
What is Micro-Whiplash syndrome associated with?
Tail vibrations on the neck
## Footnote
This syndrome can occur over extended periods while biking.
208
What can help manage generalized neck and back pain from biking?
* Massaging
* Ice
* Stretching
* Non-sedating pain relievers
## Footnote
These methods can alleviate discomfort from micro-injuries.
209
What conditions can arise from improper saddle height in biking?
* Patellar tendonitis
* Quadriceps tendonitis
## Footnote
These conditions often present with patellar pain, swelling, and joint tenderness.
210
What symptoms can occur if the saddle is positioned too high?
* Saddle sores
* Chafing
## Footnote
These issues result in localized skin irritation.
211
How can saddle sores and chafing be prevented?
* Keeping the area clean and dry
* Wearing seamless shorts
## Footnote
These practices can help alleviate symptoms associated with saddle sores.
212
What is the recommended action if concussion symptoms worsen and last longer than 15 minutes?
Evacuate the patient
## Footnote
This is crucial in managing head injuries effectively.
213
True or False: Most fractures and dislocations in mountain biking occur in the lower extremities.
False
## Footnote
Most fractures and dislocations occur in the upper extremity.
214
Fill in the blank: The treatment of a concussion varies with the _______.
[severity]
## Footnote
Mild concussions often require monitoring, while severe cases may need intensive care.
215
What is the proper seat height for a bike rider?
The rider should sit on the seat with their heel on the pedal, and the leg on the pedal should be straight.
216
How should the seat angle be adjusted for male and female riders?
For males, the seat angle is generally slightly elevated in the back; for females, it is generally depressed in the back.
217
What is the recommended handlebar position relative to the saddle?
The handlebar should be positioned one to four inches below the level of the saddle.
218
What percentage of a rider's body weight should rest on the arms while riding?
About one third of the rider's body weight.
219
What adjustments can be made to handlebars during long rides?
The height and positioning of the handlebars can be adjusted to help with back and neck pain.
220
When did rock climbing begin as a distinct athletic activity?
In the last nineteenth century in Europe.
221
What is the origin of rock climbing according to recent research?
Rock climbing began in Africa millions of years ago with our primate ancestors.
222
What is the most common injury associated with rock climbing?
Falling is the most common injury.
223
How do climbing ropes help reduce the force felt by a climber during a fall?
Climbing ropes are dynamic and can stretch up to 30% of their length.
224
What happens when a climber passes their leg in front of the rope during a fall?
The rope can grab their leg and flip them upside down, potentially causing head or neck impact.
225
What is the most dangerous moment for a climber?
The transition to descending after reaching the top of a route.
226
What critical mistake can lead to climbing deaths during descent?
Thinking they are secured to their second system and falling the full length of the route.
227
What can happen to a belayer during a fall?
The belayer can be slammed into the wall by a falling climber due to a lack of slack.
228
What types of injuries can occur to belayers?
Traumatic injuries including sprained and broken ankles and arms.
229
What can happen to climbers if their belayer is injured or killed?
Climbers can become stranded.
230
Fill in the blank: Rock climbing has been around for a very long time, with evidence of it dating back to the ______ century.
231
True or False: Helmets worn while climbing can help reduce the risk of severe spinal traumas and concussions.
232
What type of injuries are common in climbing?
Overuse injuries
## Footnote
These injuries often occur from overloading tendons, joints, and muscles.
233
What are the five pulleys in the fingers named?
A1, A2, A3, A4, A5
## Footnote
A1, A3, and A5 are considered minor pulleys, while A2 and A4 are major pulleys.
234
What is the primary function of the finger pulleys?
To prevent 'bowstringing'
## Footnote
Pulleys hold tendons tightly to the bones.
235
Which pulley is most commonly injured in climbers?
A2 pulley
## Footnote
The A2 pulley is often cited as the most injured pulley that presents to clinicians.
236
What is the basic mechanism for flexor tendon pulley injury?
Force applied above what the pulley can tolerate
## Footnote
This often occurs when using the 'crimp grip'.
237
What is a recommended prevention method for pulley injuries?
Gentle climbing and focus on good technique
## Footnote
Climbers should prioritize using their feet for upward progress.
238
What is the first step in healing a finger pulley injury?
Applying ice and taking an anti-inflammatory
## Footnote
Time off climbing is necessary until healing occurs.
239
What materials are most rock climbing shoes made of?
Leather uppers with rubber toe and heel caps
## Footnote
The rubber is specially formulated to improve friction.
240
Why do climbers wear climbing shoes several sizes smaller than street shoes?
To improve performance on different terrain
## Footnote
Features include downturned toes and stiff toe boxes.
241
What is suspension trauma?
A condition where blood pools in the legs while in a harness
## Footnote
It can lead to lightheadedness or passing out.
242
What are the symptoms of suspension trauma?
Lightheadedness and ultimately passing out
## Footnote
Symptoms can occur after over an hour of suspension, or within 5-10 minutes in 20% of cases.
243
What is the highest priority for field care of a suspension trauma patient?
Urgent evacuation to the ground
## Footnote
This is crucial as the condition can be life-threatening.
244
How many bones are in each foot?
28 bones
## Footnote
This represents nearly one-fourth of all the bones in the entire body.
245
What is the role of the big toe during hiking?
Grips the feet to the walking surface
## Footnote
The big toe carries part of the body weight with each step but no weight rests on it when standing.
246
How many arches does the foot have, and what is their purpose?
Three arches designed to act like springs
## Footnote
They aid in propulsion, store energy, and absorb shock.
247
What issues can arise from having low arches or flat feet?
Heel pain, arch pain, plantar fasciitis
## Footnote
A person may walk with their feet rotated incorrectly.
248
What problems can high arches cause?
Excessive pressure on the back part and forefoot areas
## Footnote
This can lead to heel pain and plantar fasciitis.
249
What should be done with useless shoe inserts?
Remove them and replace with proper arch supports
## Footnote
Arch supports are a less expensive alternative to new shoes.
250
What is the significance of activity-specific shoes?
They are designed for different movements
## Footnote
Running shoes for forward motion and basketball shoes for side-to-side movements.
251
What can happen if the wrong shoes are used for outdoor support?
Knee, hip, and back pain
## Footnote
Old and worn-out shoes can lead to awkward foot strikes.
252
How often should daily shoes be replaced?
Every six months at most
## Footnote
Monitor soles and replace or resole when support is low.
253
What is the proper fit for hiking shoes?
Half-inch space between longest toe and front of shoe
## Footnote
Also, the index finger should fit between shoe and foot with little force.
254
What is the importance of clipping toenails before a hike?
Prevents trauma to the nails
## Footnote
Long nails can be pushed into by shoes, causing blood to form under them.
255
Is it better to wear one sock or two while hiking?
It comes down to personal preference
## Footnote
Both approaches can protect your feet if appropriate socks are used.
256
What is the purpose of a thin, moisture-wicking synthetic sock?
Reduces friction and wicks moisture away from the foot
## Footnote
It is typically worn under an outer sock.
257
What materials are commonly found in hiking socks?
A blend of fabrics for comfort, warmth, durability, and fast drying
## Footnote
Hiking socks are rarely made from a single fabric.
258
What is the most popular material for hiking socks?
Wool
## Footnote
Wool is recommended above all other materials for hiking socks.
259
What materials are commonly blended with wool in hiking socks?
* Synthetic materials
* Polyester
* Nylon
* Spandex
## Footnote
Blending improves durability and drying speed.
260
What are the properties of polyester as a sock material?
Insulates, wicks moisture, and dries quickly
## Footnote
Polyester is a synthetic material.
261
What is the role of nylon in hiking socks?
Adds durability and improves drying times
## Footnote
Nylon is occasionally used as the primary material.
262
What are the characteristics of silk as a sock material?
Natural insulator, comfortable, lightweight, but not very durable
## Footnote
Silk is occasionally used in sock liners.
263
What is the purpose of adding spandex to hiking socks?
Helps socks hold their shape and minimizes bunching and wrinkling
## Footnote
Spandex is included in small percentages.
264
What type of socks should be avoided for hiking?
100% cotton socks
## Footnote
Cotton absorbs sweat and dries very slowly.
265
What is a blister?
A pocket of fluid between the upper layers of skin, under the epidermis
## Footnote
Blisters commonly develop on the feet during hiking.
266
What causes blisters to form?
Friction between the shoe and foot
## Footnote
Friction can be caused by the force of the shoe and the interaction of skin and sock.
267
What is a 'hot spot' in the context of blisters?
A sore spot where blisters usually begin to form
## Footnote
Identifying hot spots early can help prevent full-blown blisters.
268
What material can be placed over a hot spot to prevent blisters?
Dual-layer pads, such as Blist-o-ban
## Footnote
These pads help reduce friction and pressure.
269
How should a blister that has already formed be treated?
Cut a hole in moleskin or duct tape and place it around the blister
## Footnote
This reduces pressure and pain on the blister.
270
When is it appropriate to open a blister?
If the blister is 2 cm in diameter or larger
## Footnote
Opening smaller blisters is generally not recommended.
271
What are the three ways heat moves from the body?
* Radiation
* Conduction
* Convection
## Footnote
These methods describe how heat is lost to the environment.
272
What is the normal human body temperature?
Around 98.6°F (37°C)
## Footnote
This temperature is crucial for understanding heat loss.
273
What is the best conductor of heat?
Water
## Footnote
Water conducts heat away from the body effectively.
274
What is the purpose of layering clothing for heat retention?
Traps body heat in dead air space and wicks moisture away
## Footnote
Layering prevents conductive and convective heat loss.
275
What is the function of the base layer in clothing?
Moves or 'wicks' water away from the skin
## Footnote
The base layer is essential for moisture management.
276
What is the purpose of the base layer in clothing?
To wick sweat away to keep you dry
## Footnote
This includes socks, underwear, and an initial pant/shirt base layer if in colder conditions.
277
What is the function of the middle layer in clothing?
To retain body heat by creating 'dead air'
## Footnote
This can include clothing such as shirts and pants.
278
What is the role of the outer layer in clothing?
To act as a water- or wind-resistant barrier
## Footnote
This layer helps prevent convection loss of heat.
279
Why is it prudent to pack multiple layers of clothing?
To adapt to changing weather conditions
## Footnote
You can peel off layers to cool down or add layers if it gets colder.
280
What is a key characteristic of loose-fitting clothing in hot environments?
It facilitates ventilation by moving heat away from the body
281
What is one of the primary benefits of wool as a fabric choice?
It is an excellent insulator and maintains insulation even when wet
## Footnote
Merino wool can hold 30% of its weight in water absorption without feeling wet.
282
What makes ultra-fine merino wool a preferred choice?
It is itch-free, naturally breathable, moisture-wicking, and fast-drying
283
What are the advantages of synthetic fabrics like fleece?
Quick-drying, durable, and affordable
## Footnote
Synthetics have 3D patterns that imitate wool.
284
What is 'down' in the context of insulation?
The under plumage found beneath the feathers of ducks and geese
## Footnote
Down provides natural insulation.
285
What does the fill rating of down insulation indicate?
The amount of goose down added to the coat or sleeping bag
## Footnote
Higher numbers indicate more insulation and warmth.
286
What is a significant drawback of down insulation when wet?
It clumps and loses its ability to create dead air space
287
What are the characteristics of silk as a fabric?
Soft, thin, and light; good for cool weather
## Footnote
Silk does not wick moisture as well as wool or synthetics.
288
Why is cotton considered a poor choice for outdoor activities?
It does not wick moisture effectively and does not dry quickly
## Footnote
Wet cotton can lead to hypothermia.
289
What is the phrase used to describe the dangers of cotton in outdoor activities?
'Cotton kills'
290
What are synthetic fibers primarily made from?
Chemicals created to produce fabrics like polyester, rayon, and acrylic
291
What are some advantages of synthetic fibers?
Resistant to insects and fungus, cheaper to produce, and create dead space
292
What is a serious drawback of synthetic fibers?
They will melt and have little to no ability to absorb water
293
Why are synthetic clothes considered ideal in wet environments?
They always insulate, even when wet
294
What are the disadvantages of synthetic clothing for hiking?
They are heavy and do not pack well
295
What is Quallofil used for?
Sleeping bags and insulated jackets
296
What are the drawbacks of Quallofil?
It is heavy and bulky
297
What is PolarGuard known for?
It is considered the 'premiere' synthetic insulation
298
What improvements have been made to PolarGuard?
Less bulky and improved insulating abilities by around 10%
299
What are super thin fibers used for in clothing?
They create dead air space and more insulation
300
Name two examples of super thin fibers.
Primaloft and Thinsulate
301
What is the purpose of the Base layer in clothing?
To wick sweat away and keep you dry
302
What are examples of high-performance fabrics used for the Base layer?
* Wool
* Synthetic
* Silk
303
What is the function of the Middle layer?
To retain body heat
304
What materials are popular choices for the Middle layer?
* Wool
* Down
* Fleece
* Synthetics with high-loft options
305
What are some suitable options for wet weather in the Middle layer?
Synthetic pile or fleece options
306
What is the role of the Outer layer?
To serve as a water- or wind-resistant barrier
307
What features should an Outer layer have for wet conditions?
* Waterproof
* Sealed seams
* Zipper guards
* Cinch-able hoods
308
What is a good rule of thumb for the Mid-layer in colder weather?
Plan on wearing a synthetic as your go-to and pack an extra down jacket
309
What should you remember about dressing for the outdoors?
What you wear keeps you safe against the elements
310
Fill in the blank: There is no bad weather, only bad _______.
clothing
311
What has caused a 50 percent decrease in skiing related injuries since the 1970s?
Improvement of equipment with safety release bindings and hard-shell boots that allow for better control
312
What type of injuries have increased despite improvements in skiing equipment?
Soft tissue injuries
313
What percentage of downhill skiing accidents are due to improper equipment maintenance?
Nearly 50 percent
314
What is the primary cause of 70 percent of lower leg fractures and knee injuries while skiing?
Improper binding release
315
What is the most common type of injury among skiers?
Soft tissue knee injuries
316
Why are beginner skiers particularly susceptible to medial collateral ligament (MCL) injuries?
They are taught to use the 'snowplow' or 'wedge' technique, which can put stress on the MCL
317
What should be done if a knee injury is suspected while skiing?
Immobilize the knee with a splint and take the patient off the hill
318
What is the role of the anterior cruciate ligament (ACL) in the knee?
To prevent backward motion of the femur on the tibia and hyperextension at the knee
319
What is a common symptom reported by skiers who suffer an ACL injury?
Hearing an audible 'pop' or 'snap' prior to the knee giving out
320
What is a 'boot top' fracture?
A fracture that typically occurs at the top of the ski boot due to its hard shell providing support
321
What is the most common upper extremity injury among skiers?
Skier's thumb injury
322
How does a skier's thumb injury typically occur?
When the skier falls on their ski pole or the thumb catches snow during a fall
323
What are the symptoms of skier's thumb injury?
Tenderness in the area with deep throbbing pain
324
What is the potential severity of head injuries in skiing?
They can cause a bleed in the brain
325
What can cause an MCL tear while skiing?
The impact caused by one leg falling on another
326
What is the common outcome of an ACL injury?
Popping sound during injury and potential knee instability
327
What type of injuries may occur due to a fall affecting the shoulder?
Injuries to ligaments, muscles, and tendons
328
What is the instinctual action that can lead to wrist injuries while skiing?
Reaching out a hand for support during a fall
329
What is skier's thumb?
An acute injury that occurs when falling with your hand in the ski pole strap, causing a ligament tear
330
Fill in the blank: The most injured structure of the knee is the _______.
anterior cruciate ligament (ACL)
331
True or False: Most other skiing injuries are less severe than head injuries.
True
332
What is a boot top fracture?
Fracture of the tibia and/or fibula above the top of the boot.
## Footnote
These fractures almost always require surgical intervention due to high non-union rates.
333
What is the significance of helmet use in skiing?
Helmets offer limited protection beyond 12 mph and can create a false sense of security.
## Footnote
This may lead to reckless behaviors among skiers.
334
What should be suspected when assisting a patient who has fallen?
A head injury and common signs of concussions.
## Footnote
Vigilance is necessary to identify these injuries.
335
What is a toe side fall in snowboarding?
A fall where the snowboarder falls face forward toward the ground.
## Footnote
This can lead to clavicular fractures, shoulder separations, and head injuries.
336
What injuries can occur from a toe side fall in snowboarding?
Clavicular fractures, shoulder separations, facial injuries, and head injuries.
## Footnote
If the snowboarder braces for the fall, it can result in severe wrist or humeral fractures.
337
What is the most common wrist fracture seen among snowboarders?
'Dinner fork' fracture.
## Footnote
This term describes the characteristic appearance of the fracture.
338
What is the impact of wrist guards in snowboarding?
They prevent wrist injuries but may transfer forces to proximal joints, causing forearm fractures and shoulder injuries.
## Footnote
Wrist guards are common protective equipment for snowboarders.
339
What is a heel side fall in snowboarding?
A fall where the snowboarder falls backward toward the ground.
## Footnote
This can lead to buttock contusions, spinal compressions, and head injuries.
340
What percentage of drowning victims are male?
Nearly 80%.
## Footnote
This statistic highlights a gender disparity in drowning occurrences.
341
What role do drugs and alcohol play in drowning incidents?
They are involved in half of adolescent and adult deaths associated with water recreation.
## Footnote
Substance use significantly increases the risk of drowning.
342
What is the leading cause of drowning deaths related to boating?
Failure to wear a personal flotation device (PFD).
## Footnote
This accounts for 88% of drowning deaths while boating.
343
What happens to the lungs during drowning?
Victims inhale water, causing pulmonary damage and hypoxemia, leading to secondary organ damage.
## Footnote
The heart becomes ischemic, and neurological injury can result.
344
What are common heart issues following drowning?
Heart arrhythmias, or irregular heartbeats.
## Footnote
These are typically secondary to severe hypoxemia.
345
What is hypoxia?
A lack of oxygen that causes injury and inflammation in the brain, potentially leading to cerebral edema.
## Footnote
Oxygenation is crucial in managing submersion injuries.
346
How does drowning behavior appear to untrained observers?
It can look like calm, safe behavior.
## Footnote
Drowning itself is quick and silent, often preceded by distress that may not be obvious.
347
What is the instinctive drowning response?
A set of autonomic reactions occurring in the 20 to 60 seconds before sinking underwater.
## Footnote
Trained rescuers learn to recognize these movements.
348
What should a rescuer use to approach a drowning victim?
A buoyant object or approach from behind
## Footnote
This helps prevent the victim from submerging the rescuer.
349
What is the recommended technique if a rescuer is pushed underwater by a drowning victim?
Dive downwards to escape the victim
## Footnote
This technique allows the rescuer to avoid being held down.
350
What is the first priority after rescuing a drowning victim?
Transport the victim to the water's edge
## Footnote
This prepares the victim for removal from the water.
351
How should a cooperative drowning victim be towed?
Held at the armpits
## Footnote
This method allows for better control and safety.
352
How should an unconscious drowning victim be towed?
Held at the chin and cheeks
## Footnote
This ensures the mouth and nose are above water.
353
What is the primary issue drowning causes?
An oxygenation problem
## Footnote
Drowning primarily affects the ability to breathe.
354
What does the European Resuscitation Council recommend for rescue breaths during CPR for drowning victims?
Five rescue breaths instead of two
## Footnote
This increases the likelihood of reviving the patient.
355
What is more important than post-submersion actions?
Prevention
## Footnote
Preventative measures can avoid drowning incidents altogether.
356
What should be avoided while participating in water activities?
Alcohol
## Footnote
Alcohol impairs judgment and increases drowning risk.
357
What safety equipment should everyone on a boat wear?
Approved personal flotation devices
## Footnote
These devices help keep the person's head above water.
358
How many thunderstorms occur worldwide each day?
Approximately 50,000
## Footnote
Thunderstorms are a common global phenomenon.
359
How many people are estimated to be killed by lightning worldwide each year?
About 2,000
## Footnote
This figure is an estimate by National Geographic.
360
Which region in the United States is most prone to lightning?
Florida
## Footnote
Florida experiences a high frequency of thunderstorms.
361
What is the temperature reached by the heat of a lightning strike?
Around 27,000 C° (48,632 F°)
## Footnote
This extreme heat contributes to the formation of thunder.
362
What phenomenon is created by the rapid expansion of compressed air from a lightning strike?
Thunder
## Footnote
The shock wave produced results in the loud noise associated with lightning.
363
Where do most lightning deaths occur?
Open fields, sport parks, in/on water, under trees, on beaches, working on farm equipment
## Footnote
These locations are particularly dangerous during thunderstorms.
364
Fill in the blank: Lightning strikes the earth more than ______ times each second.
100
## Footnote
This statistic emphasizes the frequency of lightning activity.
365
What is positive lightning?
Lightning that originates from the top of a thunderstorm, which carries a large positive charge.
366
Why is positive lightning particularly dangerous?
It frequently strikes away from the rain core, usually ahead of the thunderstorm, striking areas considered low risk.
367
What is the recommended action before a storm strikes?
Get to shelter.
368
What is ground current?
Electricity that spreads out in the ground after a lightning strike, potentially causing injury.
369
What is side splash in the context of lightning injuries?
Lightning that jumps from an object to a person or from one person to another.
370
What are upward streamers?
High objects and the ground that produce leaders rising just prior to lightning strikes.
371
What is a direct strike?
Lightning that hits someone directly from the sky.
372
What are contact strikes?
Lightning that enters a person through wiring or water pipes.
373
What is blunt trauma in relation to lightning injuries?
Injuries caused by the concussive force of the lightning strike or being thrown by muscular contraction.
374
What percentage of lightning deaths are caused by ground current?
50-55%.
375
What is the most common cause of death in lightning strikes?
Cardiopulmonary arrest.
376
What should be done for a person in respiratory arrest after a lightning strike?
They may need only artificial respiration to prevent secondary hypoxic arrest.
377
What is the MARCH protocol?
A guideline to follow in emergencies, particularly for lightning strike victims.
378
What should you do if you hear thunder?
Seek shelter indoors.
379
What are some tips to reduce lightning strike risk outdoors?
* Avoid open fields
* Stay away from tall, isolated trees
* Spread out in groups
* Set up camp in low areas
* Stay away from water and metal objects
380
True or False: A tent offers protection from lightning.
False.
381
What is flashover in the context of lightning strikes?
The electrical current flowing on the outside of the body after a lightning strike.
382
What can happen to the electrical current during a lightning strike?
It may enter the body through cranial orifices and flow through the body.
383
What is the potential distance lightning can strike from a thunderstorm?
Up to 5 or 10 miles (8 or 16 kilometers).
384
Fill in the blank: The current from a lightning flash will easily travel for _______.
long distances.
385
What offers the best protection from lightning?
A house or other substantial building
## Footnote
People should stay away from windows and doors and avoid contact with anything that conducts electricity.
386
What should you do if you see lightning or hear thunder?
Go indoors
## Footnote
Wait at least 30 minutes after the last clap of thunder before leaving shelter.
387
Do rubber tires protect you from lightning?
No
## Footnote
Lightning flows around the outside of a car, not through the rubber tires.
388
What is the primary factor in avalanche survival?
The amount of time someone is buried in the snow
## Footnote
Asphyxiation is the predominant mechanism of death among avalanche victims.
389
What are the four elements required for an avalanche to occur?
1. A slab of snow
2. A weak layer of snow
3. A trigger (like new snow)
4. A slope angle steep enough for snow to slide, generally between 25-55 degrees
## Footnote
Slope angle should be one of the first considerations when traveling in the backcountry.
390
What is the second-largest cause of natural avalanches?
Changes in the snowpack, such as melting due to the sun
## Footnote
Most avalanches occur spontaneously during storms with increased snowfall.
391
True or False: Avalanches can be triggered by loud sounds.
False
## Footnote
Contrary to popular belief, avalanches are not triggered by loud sounds.
392
What group accounts for the largest number of backcountry users killed in avalanches?
Snowmobilers
## Footnote
Human factors contribute to nearly all avalanche accidents.
393
What speeds can avalanches reach in less than 10 seconds?
Up to 100 mph
## Footnote
Trauma is also a cause of death and injury for avalanche victims.
394
Fill in the blank: To be truly safe from an avalanche, a person needs to take an _______.
[avalanche safety course]
## Footnote
Understanding avalanches is critical in wilderness medicine.
395
What has dramatically increased over the past two decades regarding avalanches?
Injury and death rates
## Footnote
This increase is largely due to human factors.
396
What is a rare cause of death among avalanche victims?
Hypothermia
## Footnote
Asphyxiation is the predominant cause of death.
397
What is the role of slope angle in avalanches?
It is a primary factor in every avalanche
## Footnote
Generally, a slope angle between 25-55 degrees is steep enough for snow to slide.
398
What percentage of avalanche victims sustain significant blunt trauma?
As many as one-third
## Footnote
Trauma is a significant cause of death and injury in avalanches.
399
What is the typical range of slope angles where avalanches commonly occur?
36-38 degrees
## Footnote
Not all avalanches start on slopes with these precise angles.
400
What is remote triggering in the context of avalanches?
Triggering a slide from below on a gentle slope connected to a steeper slope
## Footnote
This is common in avalanche run-out zones.
401
What is the recommended practice when crossing avalanche run-out zones?
Cross one at a time and keep a watchful eye on one another.
402
What percentage of avalanche victims have massive trauma as the primary cause of death?
About one-fourth.
403
What types of injuries are commonly sustained by avalanche victims?
* Spinal fractures
* Long bone fractures
* Blunt abdominal trauma
* Head injuries
404
How does air pressure under an avalanche compare to atmospheric pressure?
Higher than atmospheric pressure.
405
What is the survival rate for avalanche victims rescued within 18 minutes?
Higher than 91%.
406
What happens to the survival rate for avalanche victims buried between 19 and 35 minutes?
Drops to 34%.
407
What are the two reasons air pockets fail for avalanche victims?
* Heat from expired air causes ice to form around the mouth
* Re-breathing expired air leads to carbon dioxide inhalation and asphyxiation.
408
What are critical rules to follow when traveling on snow terrain?
* Never go directly above any member of your party
* Avoid gullies and narrow valleys
* Travel on ridgelines or in dense forest
* Cross exposed areas one person at a time
* Look for 'red flags' like collapsing or cracking snow
* Start on low angle slopes less than 25°
* Call the Forest Service for current snow conditions
* Carry avalanche rescue equipment.
409
What should survivors do if an avalanche is witnessed?
Maintain sight of the victim and make a mental note of their last seen area.
410
What are the basic avalanche survival and rescue equipment?
* Transceivers (beacons)
* Shovels
* Probes
411
What is the 'golden eighteen minutes' in avalanche rescue?
The critical time frame after burial within which a victim can be found.
412
What should rescuers do with their transceivers when searching for a buried victim?
Switch from 'send' to 'receive' mode.
413
What is the primary focus of care for avalanche victims?
The MARCH protocol.
414
What environmental condition can accelerate core body cooling after an avalanche burial?
Exposure to wind.
415
Fill in the blank: Most injuries can be avoided by good decision making, minimizing risk by traveling wisely with good techniques, and avoiding _______ terrain.
[high-risk]
416
What is the primary goal to avoid in avalanche scenarios?
To never be in an avalanche.
417
What do avalanche airbags do?
Help a person avoid being buried by making them a larger object, forcing them toward the surface.
418
What principle do avalanche airbags work on?
Inverse granular convection.
419
How do avalanches behave?
Like granular materials, fluid-like, where smaller particles settle and larger particles rise.
420
What is the effect of deploying an avalanche airbag correctly?
Significantly reduced chances of complete burial.
421
What is the purpose of the Avalung device?
To help victims breathe during avalanche burial by drawing breath over a large surface area.
422
What happens to a victim's breath during an avalanche burial?
Snow melts from the heat of the breath and refreezes, blocking oxygen flow and allowing CO2 to accumulate.
423
What tragic event occurred in September 2015 in Zion National Park?
A flash flood killed seven highly trained canyoners.
424
What warning did the canyoners ignore before the flash flood?
A moderate level warning of flooding from the National Weather Service.
425
What is a flash flood?
A flood that begins within six hours of heavy rainfall.
426
What is the second leading cause of natural disaster-related deaths in the U.S.?
Flash flooding.
427
How many deaths occur annually due to flash floods in the U.S.?
Approximately 100 deaths.
428
Where can flash floods occur?
Anytime and anywhere, not just wilderness areas.
429
What factors influence the formation of flash floods?
Weather conditions, topography, and soil conditions.
430
Why are arid deserts particularly susceptible to flash floods?
Due to impermeable clay-like soil, funneling effects of slot canyons, and infrequency of storms.
431
What can happen when adventurers are in the backcountry during a flash flood?
They may see blue skies while it rains heavily miles away.
432
What color is the head of a flash flood often described as?
Dark brown due to debris, dirt, and rock.
433
What does the head of a flash flood do?
Acts as a 'moving dam' and can slow down speed, causing water to back up.
434
True or False: A small flood can knock a person over.
True.
435
What percentage of flood-related fatalities in the U.S. occur in vehicles?
More than half
## Footnote
This highlights the dangers of being in a vehicle during a flood.
436
What happens to most vehicles when submerged in six inches of water?
Lose complete control
## Footnote
Most vehicles begin to float in a foot of water.
437
What should you do if your vehicle becomes surrounded by water?
Abandon your vehicle and seek higher ground
## Footnote
This is crucial for safety during a flood.
438
What types of debris can floodwaters carry?
Trees and boulders
## Footnote
This debris can harm or kill anyone in its path.
439
What is the recommended action if caught in a flood?
Seek higher ground immediately
## Footnote
This is vital to avoid injury or death.
440
What is the best way to prevent flood-related injuries?
Prevention through planning and exercising caution
## Footnote
Being aware of flooding potential is essential.
441
What does 'turn around, don't drown' (TADD) mean?
A warning to avoid driving through flooded areas
## Footnote
This phrase emphasizes the dangers of floodwaters.
442
What is the average normal human body temperature?
98.6°F (37°C)
## Footnote
This is critical in understanding heat-related illnesses.
443
What is hyperthermia?
A rise in core temperature above 98.6°F (37°C)
## Footnote
Occurs when the body can't divest excess heat.
444
What are the three ways the body loses heat?
1. Radiation
2. Conduction
3. Convection
## Footnote
Each method has specific conditions for effectiveness.
445
What is conduction in the context of body heat loss?
Heat loss when the body is in contact with a cooler object
## Footnote
Significant when in contact with snow, ice, or cold water.
446
What is convection in heat loss?
Heat transfer through circulating air currents
## Footnote
It explains why we feel cooler in the wind.
447
How does evaporation contribute to heat loss?
Utilizes radiation, conduction, and convection
## Footnote
This occurs through sweating and can happen with wet clothes.
448
What happens when air temperatures rise in relation to body heat loss?
Radiation no longer works; the body relies on convection and conduction
## Footnote
This can lead to increased body temperature.
449
What is the illness that occurs when the body cannot transfer heat fast enough?
Hyperthermia
## Footnote
It can lead to serious health issues.
450
What is hyperthermia?
A condition that occurs when the body temperature rises significantly due to various factors
451
What medical conditions increase the risk of developing hyperthermia?
Conditions that prevent heat from leaving the body, such as dehydration, vomiting, diarrhea, and obesity
452
Name environmental factors that can increase the risk of hyperthermia.
* Exercising in a hot climate
* Lack of air conditioning
* Inappropriate clothing
* Decreased fluid intake
* Being inside a hot tent or car
* Sitting in a hot tub
453
What is the first physiological response to heat stress?
Skin turning red due to vasodilation and increased blood flow to the skin
454
What happens to the heart during heat stress?
Heart rate and cardiac output increase to facilitate heat transfer to the environment
455
What are the clinical manifestations of heat injury?
Heat cramps, heat syncope, heat exhaustion, and heat stroke
456
What causes heat cramps?
Loss of salt in the body, typically from fluid loss replaced by a fluid solution without enough salt
457
What is the key treatment for heat cramps?
Replace lost salt through salty snacks and electrolyte drinks
458
True or False: A lack of potassium causes heat cramps.
False
459
What is heat syncope?
Fainting due to dehydration, dilation of blood vessels, and pooling of blood in the legs
460
What populations are most affected by heat syncope?
* Non-acclimatized individuals
* Geriatric demographic
461
What should be done for initial treatment of heat syncope?
Lie the patient flat and elevate their feet
462
What is heat exhaustion?
A form of heat illness characterized by significant water and salt loss
463
List symptoms of heat exhaustion.
* Weakness
* Fatigue
* Nausea
* Vomiting
* Headache
* Thirst
464
What are some signs that heat exhaustion is progressing to heat stroke?
* Elevated body temperature
* Altered mental status
* Fast heart and breathing rate
* Profuse sweating
* Orthostatic hypotension
465
What is the treatment for heat exhaustion?
Give water and electrolytes, stop activities, and move to a cool area
466
What defines heat stroke?
Severe hyperthermia (≥ 40° C), neurological problems, and loss of sweating
467
What are neurological abnormalities associated with heat stroke?
* Stumbling gait
* Irritability
* Confusion
* Seizures
* Hallucinations
* Coma
468
Fill in the blank: Heat stroke is a _______ medical emergency.
[true]
469
What is the primary method of treatment for heatstroke?
Active cooling through immersion in cold water or pouring cool water on the victim
## Footnote
Active cooling is crucial for rapid temperature reduction in heatstroke victims
470
How does cold-water immersion compare to evaporative cooling?
Cold-water immersion reduces body temperature twice as fast as evaporative cooling
## Footnote
This method has been shown to be safe in young, healthy heatstroke victims
471
What should be done if immersion in cold water is not possible?
Pour cool/cold water on the victim and keep their skin 'sopping wet'
## Footnote
Continuous fanning promotes evaporation and further cooling
472
Where should ice packs and cold compresses be applied on a heatstroke victim?
In areas where large arteries run, such as:
* Groin
* Armpit
* Neck
## Footnote
This helps in rapid cooling of the body
473
What are the evacuation guidelines for heat-related conditions?
Evacuate if:
* Loss of consciousness
* More than one episode of syncope
* Signs of heatstroke
* Severe heat cramps not responding to salt solutions
## Footnote
Heat exhaustion does not require evacuation if treated effectively in the field
474
What is the most significant risk factor for developing heat-related injuries?
Dehydration
## Footnote
Dehydration is linked to most risk factors for heat-related illnesses
475
What environmental conditions inhibit the body's ability to lose heat?
High humidity
## Footnote
It reduces the effectiveness of sweating and evaporation
476
What is the recommended duration for adults to acclimatize to hot environments?
7-10 days
## Footnote
This gradual increase in activity helps improve heat coping mechanisms
477
How long do children and the elderly require to maximize acclimatization?
10-14 days
## Footnote
They need more time to adjust to heat exposure compared to adults
478
What should rehydration include to maintain proper balance in the body?
A combination of water and electrolytes
## Footnote
Too much water without electrolytes can lead to low sodium levels and neurological damage
479
What is a reliable way to gauge hydration status?
The color of urine
## Footnote
Consistently clear urine indicates proper hydration
480
What is the goal of hydration in preventing heat illness?
To avoid the onset of heat illness altogether
## Footnote
Early signs of dehydration should be addressed before headaches or heat illness develop
481
What type of clothing is recommended to prevent heat-related illness?
Loose-fitting clothing
## Footnote
It promotes airflow and facilitates evaporative cooling
482
What type of clothing should be avoided to minimize heat absorption?
Dark-colored clothing
## Footnote
It absorbs light and increases body temperature
483
Fill in the blank: The onset of a headache is often the beginning of _______.
heat illness
## Footnote
Recognizing this early can help prevent more serious conditions
484
True or False: Tight-fitting clothing helps in the effective cooling of the body.
False
## Footnote
Tight-fitting clothing restricts airflow needed for evaporation
485
What is an effective method of cooling besides immersion?
Dousing often in cooling fluids or misting sprays
## Footnote
These methods can help reduce body temperature effectively
486
What is hypothermia most often associated with?
Prolonged exposure to cold winter activities such as skiing, snowshoeing, and mountaineering
## Footnote
Hypothermia can also result from immersion accidents and can occur during hot summer months.
487
Which groups of people are particularly susceptible to hypothermia?
The elderly and young babies
## Footnote
They have a challenging time with thermoregulation.
488
What are the three methods of heat loss from the body?
* Radiation
* Conduction
* Convection
## Footnote
Evaporation is a process that utilizes all three methods of heat transfer.
489
What temperature defines the onset of hypothermia?
A core body temperature of 35°C (95°F) or less.
490
What occurs during radiation heat loss?
Heat loss occurs whenever the air temperature surrounding the body is less than 20°C (68°F).
491
How does conduction heat loss occur?
When the body is in contact with any object that is cooler than we are.
492
What is convection heat loss?
Heat is transferred away from the body through circulating air currents.
493
What is the primary physiological response when the body begins to lose heat?
Shivering utilizes muscle activity to produce heat.
494
What is vasoconstriction?
The narrowing of blood vessels to prevent blood from reaching the skin.
495
What is 'paradoxical undressing'?
The phenomenon where hypothermic individuals take off their clothes despite being cold.
496
What characterizes mild hypothermia?
A core temperature ranging from 32° to 35° C (89.6-95°F) with shivering and confusion.
497
What are the vital signs like in moderate hypothermia?
Blood pressure, heart rate, and respiratory rate decrease.
498
What core temperature range defines severe hypothermia?
Between 24°C and 28°C (75.2-82.4°F).
499
What happens to the body at a core temperature below 24°C?
Profound hypothermia occurs with little chance of survival.
500
Fill in the blank: Heat is lost from the body through _______.
radiation, conduction, convection, and evaporation.
501
True or False: Cold-related injuries can occur in above-sub-zero temperatures.
True.
502
What is the most important aspect of preventing hypothermia?
Adequate preparation.
503
What happens to shivering at a core temperature of 30°C?
Shivering ceases.
504
What are the symptoms of mild hypothermia?
* Turning blue
* Sensation of cold
* Uncontrollable shivering
* Impaired mental status
## Footnote
Varying degrees of confusion and disorientation may occur.
505
What is the perception of temperature closely linked to?
Skin temperature rather than core temperature.
506
What should be considered when seeking shelter to limit heat loss?
* Areas that are dry (conduction)
* Insulated (radiation)
* Out of the wind (convection)
* No direct contact with ice and snow (conduction)
507
What are the four stages of hypothermia?
Mild, Moderate, Severe, Profound
508
What are the clinical symptoms of mild hypothermia?
Conscious, shivering
509
What is the typical core temperature range for moderate hypothermia?
28 to 32°C (82 to 90°F)
510
What is the treatment priority for hypothermia in the field?
Preventing further heat loss
511
What should be done first when treating a victim of hypothermia?
Remove the victim from the situation that caused them to become cold
512
List the three methods of heat loss that need to be prevented.
* Radiation
* Conduction
* Convection
513
Fill in the blank: Evaporative heat loss is addressed through the application of a _______.
vapor barrier
514
What type of beverages should be avoided when treating hypothermia?
Alcoholic beverages
515
True or False: In a rescue situation, a person is considered dead until they are warm and dead.
True
516
What is a recommended treatment for mild hypothermia?
Dress in dry clothes and wrap in blankets
517
What should be avoided in treating mild hypothermia?
Baths or water immersion
518
What is critical for patients with moderate hypothermia?
Active rewarming must be performed
519
What items can be used for rewarming in the field for moderate hypothermia?
* Large electric heat pads
* Warm water bottles
520
What characterizes severe hypothermia?
True medical emergency requiring aggressive treatment
521
What should be assessed for at least 60 seconds in severe hypothermia?
Vital signs
522
When should CPR be initiated in severe hypothermia?
After determining the patient has no vital signs
523
What is the evacuation guideline for victims with moderate to severe hypothermia?
Must be evacuated from the wilderness
524
How should hypothermic patients be handled during transport?
Very gently and kept horizontal
525
What is the single most important aspect of hypothermia treatment?
Adequate prevention through preparation
526
What is hypothermia often referred to as?
The killer of the unprepared
527
What occurs if a person is taken immediately to the summit of Mt. Everest?
They would pass out and likely die within minutes.
528
What altitude is referred to as the 'death zone'?
About 27,000 feet (8,200 meters).
529
What is the main cause of altitude illness?
Hypobaric hypoxia due to decreased oxygen pressure at high altitudes.
530
What happens to the body's carbon dioxide levels at high altitude?
They are lowered by hyperventilation.
531
What severe symptoms arise from altitude sickness?
Edema or fluid accumulation in the body.
532
What is acute mountain sickness (AMS) diagnosed by?
A headache and at least one other symptom: dizziness, fatigue, nausea, or insomnia.
533
What are the common symptoms of High Altitude Cerebral Edema (HACE)?
Poor muscle control, altered level of consciousness, severe lack of energy.
534
What is the treatment for Acute Mountain Sickness (AMS)?
Discontinue ascent and rest, with descent being the most effective treatment.
535
What is High Altitude Pulmonary Edema (HAPE) characterized by?
Shortness of breath at rest, cough, weakness, and chest tightness.
536
What is the safest method to prevent altitude illness?
Slow ascent to allow for acclimatization.
537
What medicine is mentioned as helpful for AMS?
Acetazolamide.
538
What is the recommended ascent limit to prevent HAPE?
No more than 300 meters (1,000 feet) a day.
539
True or False: HACE almost never occurs without AMS symptoms first.
True.
540
What should be done immediately if HACE is suspected?
Immediate descent with assistance.
541
Fill in the blank: The initial sign of HAPE is a marked decrease in _______.
exercise tolerance.
542
What happens during hyperventilation at high altitudes?
It lowers CO2 levels, which can reduce the drive to breathe.
543
What is the likely consequence of edema in the brain at high altitude?
Acute Mountain Sickness (AMS) can progress to High Altitude Cerebral Edema (HACE).
544
What can happen to mild cases of HAPE?
They may resolve within hours after descent.
545
How long can the recovery from HACE last?
Recovery can last for weeks.
546
What is the primary purpose of water purification?
To eliminate pathogens that will cause symptoms and disease in humans.
547
List three outcomes of water purification besides pathogen removal.
* Removes toxic compounds
* Eliminates unpleasant tastes
* Improves water quality
548
What is recommended for ensuring safe drinking water?
Use at least two methods to treat water.
549
Define 'Purify' in the context of water treatment.
Removes taste, odor and smell.
550
Define 'Disinfect' in the context of water treatment.
Removes or destroys pathogens.
551
Define 'Sterilize' in the context of water treatment.
Destroys all life forms.
552
What does 'Filtration' refer to in water treatment?
Mechanical process of forcing water through a membrane to remove pathogens.
553
True or False: Water sterilization is necessary for safe drinking.
False.
554
What are the most common pathogens causing illness in water?
* Bacteria
* Viruses
* Protozoa
* Parasites
555
What is the best water source for purification?
Get close to the source, such as a snowbank or fast-moving water.
556
Why are slow-flowing rivers and ponds considered poor water sources?
Bacteria and parasites tend to thrive in these environments.
557
What is the purpose of pre-treatment in water purification?
To remove contaminants such as sediment, leaves, and small twigs.
558
What is the first step in the pre-treatment process?
Screening.
559
Describe the screening process in water pre-treatment.
Pouring water through a cloth to remove large contaminants.
560
What is the purpose of the standing process in water pre-treatment?
Allows smaller particles to settle to the bottom of the container.
561
What chemical is commonly used for flocculating water?
Alum.
562
How long should water be boiled for effective disinfection at high elevations?
At least 3 minutes if above 6,562 feet (2000m).
563
What is the boiling point of water at sea level?
100°C (212°F).
564
What is a disadvantage of boiling water for purification?
The water is hot and may not taste good.
565
What pathogens can be effectively killed by boiling water?
Most human pathogens.
566
What is the effectiveness of filters in water treatment?
Filters screen out bacteria, protozoa, and helminths, but are not reliable for eliminating viruses.
567
True or False: Filters can completely eradicate viruses from water.
False.
568
What happens to filters over time during use?
They clog and become less effective.
569
What should be done in areas with potential contamination when using filters?
Use an additional method of disinfection, such as halogenation.
570
What are iodine and chlorine effective against?
Viruses and bacteria
## Footnote
Their effectiveness against protozoa and helminths varies greatly.
571
Which protozoan is effectively killed by halogen disinfection?
Giardia lamblia
## Footnote
Cryptosporidium oysts are extremely resistant to halogen disinfection.
572
What major problem affects chemical disinfection?
Improper treatment by the user
573
What factors does disinfection depend on?
Halogen concentration and contact time
574
Why is chlorine less suitable for cold, contaminated water?
It is more sensitive to halogen concentration and contact time
575
Why are household cleaners like bleach not recommended for disinfection of drinking water?
They have some efficacy against bacteria but not viruses
576
What can neutralize the unpleasant taste of halogens in water?
Ascorbic acid (vitamin C) or flavored drink mixes
577
What is a risk associated with using iodine for water disinfection?
Potential effect on the thyroid gland
578
What is required for using iodine safely for disinfection?
Following appropriate disinfection techniques and manufacturer guidelines
579
What is the relationship between iodine concentration and contact time?
A lower concentration of iodine can be used if the contact time is longer or the water temperature is warmer
580
What is the primary mechanism of Ultraviolet Radiation (UVR) treatment?
It destroys illness-causing microorganisms by attacking their DNA
581
What factors affect the effectiveness of UVR treatment?
Exposure time, lamp intensity, and water quality parameters
582
What must be low for UV treatment to work effectively?
Turbidity
583
What is a significant risk after UV irradiation treatment?
Reactivation of pathogens
584
What must not happen to UV-treated water before consumption?
It must not be exposed to visible light for any significant period
585
What is a long-term disadvantage of UV purification?
No residual treatment
586
What should be added to water purified by UV radiation for continued disinfection?
A chlorine compound
587
What advantages does chlorine dioxide have over chlorine?
Wider range of effective pH and does not require more than simple mixing
588
What does chlorine dioxide release to neutralize pathogens?
A very reactive form of oxygen
589
What is one important quality of chlorine dioxide?
High-water solubility, especially in cold water
590
What are tannins and humics?
Natural organic matter that leach into wilderness water
591
How can activated carbon improve water quality?
It can remove bad taste and purify the water
592
What is the primary focus of water treatment?
Tiny bugs or germs due to their immediate and serious risk to health
593
What toxic resin is responsible for the skin reaction caused by poison ivy, oak, and sumac?
Urushiol
## Footnote
Urushiol is contained within the leaves, fruit, root, and stem of the plant.
594
What is the primary function of urushiol in these plants?
Helps the plant to retain water
595
How can urushiol be released from the plant?
The plant must be broken open
596
What can cause urushiol to cling to objects?
Its remarkable adhesive properties
597
Where are poison ivy, poison oak, and poison sumac predominantly found in the United States?
* Poison ivy: east of the Rocky Mountains
* Poison oak: west of the Rocky Mountains
* Poison sumac: southeastern United States
598
What is the most common reaction to exposure to poison ivy, oak, or sumac?
An itchy red rash
599
When do skin lesions typically appear after first-time exposure to urushiol?
21 to 48 hours, but may be delayed up to 21 days
600
What is the best method to prevent a rash from urushiol exposure?
Avoidance of the plants
601
What should be used to wash the area exposed to urushiol?
Warm or cold water and soap
602
What topical treatment can be applied directly to the rash caused by urushiol?
Topical steroid cream
603
What is Zanfel® Poison Ivy Wash used for?
To remove urushiol from the skin after an outbreak
604
What causes sunburn?
Overexposure to the sun's ultraviolet (UV) rays
605
What are the two clinically important classes of UV rays?
* UVA
* UVB
606
Which UV rays penetrate the skin deeply and contribute to skin cancers?
UVA rays
607
Which UV rays are the chief cause of skin reddening and sunburns?
UVB rays
608
What is the best way to prevent sunburn?
Avoid sun exposure
609
What type of clothing is recommended to prevent sunburn?
Breathable full-length clothing
610
What should sunscreen be labeled as to ensure it protects against both UVA and UVB rays?
Broad spectrum
611
What does SPF stand for?
Sun Protection Factor
612
How is SPF used to measure sunscreen effectiveness?
It measures the sunscreen's ability to protect against UVB rays
613
What is a common misconception about sunscreen?
There is no such thing as waterproof sunscreens
614
Which medications can be used for pain control after sunburn?
* Acetaminophen
* Ibuprofen
615
What topical treatment shows little to no benefit for sunburn relief?
Topical steroids
616
What is an effective method for relieving itching from sunburn?
Cool soaks in water or cold showers
617
What is the general management approach for bites and stings?
Conduct a primary and secondary survey to ensure the scene is safe and the victim is stable.
## Footnote
Infection is common with animal bites, and bites are tetanus-prone wounds.
618
Name three types of bears found in North America.
* Brown bear (Grizzly and Kodiak)
* American black bear
* Polar bear
619
How fast can North American bears run?
Up to 40 mph
620
What is an effective way to prevent bear attacks?
Make noise, such as talking or using hand clickers.
621
What should you do if you encounter a brown bear?
* Do not look into the bear's eyes
* Do not make sudden movements
* Stand your ground but be submissive
* If attacked, protect your neck in the fetal position.
622
What actions should be taken if a black bear attacks?
* Yell and throw things
* Act aggressively towards the bear
* Continue to fight back if attacked.
623
What is another name for the mountain lion?
Cougar, puma, panther, or catamount.
624
What is the main method by which snakes capture their prey?
They use specialized salivary glands that produce venom.
625
What are the three families of snakes classified for medicine?
* Vipers
* Round snakes
* Sea snakes
626
What is the most common type of pit viper found in North America?
Rattlesnakes, copperheads, and cottonmouths.
627
What is a significant characteristic of pit vipers?
Triangle-shaped head and heat sensing pits.
628
What should be done in the case of a pit viper bite?
Evacuate all victims of bites from venomous snakes.
629
What distinguishes coral snakes from other snakes?
Distinct color banding pattern.
630
True or False: The bite from a coral snake is typically very painful.
False
631
What should be avoided when treating snake bites?
* Sawyer Extractor™
* Pressure immobilization
* Electric shock therapy
* Local application of ice
* Cutting and sucking the wound
* Tight-fitting tourniquet
632
What is the main vector for diseases responsible for deaths worldwide?
Mosquitoes
633
What does a mosquito inject into the skin while biting?
Saliva containing an anticoagulant.
634
What are some suggestions for avoiding mosquito bites?
* Stay indoors at dusk
* Choose campsites away from standing water
* Wear long sleeves and pants
* Use repellents like DEET, Picaridin, or Lemon Oil Eucalyptus.
635
What type of organism are ticks classified as?
Arachnids
636
What is the process by which ticks find hosts called?
Questing
637
What is the maximum time frame in which a tick can transmit disease?
2-3 days
638
What should you do if bitten by a tick?
Pull it off straight upward with steady pressure.
639
What order of insects includes ants, bees, and wasps?
Hymenoptera
640
What is the most common reaction to a bee sting?
Local reaction consisting of a small red patch that burns and itches.
641
What should be done immediately after a scorpion sting?
Clean the sting site with soap and water.
642
What is the most medically important scorpion in the United States?
Bark scorpion (genus Centruroides)
643
What should be done immediately after a scorpion sting?
Epinephrine should be given immediately or go straight to the hospital.
644
In which climates are scorpions typically found?
Desert and semiarid climates between 50 degrees north and south latitude.
645
What is the most medically important scorpion in the United States?
The bark scorpion (genus Centruroides).
646
Where is the bark scorpion primarily found?
Arizona and New Mexico.
647
What is the typical outcome of most scorpion stings?
Most result in only local pain and inflammation.
648
What is the first step in treating a scorpion sting?
Clean the sting site with soap and water.
649
What should be used to help with pain from a scorpion sting if available?
Ice.
650
What do studies suggest about the use of ice for scorpion stings?
Ice will help to neutralize the pain.
651
What action should be taken if a bark scorpion is identified?
Evacuate as soon as possible.
652
Who is at a greater risk of rapid decompensation after a scorpion sting?
Children and elders.
653
What is the primary energy source for the body while hiking and backpacking?
Carbohydrates
## Footnote
Carbohydrates are easier for the body to process than fats or protein.
654
How many grams of carbohydrates should one consume per hour while backpacking?
30 to 60 grams
## Footnote
This equates to approximately 120 to 240 calories.
655
What can happen if you don't consume enough carbohydrates during a hike?
The body will burn muscle protein and stored body fat
## Footnote
This can lead to feelings of weakness and hinder progress.
656
List three examples of good carbohydrate sources for hiking.
* Energy gels
* Dried fruit
* Protein bars
657
What types of foods should be included in your diet prior to hiking?
* Whole grains (brown rice, quinoa, oats)
* Starchy vegetables (potatoes, peas)
* Fruits of all kinds
658
Why should you consume electrolytes while hiking?
To replenish sodium, chloride, potassium, magnesium, manganese, and calcium
## Footnote
This is crucial especially in heat to maintain performance levels.
659
What can happen if you consume high volumes of water without electrolytes?
Hyponatremia
## Footnote
This is a life-threatening condition where the body lacks sufficient salts.
660
What is the ideal ratio of carbohydrates to protein for recovery after exercise?
4:1 ratio
## Footnote
Carbohydrates replace lost glycogen while protein repairs muscle tissue.
661
How soon after exercise should you eat for recovery?
Within 30 to 45 minutes
## Footnote
This is when the body is especially receptive to replenishing and repairing.
662
True or False: Thirst is a reliable indicator that you are adequately hydrated.
False
## Footnote
Thirst is an early symptom of dehydration, indicating that you are already dehydrated.
663
How much water should you drink about 2 hours before starting a hike?
14 to 22 ounces
## Footnote
This helps ensure you start your hike hydrated.
664
What is a good goal for water or sports drink intake during a hike?
6 to 12 ounces every 15 to 20 minutes
## Footnote
This helps maintain hydration levels.
665
What should you do to recover hydration after a hike?
Drink 16 to 20 ounces of water or sports drink every hour for a few hours
## Footnote
This is crucial for full rehydration.
666
What should you consider when choosing a first aid kit for a trip?
Consider the following questions:
* Type of activity or sport
* Duration of the trip
* Size of the group
* Group kit or individual kit
* Distance from help
* Endemic diseases in the area
* Participants' known conditions
* Distance from definitive care
667
What is the main difference between a pre-made medical kit and a custom kit?
Pre-made medical kits cover general cuts and scrapes but may not be specific enough for all injuries. Custom kits can be tailored to specific activities and locations.
668
What does the acronym PAWS stand for in the context of first aid kits?
PAWS stands for:
* Prevention / Procedures
* Analgesics / Antibacterials / Antiseptics
* Wound care
* Survival
669
What are some prevention items that should be included in a first aid kit?
Items for prevention include:
* Water filter and purification tablets
* Gloves
* Sunscreen/lip balm
* Sunglasses
* Blister prevention and treatment
* Insect repellant and barriers
670
Name three specific tools that can be used for procedures in a first aid kit.
Specific tools include:
* Wound care material (e.g., steri-strips, gauze)
* Scissors
* Blood pressure cuff and stethoscope
671
True or False: Aspirin should be used in head injuries.
False
672
What are some common broad-spectrum antibiotics to consider for a first aid kit?
Common antibiotics include:
* Doxycycline
* Cipro
* Amoxicillin/clavulanic acid
* Azithromycin
673
What is anaphylaxis and what should be included in a first aid kit to treat it?
Anaphylaxis is a severe allergic reaction. Items to treat it include:
* EpiPen®
* Antihistamines
* Albuterol inhaler
* Oral steroids
* Ranitidine
674
What wound care supplies are essential for a first aid kit?
Essential wound care supplies include:
* Gloves
* Alcohol swabs
* Gauze
* Steri-strips
* Tape
* Antibiotic ointment
675
Fill in the blank: The potential for group members to be separated necessitates the inclusion of _______ items in a first aid kit.
[survival]
676
List three items that should be included for survival in a first aid kit.
Survival items include:
* Map
* Compass
* Fire starter
677
What is the importance of knowing endemic diseases in the area for which you are preparing a first aid kit?
Knowing endemic diseases helps in selecting appropriate medications to bring on the trip.
678
What constitutes a lightweight medical kit for a backpacking trip?
A lightweight medical kit should contain items for treating high-altitude illness, cold exposure, trauma, and specific infectious diseases.
679
What should you ensure regarding wound care supplies for each participant in a trip?
Each participant should bring their own necessary wound care supplies to ensure adequacy.
680
What is the primary purpose of the primary assessment?
To keep the victim alive and identify major injuries
681
What does the M in the MARCH acronym stand for?
Massive Hemorrhage
682
What is the leading cause of death among Americans younger than 45?
Trauma
683
Why is bleeding control prioritized in trauma care?
Bleeding out is the primary reason why physical trauma becomes fatal
684
What type of bleeding is considered life-threatening?
Massive hemorrhage, such as from a lacerated artery
685
What is the first step in addressing massive hemorrhage?
Perform a blood sweep
686
Why is it important to look under layers of clothing during a blood sweep?
Blood can collect between layers, especially if clothing is waterproof or thick
687
Which arteries are especially vulnerable to rapid bleed-outs?
* Femoral artery
* Carotid artery
* Brachial artery
688
What can happen if the femoral or carotid artery is punctured?
Immediate blood pressure drop and extremely rapid blood loss
689
Where can major hemorrhage also occur besides external injuries?
Internally in cavities such as chest, abdomen, behind the kidney, and thigh
690
What should you do if someone is bleeding to death internally?
Recognize the signs and evacuate them very quickly
691
True or False: All bleeding control is a priority in trauma care.
False
692
Fill in the blank: The _______ assessment starts with the primary MARCH assessment.
primary
693
What should you look for on the ground or street when assessing a bleeding patient?
Blood
694
What is the first step in stopping any blood loss?
Direct pressure
## Footnote
Direct pressure controls bleeding from most wounds and is the first action to take.
695
What should you use to apply direct pressure to a wound?
The cleanest materials available
## Footnote
Using clean materials helps prevent infection.
696
How long may scalp wounds require continuous, direct pressure?
30 to 60 minutes
## Footnote
Scalp wounds often bleed profusely and may need extended pressure.
697
Where should you apply finger pressure when controlling a bleed?
Directly over the source of the bleed
## Footnote
Applying pressure too broadly may be less effective.
698
What should you do to reduce blood flow to an injured limb?
Elevate the limb above the heart
## Footnote
Elevating helps decrease blood flow and can aid in controlling bleeding.
699
What is a tourniquet?
A limb-constricting device to stop hemorrhage
## Footnote
It cuts off blood flow to the limb to control severe bleeding.
700
Where should a tourniquet be placed in relation to the injury?
2-6 inches above the injury
## Footnote
It should not be placed directly over the wound or over a joint.
701
What is the risk if a tourniquet is used for more than 3-4 hours?
Limb loss
## Footnote
Prolonged use of a tourniquet can cause irreversible damage to the limb.
702
Should a tourniquet be intermittently loosened to allow blood back into the extremity?
No
## Footnote
Intermittent loosening is unnecessary and can worsen bleeding.
703
True or False: You should remove a tourniquet as soon as bleeding stops.
False
## Footnote
The tourniquet should remain in place until the victim reaches a hospital.
704
What is an improvised tourniquet used for?
To stop severe bleeding.
705
What is the first step in applying an improvised tourniquet?
Wrap the brown bandana tightly around the limb.
706
What should be done after wrapping the bandana around the limb?
Tie a knot.
707
What type of item should be placed through the knot of the tourniquet?
A long, sturdy item.
708
List some examples of sturdy items that can be used in an improvised tourniquet.
* Stick
* Ski pole
* Tree branch
* Kitchen utensil
709
What is the next step after placing a sturdy item through the knot?
Twist as tight as possible.
710
How should the sturdy item be secured once twisted?
With another piece of cloth or wrap.
711
Fill in the blank: To apply an improvised tourniquet, first wrap a _______ tightly around the limb.
[brown bandana]
712
What is the next step in the MARCH primary assessment?
Rapid airway assessment
## Footnote
Airway obstruction is a leading cause of death after head injuries.
713
What is one of the leading causes of death after head injuries?
Airway obstruction
## Footnote
Can also occur after vomiting by an unconscious person.
714
How long can the brain survive without oxygen before permanent damage occurs?
A few minutes
## Footnote
The brain can sustain permanent damage after just a few minutes of oxygen deprivation.
715
What is a quick way to assess if the airway is clear?
Ask the victim to state their name
## Footnote
If the victim can speak, their airway is likely clear.
716
What should be done if the victim is unconscious or if their airway is obstructed?
Reposition them for easier breathing
## Footnote
The goal is to lift the tongue and soft tissue off the back of the airway.
717
What is the first method to reposition the airway?
Head-Tilt-Chin-Lift method
## Footnote
This method bends the neck backwards and should only be used if there is no spinal cord injury.
718
What is the second method to reposition the airway?
Jaw-Thrust Method
## Footnote
This method minimizes neck motion while lifting the tongue off the throat.
719
What should be specifically assessed in cases of airway obstruction?
Possibility of cervical spine injury
## Footnote
Assume a cervical spine injury in cases of high velocity fall, head injury, or significant injury above the chest.
720
When should the jaw-thrust method be used?
When a cervical spine injury is suspected
## Footnote
The method helps to open the airway without moving the neck.
721
What should never be done to establish or maintain an airway if a cervical spine injury is suspected?
Hyperextended, hyperflexed, or rotated the head or neck
## Footnote
These movements can exacerbate cervical spine injuries.
722
What is respiration?
Breathing delivers oxygen to the lungs during inhalation and removes carbon dioxide during exhalation.
723
What can cause a person to stop breathing?
Head or spinal injuries, lightning strikes.
724
What conditions can lead to inadequate respiration?
Heart failure, severe asthma attacks, burns, chest injuries, fluid in the lungs.
725
How can you assess for adequate respiration?
Watch the chest wall movement; it should rise and fall equally on both sides.
726
What might be necessary to visualize chest wall movement effectively?
Removing clothing from the victim if they are wearing heavy gear.
727
What should you do if the victim is not breathing on their own?
Assist by delivering breaths to them.
728
What percentage of oxygen is found in exhaled air from a human?
16% oxygen.
729
What is the most effective way of delivering rescue breaths?
Using a CPR mask.
730
What is crucial for the effectiveness of a CPR mask?
It must be tightly sealed around the victim's mouth and nose.
731
What are the dimensions of compact and collapsible CPR masks suitable for backcountry med kits?
1 inch x 1 inch.
732
What should be done if no CPR mask is available?
Mouth-to-mouth may be needed.
733
What technique should the rescuer use during mouth-to-mouth resuscitation?
Pinching the nose closed and tilting the chin up to open the airway.
734
What should you do if your breaths are hitting resistance?
Try to reposition the airway.
735
What is the fourth step of the MARCH protocol?
Quickly checking for a pulse
## Footnote
Check for pulses for 10 seconds at the neck (carotid artery) using the tips of your index and middle fingers.
736
What motto has the American Heart Association emphasized for layperson CPR?
"Push Hard-Push Fast."
## Footnote
This motto is aimed at encouraging effective chest compressions.
737
What should a rescuer do if a victim is unresponsive and not breathing?
Call 911, obtain an AED if available, and start chest compressions.
738
How should the victim be positioned for chest compressions?
On their back on a firm surface.
739
Where should you place your palm during chest compressions?
Over the victim's breastbone.
740
What is the recommended depth for each chest compression?
At least two inches.
741
What is the target rate for chest compressions per minute?
About 100 compressions per minute.
742
Name two songs that can be used as a rhythm for chest compressions.
* Staying Alive
* Sweet Home Alabama
743
What should you do if you are comfortable with CPR and delivering breaths?
Alternate between 30 compressions and 2 rescue breaths.
744
What is the most important part of CPR?
Chest compressions.
745
Under what conditions should you stop performing CPR?
* Someone can assist
* You become exhausted
* The victim is revived
* A qualified person pronounces the victim dead
746
After how long should you typically stop CPR if the victim remains unresponsive?
30 minutes.
747
What should you do if you have access to an AED?
Place the pads on the victim's chest as soon as possible.
748
What is important to follow when using an AED?
The instructions of the AED about whether to deliver a shock or to continue compressions.
749
What is the final step of the MARCH protocol?
Assessing whether the victim needs urgent evacuation or may stay in the field for further assessment.
750
What are some indicators that always require urgent evacuation?
* Difficulty breathing
* Weak or rapid pulse
* Head or spinal injury
* Open fracture
* Major hemorrhage
751
In the MARCH protocol, what does the 'H' sometimes refer to?
'Hypo/hyperthermia' rather than 'hike vs helicopter.'
752
What should you do if a major injury or disability is present?
Call for evacuation.
753
What is the purpose of the MARCH primary assessment?
To make a quick overall assessment of the patient's potential life-threatening injuries.
754
If the patient is stable after the MARCH primary assessment, what should you do next?
Proceed to a complete physical examination and secondary assessment.
755
True or False: The MARCH protocol includes a step for assessing breathing difficulties.
True.
756
Fill in the blank: The MARCH protocol is used to assess potential life-threatening _______.
[injuries].
757
What is the focus of the secondary assessment?
A more thorough investigation of the medical problem and the circumstances surrounding the injury or illness.
758
What are the two components of the secondary assessment?
* A complete physical examination
* A SAMPLE History
759
What does a complete physical examination entail?
A head-to-toe physical exam on the patient.
760
What is a key guideline for performing a physical examination?
Explain what you are doing and why to involve the patient in their own care.
761
When should you avoid moving the patient during the examination?
Except in cases of imminent danger, avoid moving the patient until after the head-to-toe exam is complete.
762
How do you measure heart rate?
Place your fingers on the neck (carotid artery) and count for 15 seconds (multiply by 4) or 30 seconds (multiply by 2).
763
What is the normal heart rate range for adults?
50 to 100 beats per minute.
764
What should a standard pulse reading include?
* Rate
* Rhythm
* Strength
765
What might a well-conditioned athlete's pulse rate be?
A normal pulse rate below 50.
766
What factors can increase heart rate?
* Shock
* Exercise
* Altitude
* Illness
* Emotional stress
* Fever
767
How is respiratory rate counted?
Each rise of the chest is counted over 15 seconds (multiply by 4) or 30 seconds (multiply by 2).
768
What is the normal respiratory rate range?
12 to 20 breaths per minute.
769
What should be noted when assessing respiratory rate?
* Labored vs unlabored
* Regular vs irregular
* Shallow vs deep
* Clear vs wheezing
770
Fill in the blank: The respiratory rate is _______.
[key learning term]
771
True or False: Children may have resting heart rates higher than 100 beats per minute.
True
772
What is an example of a complete pulse reading?
The pulse is 110, irregular, and weak.
773
What is another example of a complete respiratory rate reading?
Respiratory rate is 30, shallow and irregular.
774
What is the Level of Responsiveness?
A quick gauge of brain function critical for assessing individuals with potential head injuries or other conditions affecting awareness
## Footnote
Level of responsiveness is evaluated based on a person's awareness of self, location, and time.
775
What does A+Ox3 indicate?
The person is awake and oriented to person, place, and time
## Footnote
One point is given for each correct identification: name, location, and date/time.
776
What does A+Os4 signify?
The person knows person, place, time, and events
## Footnote
This indicates a high level of cognitive function.
777
What does A+O≤3 represent?
The person knows three of the four: person, place, time, or events
## Footnote
This shows a moderate level of orientation.
778
What does A+Ox2 mean?
The person knows two of the categories: events and time
## Footnote
This reflects a lower level of awareness.
779
What does A+Ox1 indicate?
The person knows only one category
## Footnote
This suggests significant confusion or disorientation.
780
What does A+Os0 mean?
The person does not know person, place, or time, or they are completely unconscious
## Footnote
This indicates a critical level of impaired consciousness.
781
What are the key skin signs that indicate the condition of respiratory and cardiovascular systems?
Skin color, temperature, and moisture
## Footnote
These factors help assess a person's overall health status.
782
Describe the skin condition of a healthy person.
Warm and relatively dry
## Footnote
This is the expected state of skin in a healthy individual.
783
What does it mean if a patient's skin is described as pale, cool, and clammy?
It indicates potential distress or poor circulation
## Footnote
This can be a sign of shock or other serious conditions.
784
What does it mean if a patient's skin is warm, pink, and dry?
It indicates good circulation and hydration
## Footnote
This is a positive sign of health and stability.
785
What is the purpose of a head-to-toe assessment?
To ensure no injuries are missed by assessing the whole body.
786
What does PERRL stand for in eye assessment?
Pupils are Equal, Round, and Reactive to Light.
787
What should be checked in the nose during a head assessment?
Check for breaks and for blood or clear fluid (CSF).
788
What should be assessed behind the ears?
Check for bruising and inside ears for blood and clear fluid (CSF).
789
What should be checked in the mouth during the assessment?
Check for blood, vomit, and missing teeth.
790
How should the neck be assessed?
Palpate the front/backside of neck, collarbone, and shoulder for deformities.
791
What does a deviation of the trachea indicate?
A deviation may indicate a pneumothorax on the opposite side.
792
What technique is used to assess lung function?
Place hand vertically along the sternum and observe lung movement.
793
What should be palpated in the abdomen?
Watch for visible signs of pain while palpating each quadrant.
794
What is the procedure for assessing the pelvis?
Firmly press downward and then inward on the sides.
795
How do you check for bone breaks in the legs?
Place hands about 3 inches apart and push in opposite directions on the bone.
796
What is the first step before testing knee mobility?
Check the upper and lower legs for bone breaks.
797
What should be assessed in the feet?
Test voluntary movement, strength, sensation, and capillary refill time.
798
How is capillary refill time tested in toes?
Press down on the toenail for 5 seconds; color should return in 2 seconds.
799
What should be done to test voluntary movement in hands?
Ask the patient to squeeze your fingers.
800
How should sensation be tested in hands?
Scratch or tap the hand and ask the patient to describe what is happening.
801
What is checked during the shoulder assessment?
Palpate shoulders for pain and check for full range of motion.
802
Fill in the blank: When assessing the abdomen, you should watch the patient's face for visible signs of _______.
pain.
803
True or False: It is important to check the patient's mouth for vomit during a head-to-toe assessment.
True.
804
What does the acronym SAMPLE stand for in patient assessment?
Symptoms, Allergies, Medications, Past Medical History, Last Intake and Output, Events
805
What is the difference between a symptom and a sign?
A symptom is something the patient perceives (e.g., pain), while a sign is something you can find during an exam (e.g., tenderness)
806
What should you ask a patient regarding their symptoms?
Ask about nausea, dizziness, headache, and any discomfort
807
What information should you gather about allergies?
Current medications, known allergies, exposure to allergens, and usual response
808
What types of drugs should be inquired about during patient assessment?
Both nonprescription and prescription drugs, as well as possible alcohol or drug use
809
Why is it important to ask about past medical history?
To identify any previous and relevant medical problems and check for medical alert tags
810
What information is relevant regarding last intake and output?
When the patient last ate and drank, last urinated, and last defecated
811
What does clear, copious urine indicate?
Good hydration
812
What does dark, smelly urine suggest?
Dehydration
813
What are some signs that a patient may be dehydrated?
Dark, smelly urine, diarrhea, or vomiting
814
What should you ask regarding recent events?
Unusual circumstances that occurred in the past few days relevant to the patient's situation or injury
815
What does the SOAP note serve as in wilderness medicine?
Documentation for the patient’s medical condition and treatment or evacuation plans.
816
Why is it important to document the patient's experience?
To give an accurate report to EMS and protect against legal claims.
817
What does the 'S' in SOAP stand for?
Subjective.
818
What type of information is included in the Subjective component?
Information provided by the patient or bystanders, including the event/injury summary.
819
What key points should be communicated in the Subjective section?
* Patient’s age and gender
* Chief complaint
* Mechanism of injury (MOI) or history of present illness (HPI)
820
What does 'MOI' stand for and what does it explain?
Mechanism of Injury; it explains what led to the injury.
821
Provide an example of a chief complaint.
Throbbing pain in the left wrist.
822
What does the 'O' in SOAP stand for?
Objective.
823
What type of data is included in the Objective component?
Quantifiable and measurable data, findings, and observations.
824
What should be noted about the patient's position after the MOI?
The position you found the patient in.
825
List some relevant findings to convey to a healthcare provider.
* Bruises/bleeding
* Unusual hardness/softness
* Breathing sounds
* Pain responses
* Changes to circulation, sensation, and motion (CSMs)
826
What are vital signs and why are they important in a SOAP note?
They provide critical information about the patient's current state and changes over time.
827
What does 'AAO x 4' indicate?
Alert and Oriented to person, place, time, and event.
828
What does the 'A' in SOAP stand for?
Assessment.
829
What is included in the Assessment component?
The diagnosis based on signs/symptoms and reasoning.
830
What should be done if unsure about a diagnosis?
List more than one possibility.
831
What does the 'P' in SOAP stand for?
Planning or Plans for Patient.
832
What should be outlined in the Planning component?
The beginning treatment plan and possible future steps.
833
What is important to remember when presenting to EMS?
Always defer to their recommendations for evacuation and care.
834
Fill in the blank: The SOAP note is a critical part of _______ certification.
[Wilderness First Responder]
835
What is the most important topic in wilderness medicine?
The management of someone injured or sick in the wilderness
836
What are the four effective survey techniques for initial assessment in wilderness medicine?
* Scene survey
* Primary survey
* Secondary survey
* Ongoing survey
837
What is the first step in a scene survey?
Ensure that the scene is safe before entering to assess the victim
838
What does the MARCH acronym stand for in primary survey prioritization?
* Massive hemorrhage
* Airway (with C-spine precautions)
* Respiration
* Circulation
* Hypothermia/Hyperthermia or Hike vs. Helicopter
839
In the primary survey, what is the top priority?
Preventing major hemorrhage
840
What acronym is used for the secondary survey?
SAMPLE
841
What does the SAMPLE acronym stand for?
* Symptoms/Subjective
* Allergies
* Medicine
* Prior medical history
* Last oral intake
* Events leading up to illness/injury
842
What should be done in the ongoing survey?
Repeat the survey as often as needed, especially if the patient is unstable
843
What does the AVPU acronym represent in ongoing surveys?
* Alert
* Verbal
* Pain
* Unresponsive
844
What is the purpose of the AEIOU Tips mnemonic?
To identify potential causes for a victim's altered mental status
845
What does AEIOU Tips stand for?
* Allergies/Altitude
* Environment/Epilepsy
* Infection
* Overdose
* Underdose
* Trauma, toxins
* Insulin (diabetes)
* Psychological disorders
* Stroke
846
What acronym is used to characterize a victim's pain?
COLDERR
847
What does COLDERR stand for?
* Character
* Onset
* Location
* Duration
* Exacerbation
* Relief
* Radiation
848
What is the recovery position?
The patient is placed on their side to keep the airway open and prevent aspiration if they vomit
849
What should be the first action if you suspect a drowning victim?
Perform rescue breaths if the patient has a pulse
850
What is the risk-to-benefit ratio in scene safety?
It weighs the risks of moving the victim against the potential dangers of leaving them in a hazardous situation
851
What is a blood sweep?
A quick assessment to identify any major bleeding or deformities in the musculoskeletal system
852
What mnemonic helps remember areas where internal bleeding can occur?
CARTS
853
What does CARTS stand for?
* Chest
* Abdomen
* Renal
* Thigh
* Skin/street
854
What is the purpose of wound irrigation?
To clean the wound and remove debris, while protecting oneself with Body Substance Isolation (BSI)
855
What is the SOAP acronym used for?
Medical documentation
856
What does SOAP stand for?
* Subjective
* Objective
* Assessment
* Plan
857
True or False: The verbal presentation when handing off a patient should follow the structure of a SOAP note.
True
858
What symptoms indicate that Pat may be experiencing a heart attack?
Squeezing chest pressure and shortness of breath
859
What should Pat avoid doing if he is experiencing a potential heart attack?
Skiing the rest of the way down the hill
860
What is the recommended action for ski patrol when assisting Pat?
Come to him and assist him down
861
Why is it important for someone experiencing a heart attack to rest in place?
To avoid further strain on the heart
862
When should a person experiencing a heart attack exert themselves?
Only if there is no other way to get to medical care
863
What is the urgency level for evacuating someone having a heart attack?
Urgent; they should be taken to medical care as fast as possible
864
What medication should be given to Pat as soon as possible?
Aspirin
865
What is the appropriate dosage of aspirin for a heart attack?
160-325mg, usually 1 adult strength or 4 baby aspirin
866
How should the aspirin be administered for faster absorption?
Crush it once between molars and swallow the fragments
867
What is the risk of delaying aspirin administration during a heart attack?
Causing more damage to the cardiac tissue
868
Can heart attack symptoms improve while at rest?
Yes, but the heart attack may still be happening
869
What additional medication can be given if available and deemed necessary?
Nitroglycerin
870
What can Tylenol help with when administered before or with nitroglycerin?
Prevent/treat headaches associated with nitroglycerin use
871
What should be done if aspirin is not immediately available?
Instruct patient to take 2-3 Pepto-Bismol tablets
872
What is the active ingredient in Pepto-Bismol that can help during a heart attack?
Subsalicylate
873
What does subsalicylate convert to in the stomach?
Salicylate (salicylic acid)
874
What is the purpose of taking Pepto-Bismol during a potential heart attack?
To provide an adequate dose of salicylate to thin the blood
875
What condition did Ashley likely experience?
Syncope from dehydration or overheating
## Footnote
Syncope refers to a temporary loss of consciousness often related to insufficient blood flow to the brain.
876
What symptoms did Ashley exhibit before collapsing?
Lightheadedness and tunnel vision
## Footnote
Tunnel vision refers to the narrowing of the field of vision, often experienced just before fainting.
877
What should Ashley do after experiencing syncope?
Rest in the shade and rehydrate
## Footnote
Resting and rehydrating helps restore electrolyte balance and prevent further episodes.
878
What fluids should be given to Ashley to aid recovery?
Fluids with electrolytes
## Footnote
Electrolytes are essential for nerve and muscle function, especially after dehydration.
879
What is a recommended way to ensure electrolyte intake?
Use electrolyte packets
## Footnote
Electrolyte packets, such as Pedialyte Advance Care, can be easily mixed with water.
880
List other possible diagnoses for fainting.
* Low blood pressure
* Heart problems
* Dehydration
* Hypoglycemia
* Seizure
* Medications
* Pregnancy
## Footnote
Each of these conditions can lead to reduced blood flow to the brain, resulting in fainting.
881
What can low blood pressure cause?
Reduced blood flow to the brain
## Footnote
Low blood pressure may lead to symptoms such as dizziness and fainting.
882
What distinguishes a seizure from syncope?
Seizures may involve convulsions and longer recovery time
## Footnote
During a seizure, the person may not regain consciousness immediately and may exhibit shaking.
883
What medications can cause fainting as a side effect?
Blood pressure medications and antidepressants
## Footnote
Some medications can lower blood pressure or affect the nervous system, leading to syncope.
884
What factors determine the decision to evacuate someone after fainting?
* Overall health and medical history
* Severity of symptoms
* Resources available for treatment and transport
## Footnote
Evaluating these factors is crucial for ensuring patient safety.
885
What specific signs warrant immediate evacuation?
* Unconsciousness for more than a few minutes
* Severe dehydration
* Hypothermia
* Pregnancy-related issues
## Footnote
These conditions can indicate serious health risks that require urgent care.
886
What was Ashley's likely cause of fainting?
Inadequate water intake during a long hike in the heat
## Footnote
Proper hydration is crucial, especially during physical activities in hot conditions.
887
True or False: Ashley has a personal or family history of heart problems.
False
## Footnote
Ashley has no known heart issues, making her case less concerning for cardiac-related fainting.
888
Fill in the blank: If Ashley had experienced sudden abdominal pain along with fainting, it would raise concerns about _______.
[pregnancy]
## Footnote
Sudden abdominal pain in conjunction with fainting can indicate serious pregnancy complications.
889
What are potential allergens found in the wilderness?
Bees, insects, plants, foods, and countless other exposures.
890
Why is it important to be prepared for allergic reactions in the wilderness?
Symptoms can develop within seconds of exposure, necessitating rapid response and treatment.
891
What are the three categories of allergic reactions?
* Local
* Generalized
* Systemic (anaphylaxis)
892
What characterizes a local allergic reaction?
Development of inflammation symptoms (redness and swelling) and itching on the skin.
893
What are the common treatments for local allergic reactions?
* Topical corticosteroids
* Diphenhydramine (Benadryl)
894
What symptoms are associated with generalized allergic reactions?
Symptoms similar to local reactions, but occurring in areas beyond the site of exposure, such as hives throughout the abdomen, face, and extremities.
895
Are generalized allergic reactions life-threatening?
Generally not life threatening.
896
Fill in the blank: Local allergic reactions are the _______ severe of the three categories.
[least]
897
True or False: Diphenhydramine is effective for alleviating itching symptoms and seasonal allergies.
True
898
What is anaphylaxis?
A medical emergency that could result in significant respiratory and circulatory compromise if treatment is not provided promptly.
899
How quickly can symptoms of anaphylaxis develop?
Symptoms may develop rapidly (within seconds to minutes) or over a longer period (in rare cases, may occur hours after exposure).
900
What are the initial symptoms of anaphylaxis?
Itching, urticaria (hives), and inflammation of exposed and distant areas (including the lips and tongue).
901
What respiratory issues can arise during anaphylaxis?
Inflammation of the airway can lead to diminished respiratory function and capacity, causing shortness of breath, chest tightness, and wheezing.
902
What happens to blood pressure during anaphylaxis?
Blood pressure can drop dangerously low due to systemic vasodilation.
903
What gastrointestinal symptoms can occur in anaphylaxis?
Vomiting and diarrhea.
904
True or False: Anaphylaxis is less dangerous than other allergic reactions.
False
905
Fill in the blank: Anaphylaxis may cause _____ in the airway, leading to respiratory issues.
inflammation
906
What is the primary purpose of an EpiPen®?
To treat rapid onset of respiratory failure and shock due to anaphylactic reactions
## Footnote
EpiPen contains epinephrine, which is crucial in emergencies.
907
What physiological effects does epinephrine have during anaphylactic shock?
Induces vasoconstriction and bronchodilation
## Footnote
These effects help reduce shock and airway inflammation.
908
What is the recommended location for administering an EpiPen injection?
Intramuscularly into the thigh
## Footnote
The needle can penetrate through clothing.
909
What is the guideline for the EpiPen's orientation during injection?
Blue to the sky, orange to the thigh
## Footnote
The orange end contains the injectable needle.
910
How long should the EpiPen be held in place after injection?
About ten seconds
## Footnote
This ensures the medication is administered effectively.
911
When might a second dose of epinephrine be necessary?
Within 5-20 minutes if symptoms do not improve
## Footnote
Symptoms include wheezing and respiratory difficulties.
912
What additional medications can be administered after epinephrine for anaphylactic reactions?
Antihistamines, corticosteroids, and inhaled beta2 agonists
## Footnote
Examples include Benadryl, Zantac, prednisone, and albuterol.
913
True or False: Antihistamines and corticosteroids alone can effectively treat anaphylaxis.
False
## Footnote
Only the EpiPen is effective for serious body-wide complications and airway closure.
914
Fill in the blank: The EpiPen should ideally be available in both _______ and _______ forms.
pediatric, adult
## Footnote
This ensures proper dosing for individuals of different ages.
915
What should be done immediately after administering an Epi Pen for anaphylaxis?
Transport the patient to a medical center as quickly as possible
## Footnote
This is crucial because symptoms may return even if they initially disappear.
916
What is a biphasic reaction in the context of anaphylaxis?
A second wave of anaphylaxis that can occur after initial symptoms have been treated
## Footnote
It emphasizes the need for continued medical observation.
917
What is the legal protection provided by Good Samaritan Laws?
Protection against civil damages for individuals rendering emergency care
## Footnote
This applies as long as the assistance is given in good faith and without compensation.
918
Can a bystander be sued for administering an Epi Pen?
In most cases, no
## Footnote
Good Samaritan Laws generally protect such actions.
919
What must an individual do to be protected under Good Samaritan Laws?
Offer assistance in good faith and without compensation
## Footnote
This is crucial for legal protection.
920
What should outdoor programs and recreational businesses obtain regarding Epi Pen administration?
Medical and legal guidance
## Footnote
This is essential for compliance with varying state and county laws.
921
Fill in the blank: Anaphylaxis can return in a second wave known as a _______.
biphasic reaction
922
True or False: Epi Pens can fully resolve anaphylaxis without further medical attention.
False
## Footnote
Even if symptoms improve, emergency medical care is still necessary.
923
What types of laws vary between jurisdictions concerning Epi Pen administration?
Good Samaritan Laws
## Footnote
These laws affect both laypersons and caregivers differently.
924
What do Good Samaritan Laws provide?
Widespread legal protection for providing care at the scene of an emergency
## Footnote
Protection is granted as long as the caregiver acts in good faith, without compensation, and without reckless action.
925
What should you do if you suspect a patient is experiencing anaphylaxis?
Administer the Epi Pen
## Footnote
A single dose poses little danger even if the patient is not truly experiencing anaphylaxis.
926
What are common side effects of administering epinephrine?
Tachycardia, anxiety, weakness, shaking
## Footnote
These side effects are usually mild and last only a few minutes.
927
What is the legal requirement under Good Samaritan Law to administer an Epi Pen?
Have reason to believe the individual is suffering or about to suffer a life-threatening reaction
## Footnote
This legal protection applies in most cases.
928
What is the conclusion regarding the benefits of giving an Epi Pen?
The benefits outweigh the risks if there is any suspicion of anaphylaxis.
929
Do you need to be certified to administer an Epi Pen?
No, certification is not required for lay person administration
## Footnote
This applies in the case of a suspected severe allergic reaction.
930
What should outdoor industry workers check regarding Epi Pen administration?
Workplace specific guidelines for staff training.
931
What should EMTs, paramedics, and nurses do regarding Epi Pen administration?
Defer to their medical director, county, and hospital regulations.
932
Do Good Samaritan Laws apply to paid medical services during emergencies?
No, they do not specifically apply to those being paid for their services.
933
Do I need a parent's permission to inject epinephrine into a child?
No, if you believe the child is having an anaphylactic reaction
## Footnote
The Good Samaritan Law allows for this under emergency circumstances.
934
What should you do if parents are nearby when administering epinephrine?
Include them in the discussion and decision
## Footnote
It's important to involve parents if they are able to assist.
935
Are volunteers protected under the Good Samaritan Law when administering epinephrine?
Yes, if certain conditions are met
## Footnote
Conditions include being employed by an organization, having doctor authorization, being trained, and believing in good faith that an allergic reaction is occurring.
936
What are the conditions that protect a volunteer administering epinephrine?
* Employed by an organization
* Doctor's authorization
* Trained to administer
* Good faith belief of allergic reaction
## Footnote
Protection may not apply if gross negligence or misconduct occurs.
937
What happens if epinephrine is accidentally injected into the hands or feet?
May result in loss of blood flow and requires immediate medical attention
## Footnote
Go to the nearest emergency room for treatment.
938
True or False: You can be sued for administering epinephrine if you are a paid employee.
True, unless you meet specific criteria for protection
## Footnote
The Good Samaritan Law typically does not protect paid individuals.
939
If you accidentally inject an Epi Pen into your hand or foot, what should you do?
Go to the nearest emergency room immediately
## Footnote
Prompt medical treatment is crucial to address potential complications.
940
Can an adult-strength EpiPen be given to a child if it's the only medication available?
Yes, a larger than prescribed dose of epinephrine can be given if that is the only medication available
## Footnote
It is unlikely to cause serious harm at the larger dose, and it could save the child's life.
941
What is the dosage of adrenaline in an EpiPen®?
0.3mg adrenaline
## Footnote
EpiPen® contains 0.3mg of adrenaline.
942
What is the dosage of adrenaline in an EpiPen® Jr?
0.15mg adrenaline
## Footnote
EpiPen® Jr contains half the dose of the adult version.
943
Who is recommended to use EpiPen® 0.3mg?
Anyone weighing over 25kg
## Footnote
EpiPen® 0.3mg is recommended for individuals weighing over this threshold.
944
What is the recommended use of EpiPen® Jr?
Children weighing between 7.5 – 25kg
## Footnote
EpiPen® Jr. 0.15mg is specifically for this weight range.
945
Can an adult EpiPen be used on a child?
Yes, if an EpiPen Jr. is not available
## Footnote
An adult EpiPen can be administered to a child in emergency situations.
946
Is it safe to use an expired EpiPen?
There is no guarantee it will work, but it is better than nothing
## Footnote
It may still be effective, especially if it is recently expired.
947
What determines the expiration date of a medication like EpiPen?
A series of tests conducted by the medication’s manufacturer
## Footnote
The expiration date ensures the medication works as expected until that date under proper storage conditions.
948
Do liquid medications, like EpiPens, have a higher chance of failing after expiration?
Yes, they break down faster than solid dosage forms
## Footnote
Liquid medications are more susceptible to degradation post-expiration.
949
What should you do if a recently expired EpiPen is all you have?
You should use it
## Footnote
It can be the only out-of-hospital intervention available for an anaphylactic reaction.
950
True or False: It is safest to always use an EpiPen before it expires.
True
## Footnote
The guarantee of effectiveness only applies up to the expiration date.
951
What should be assessed in a patient with suspected cervical spine injury?
Level of consciousness, signs of spinal injury, potential signs of increased intracranial pressure
## Footnote
Signs of spinal injury include neck pain, weakness, and numbness. Signs of increased intracranial pressure may include altered mental status and vomiting.
952
What is the importance of maintaining a neutral position in suspected cervical spine injury?
Minimizes movement and prevents further injury to the spine
## Footnote
This typically involves keeping the head aligned with the rest of the body.
953
How should movement of the patient's head and neck be managed during initial assessment?
Limit movement as much as possible
## Footnote
This may involve stabilizing the head manually or using improvised materials like rolled-up clothing or a cervical collar.
954
What is the recommended head elevation angle if increased intracranial pressure is suspected?
Approximately 30 degrees
## Footnote
This elevation can help facilitate venous drainage and reduce swelling.
955
What should be ensured when applying a cervical collar?
It should be applied correctly and snugly to maintain spinal alignment
## Footnote
A cervical collar helps stabilize the C-spine while allowing for head elevation.
956
What should be continuously monitored while maintaining spinal precautions?
Airway, breathing, and circulation (ABCs)
## Footnote
Monitoring is crucial to detect signs of airway compromise or deterioration in neurological status.
957
What should be prioritized in cases of head trauma with suspected C-spine injury?
Timely evacuation to a medical facility
## Footnote
Proper immobilization and stabilization of the head and neck should be maintained during evacuation.
958
What is the overall goal when addressing head elevation and spinal precautions?
Balance the benefits of head elevation with the need to maintain spinal precautions
## Footnote
Interventions should be done cautiously to avoid compromising spinal stability or exacerbating spinal injury.
959
True or False: Elevating the head is always safe in patients with suspected cervical spine injuries.
False
## Footnote
Elevation should only be done if it does not compromise the stability of the C-spine.
960
Fill in the blank: In doubt, err on the side of caution and prioritize ______ until further evaluation can be performed.
spinal precautions
## Footnote
This approach ensures the safety of the patient until medical professionals can assess the situation.
961
What is a significant difference between wound management in the wilderness and urban settings?
Backcountry wounds are often dirty or may become dirty, and there is often a lack of first aid materials.
962
What is the first step in managing wounds after the primary survey?
Exposure to the injured area for direct visualization.
963
What does hemostasis refer to in wound management?
The process of stopping bleeding.
964
What is the first step in stopping any blood loss?
Applying direct pressure to the source of bleeding.
965
When should a tourniquet be used?
If direct pressure does not stop the bleeding and there is rapid arterial bleed.
966
How should a tourniquet be applied?
Place it over clothing, about two to four inches above the wound, and tighten until bleeding stops.
967
What is the most important intervention to prevent infection in wounds?
High-pressure irrigation to clean the wound.
968
What should be done to a wound before closing it?
It should be cleaned through irrigation and decontamination.
969
What is the purpose of dressing a wound?
To protect it from the environment and help prevent infection.
970
What topical antibiotic is a good choice for skin wounds in the wilderness?
Bacitracin.
971
When should evacuation be considered for a wound?
For complex or mutilating wounds, grossly contaminated wounds, and bites of hands, legs, or feet.
972
True or False: Keeping a wound moist promotes healing and reduces scar formation.
True.
973
What are the two courses of action for closing a laceration in the wilderness?
* Primary closure
* Delayed primary closure
974
What is the Rule of Nines used for?
To estimate the Total Body Surface Area (TBSA) affected by burns.
975
What type of burn is characterized by red, painful skin?
Superficial burn.
976
What is the recommended treatment for partial-thickness burns?
Gently clean with cool water, apply antibacterial ointment, and cover with a sterile dressing.
977
What should be done if a blister is 2 cm in diameter or larger?
It may be treated by intentionally rupturing it with a sterile needle.
978
What is the primary reason to avoid placing an amputated digit directly on ice?
It can cause further tissue damage.
979
Fill in the blank: The application of _______ is necessary to control bleeding from scalp wounds.
continuous direct pressure
980
What is a common cause of blisters in the wilderness?
Friction from poor fitting shoes.
981
What is a key factor in preventing blisters?
Reducing 'hot spots' by properly breaking in boots.
982
What is the purpose of a scab?
To protect the wound from environmental contamination.
983
What should be done with wounds showing signs of infection?
Apply a new dressing and consider evacuation.
984
What are the classifications of burns based on depth?
* Superficial
* Partial thickness
* Full thickness
985
What should be done if ice is applied to burns?
Avoid applying ice directly for more than 15 minutes to prevent tissue damage.
986
What should be done with skin from a blister?
Apply an antibiotic ointment and cover the blister with a sterile dressing
## Footnote
Moleskin or mole foam can be used for protection. Hydrocolloid dressings provide added comfort.
987
How should an amputated digit be transported?
Promptly, and it should never be placed directly on ice
## Footnote
An attempt to reattach the finger in the wilderness is not advised.
988
What should you do with a penetrating object in a patient?
Stabilize the object with gauze or bulky dressing and evacuate as soon as possible
## Footnote
Removal in the field may cause additional damage or bleeding.
989
Should puncture wounds be irrigated?
Generally, no
## Footnote
Irrigation may push in contamination; the wound should be dressed without closure.
990
What is the purpose of honey in wound care?
To prevent infection and speed the healing process
## Footnote
Medihoney keeps the wound bed moist and releases an antibacterial agent.
991
What type of honey is specifically used in Medihoney?
Manuka honey
## Footnote
It contains methylglyoxal, which helps fight a broader range of bacteria strains.
992
What is Lodosorb used for?
To treat open wounds, stalled wounds, and infected wounds
## Footnote
It slowly releases antibacterial iodine into the wound bed.
993
What are common topical first aid antibiotics available over the counter?
Bacitracin, neomycin, and polymyxin B sulfate
## Footnote
Some may contain lidocaine for pain relief.
994
What is a significant issue with neomycin?
High allergic reaction rate
## Footnote
Clinics are moving away from using it.
995
What should be checked regarding bacitracin use?
Check for sulfa allergies
## Footnote
Bacitracin is sulfa-based.
996
What is Silvadene Cream 1% used for?
Prevention and treatment of wounds and second- and third-degree burns
## Footnote
It contains silver as an antimicrobial and emollients for pain relief.
997
What does Silvadene Cream contain to aid in wound care?
Silver and emollients
## Footnote
Silver acts as an antimicrobial, while emollients help ease pain.
998
What are the most common causes of weather-related deaths in outdoor medicine?
Heat-Related illnesses
## Footnote
Heat-related illnesses have a 30-year average well above all other outdoor-related weather deaths.
999
What is the normal average human body temperature in Fahrenheit?
98.6°F
## Footnote
This is equivalent to 37°C.
1000
What is hyperthermia?
A rise in body temperature above the average of 98.6°F (37°C) due to inability to divest excess heat.
1001
How does the body primarily lose heat?
Through three methods:
* Radiation
* Conduction
* Convection
## Footnote
Evaporation is a process that utilizes all three methods.
1002
What is the role of evaporation in heat loss?
It is a process that occurs when sweating and utilizes all three methods of heat transfer.
1003
What happens when air temperatures rise in relation to body heat loss?
Radiation no longer works, and the body relies on convection and conduction.
1004
What can exacerbate the risk of developing hyperthermia?
Medical conditions such as:
* Heart disease
* Skin diseases
* Burns
* Dehydration
* Endocrine and neurological disorders
* Obesity
## Footnote
Certain drugs and toxins can also prevent heat loss.
1005
What are environmental factors that increase the risk of hyperthermia?
Factors include:
* Exercising in a hot climate
* Lack of air conditioning
* Inappropriate clothing
* Decreased fluid intake
* Hot environments like tents or cars.
1006
What is a physiological response to heat stress?
Vasodilation occurs, increasing blood flow to the skin for heat loss.
1007
What are the symptoms of heat cramps?
Symptoms include:
* Brief, intermittent muscle contractions
* Usually in calves
* History of prolonged activity in heat
* Attempted hydration with non-electrolyte solutions.
1008
How are heat cramps treated?
Replace lost salt with:
* Salty snacks
* Electrolyte drinks
## Footnote
Plain water worsens the situation.
1009
What is heat edema?
Extremity swelling due to fluid pooling from hydrostatic pressure or vasodilation.
1010
What is heat syncope?
Loss of consciousness due to dehydration and blood pooling in the legs while standing.
1011
What are symptoms of heat exhaustion?
Symptoms include:
* Weakness
* Fatigue
* Nausea
* Headache
* Thirst
* Fast heart rate
* Altered mental status.
1012
What is the treatment for heat exhaustion?
Treat with:
* Fluid and electrolyte replacement
* Move to a shaded area
* Use a fan
* Apply cold compresses.
1013
What defines heat stroke?
Severe hyperthermia (>40°C), CNS disturbances, and anhidrosis.
1014
What neurological abnormalities are associated with heat stroke?
Includes:
* Ataxia
* Confusion
* Combativeness
* Fainting
* Coma.
1015
What is the initial treatment goal for heat stroke?
To drop the body core temperature below 40°C (104°F) as rapidly as possible.
1016
What should be done if a patient exhibits signs of heat stroke?
Evacuate the patient immediately.
1017
What are significant risk factors for heat-related illnesses?
Risk factors include:
* Dehydration
* Heart disease
* High humidity
* Heavy clothing
* Lack of acclimatization.
1018
What can happen if plain water is consumed excessively in hot conditions?
It can lead to toxicity and death if body salt is low.
1019
What can excessive ingestion of plain water lead to?
Toxicity and death due to low body salt from profuse sweating.
## Footnote
This highlights the importance of electrolyte drinks in certain situations.
1020
What types of beverages should be avoided to prevent dehydration?
Highly caffeinated beverages due to their diuretic effects.
## Footnote
Caffeine can increase fluid loss, exacerbating dehydration.
1021
What factors can increase the risk of developing heat-related illness?
* Obesity
* Alcohol use
* Antihistamines (e.g., Benadryl)
* Certain motion sickness medications
* Stimulants (e.g., cocaine, amphetamines)
* Salt and water depletion
## Footnote
These factors can impair the body's ability to cope with heat.
1022
What should rehydration include to maintain proper balance in the body?
A combination of water and electrolytes.
## Footnote
This helps prevent dangerously low sodium levels.
1023
What can happen if too much water is consumed in the absence of electrolytes?
It can lead to dangerously low levels of sodium, causing neurological damage and dysfunction.
## Footnote
This emphasizes the need for electrolyte balance.
1024
How should rehydration occur?
Slowly over several hours to allow the body to maintain fluid and electrolyte balance.
## Footnote
Rapid rehydration can disrupt this balance.
1025
What is a proper rule of thumb for fluid replacement after sweating?
Replace each pound of sweat lost with 500ml, or 2 cups, of fluid.
## Footnote
This guideline helps in effective rehydration.
1026
What is a reliable way to gauge hydration status?
Consistently clear urine.
## Footnote
Urine color is a practical indicator of hydration level.
1027
What is the best method to prevent heat illness?
Hydration is essential in preventing heat illness.
## Footnote
Early detection of dehydration is crucial.
1028
What clothing should be worn to prevent heat-related illness?
Loose-fitting clothing that promotes airflow and evaporative cooling.
## Footnote
Dark-colored and tight-fitting clothing should be avoided.
1029
What is acclimatization in relation to heat exposure?
A complex series of changes or adaptations that improve the body's ability to cope with heat stress.
## Footnote
This process enhances performance in hot environments.
1030
How long should adults gradually increase activity in hot environments for optimal acclimatization?
Over 7-10 days.
## Footnote
This gradual increase helps the body adapt to heat.
1031
What is the acclimatization period for children and the elderly?
10-14 days.
## Footnote
These groups require longer acclimatization due to physiological differences.
1032
What can be used to assist in acclimatization before exposure to heat?
Saunas and steam rooms.
## Footnote
These can help simulate heat stress and prepare the body.
1033
How quickly does de-acclimatization occur after leaving a hot environment?
Within 1-2 weeks.
## Footnote
This means acclimatization needs to be repeated before returning to heat.
1034
What is hypothermia most often associated with?
Prolonged exposure to cold winter activities such as skiing, snowshoeing, and mountaineering
## Footnote
It can also result from immersion accidents.
1035
Who is more frequently affected by hypothermia?
The urban homeless, intoxicated individuals, or patients with co-morbidities.
1036
What is the lowest known core temperature from which a patient with accidental hypothermia has been successfully resuscitated?
13.7°C (57°F).
1037
In what conditions can hypothermia be a danger during the summer months?
Elevated levels of air conditioning indoors, windy days, wet, cold weather, and cold water exposure.
1038
How does the body lose heat?
Through radiation, conduction, convection, and evaporation.
1039
What is the average human body temperature?
Approximately 37°C (99°F).
1040
What is radiation in the context of heat loss?
Heat loss occurring whenever the air temperature surrounding the body is less than 20°C (68°F).
1041
What is conduction?
Heat loss occurring when the body is in contact with any object that is cooler than the body.
1042
What occurs during convection?
Heat is transferred away from the body through circulating air currents.
1043
What is the process of evaporation in terms of heat loss?
It utilizes all three methods of heat transfer and occurs when you sweat.
1044
What are the four methods for heat loss?
* Radiation
* Conduction
* Convection
* Evaporation
1045
What is the single most important aspect of preventing hypothermia?
Adequate preparation.
1046
What physiological response occurs to conserve heat in the body?
Vasoconstriction of the skin and extremities.
1047
What defines hypothermia in terms of core body temperature?
A core body temperature of 35°C (95°F) or less.
1048
What phenomenon may occur as hypothermic individuals feel warm?
Paradoxical undressing.
1049
What is after-drop?
A decrease in core temperature as the extremities are rewarmed.
1050
What is the typical core temperature range for mild hypothermia?
32°C to 35°C (89.6°F to 95°F).
1051
What are the clinical symptoms of moderate hypothermia?
Impaired consciousness, not shivering, and vital signs decreasing.
1052
What is the core temperature range for severe hypothermia?
24°C to 28°C (75.2°F to 82.4°F).
1053
What is the core temperature for profound hypothermia?
Below 24°C (75.2°F).
1054
What is the first step in the treatment of hypothermia?
Preventing further heat loss.
1055
What should be avoided in the treatment of hypothermia?
Alcoholic beverages.
1056
What is the key to treating mild hypothermia?
Remove from elements and shelter to avoid further heat loss.
1057
What is a recommended method for rewarming in moderate hypothermia?
Use of large electric heat pads or blankets.
1058
What is required for treating severe hypothermia?
Aggressive treatment and prompt medical management.
1059
What should be done with hypothermic patients during transportation?
Handle very gently to prevent fatal rhythms.
1060
What is frostbite?
Occurs when the skin is exposed to temperatures below freezing.
1061
Where does frostbite most commonly occur?
In the extremities, especially feet and hands.
1062
What occurs when the skin is exposed to temperatures below freezing?
Frostbite
## Footnote
Frostbite occurs most often in extremities, especially feet and hands, but can affect any body part.
1063
What is the most common risk factor for frostbite?
Diabetes
## Footnote
Diabetes leads to poor circulation and nerve damage, increasing the risk of cold injuries.
1064
What are the four degrees of frostbite?
* 1st Degree: Superficial layers only, no blisters
* 2nd Degree: Deeper layers frozen, blisters with clear fluid
* 3rd Degree: Complete freezing of skin and deeper tissues, blood blisters form
* 4th Degree: Full-thickness skin, muscle, tendon involvement, red fluid blisters, can freeze bone.
1065
What is the optimal temperature for rewarming a frostbitten extremity?
40-42°C (104-108°F)
## Footnote
The temperature must be closely monitored to avoid burns or delayed thawing.
1066
Fill in the blank: Refreezing a previously thawed frostbitten body part will result in a significant increase in _______.
damage
1067
What should you not do to a frostbitten area?
Do not rub the frostbitten area
## Footnote
Rubbing can cause further skin damage.
1068
What medications can be given to prevent clotting and inflammation in frostbite victims?
* Aspirin
* Ibuprofen
## Footnote
Ibuprofen is preferred as it may aid in injury repair.
1069
What is frostnip?
A condition without ice crystal formations where the skin remains soft and pliable
## Footnote
Frostnip can lead to frostbite if untreated.
1070
How long does it typically take for chilblains to heal?
About one week
1071
What is trench foot (immersion foot)?
A condition caused by prolonged exposure of feet to cold water
## Footnote
Important steps include drying feet and warming them.
1072
What is the primary treatment for cold-related injuries?
Prevention
## Footnote
Adequate preparation is crucial for avoiding hypothermia and cold injuries.
1073
True or False: Evacuation is always necessary for frostnip.
False
## Footnote
Evacuation is not usually necessary unless rewarming is problematic.
1074
What should be avoided when treating trench foot?
Do not put feet in very warm water
## Footnote
Feet should be dried before warming to prevent further damage.
1075
What develops after rewarming frostbite?
* Blisters
* Edema
* Hard eschar
## Footnote
These can form with healthy tissue deep to the eschar.
1076
Fill in the blank: The pain felt while thawing indicates that _______ is returning to the affected area.
warm blood
1077
What is the voltage potential difference for every ten feet of ascension through the air?
300 volts
## Footnote
This amounts to approximately 380,000 volts at the top of the atmosphere.
1078
How many times does lightning strike the earth each second?
More than 100 times
## Footnote
This totals approximately 8 million times per day.
1079
Approximately how many thunderstorms occur worldwide each day?
50,000 thunderstorms
1080
What is the estimated annual global death toll from lightning?
2,000 people
## Footnote
Estimates vary, with one view listing the toll at 6,000.
1081
What is the chance of an individual falling victim to lightning in their lifetime?
1 in 100,000
1082
What is the average annual lightning strike fatalities in the United States over the last 20 years?
51 fatalities
1083
What percentage of people struck by lightning are estimated to survive?
90 percent
1084
What are the top three locations where people are most at risk of being struck by lightning?
* Open fields, sport parks, in/on water
* Under trees
* On beaches
1085
How many lightning flashes strike the ground each year in the United States?
22 million flashes
1086
Which U.S. state is the most lightning-prone region?
Florida
1087
What is the most dangerous activity during a thunderstorm?
Swimming
1088
What are the four primary types of lightning?
* Intra-cloud
* Cloud to cloud
* Cloud to air
* Cloud to ground
1089
What is positive lightning?
Lightning that originates at the top of the thunderstorm carrying a large positive charge
1090
What are the mechanisms of lightning injury?
* Ground current
* Side splash
* Upward streamer
* Direct strike
* Contact
1091
What percentage of lightning deaths are attributed to blunt trauma?
50-55 percent
1092
What is the most common cause of death in lightning strikes?
Cardiopulmonary arrest
1093
What should be prioritized in triage for lightning strike victims?
Reverse-triage for those in cardiac and/or respiratory arrest
1094
What are common complications of being struck by lightning?
* Neurologic complications
* Eye complications
* Hearing complications
* Chronic pain syndrome
* Neurocognitive deficits
1095
What should you do when you hear thunder?
Seek shelter indoors
1096
What types of structures provide the best protection from lightning?
Substantial buildings or cars
1097
What is the MARCH protocol?
A protocol to follow for evacuating lightning strike victims
1098
Fill in the blank: Lightning is attracted to _______.
tall objects
1099
True or False: Water and metal attract lightning.
False
## Footnote
They do not attract lightning, but they are excellent conductors of electricity.
1100
What offers the best protection from lightning?
A house or other substantial building
## Footnote
It is important to stay away from windows and doors and avoid contact with conductive materials.
1101
What should you avoid during a lightning storm?
Contact with anything that conducts electricity, such as landline telephones
## Footnote
Staying indoors is the safest option.
1102
How do cars protect against lightning?
Lightning flows around the outside of a car, with the majority of current flowing into the ground below
## Footnote
The protection is due to the metal cage of the car, not the rubber tires.
1103
What is a Faraday cage?
An enclosure formed by conductive material used to block electric fields
## Footnote
Cars act as mobile Faraday cages during lightning storms.
1104
What happens to convertibles during a lightning storm?
They do not have metal roofs, compromising the Faraday cage effect
## Footnote
This makes them less safe compared to regular cars.
1105
What is the best rule to follow when you see lightning or hear thunder?
Go indoors
## Footnote
The threat of lightning persists longer than most people realize.
1106
How long should you wait after the last clap of thunder before leaving shelter?
At least 30 minutes
## Footnote
This ensures that the threat of lightning has passed.
1107
True or False: Sunshine or blue sky means it is safe to go outside during a lightning storm.
False
## Footnote
Do not be fooled by weather conditions; lightning can still pose a threat.
1108
What happens to someone taken immediately to the summit of Mt. Everest?
They would pass out and likely die within minutes.
1109
What altitude is referred to as the 'death zone'?
About 27,000 feet (8,200 meters).
1110
What is altitude illness?
A condition that can occur when ascending to high altitudes, leading to illness or death.
1111
What is the primary cause of altitude illness?
The decrease in partial pressure of oxygen at high altitudes, leading to hypobaric hypoxia.
1112
At what elevation is altitude illness extremely rare?
Below 2,000 meters (6,500 feet).
1113
What is the alveolar gas equation?
PaO2 = PiO2 - PaCO2/RER.
1114
What does PaO2 represent in the alveolar gas equation?
Arterial oxygen pressure.
1115
What is the effect of hyperventilation at high altitudes?
It lowers PaCO2, allowing for higher PaO2 retention.
1116
What is acute mountain sickness (AMS)?
A common illness occurring in 10% - 70% of individuals after a recent gain in altitude.
1117
What are the symptoms used to diagnose AMS according to the Lake Louis Consensus criteria?
* Headache
* Dizziness or lightheadedness
* Fatigue or weakness
* Nausea/vomiting/anorexia
* Insomnia
1118
What are the significant risk factors for AMS?
* Prior history of AMS
* Fast or high ascents
* Obesity
1119
What is High Altitude Cerebral Edema (HACE)?
A life-threatening condition characterized by severe AMS symptoms and neurologic dysfunction.
1120
What are common symptoms of HACE?
* Ataxia
* Altered level of consciousness
* Severe lassitude
1121
What is High Altitude Pulmonary Edema (HAPE)?
A condition arising from fluid accumulation in the lungs due to altitude exposure.
1122
What are some symptoms of HAPE?
* Dyspnea at rest
* Cough
* Weakness or decreased exercise performance
* Chest tightness or congestion
1123
What is the primary treatment for AMS?
Discontinue ascent and rest, with acetazolamide as the treatment of choice.
1124
What is the immediate treatment for HACE?
Immediate descent and administration of dexamethasone.
1125
What medication is used for AMS prophylaxis?
Acetazolamide, 125 mg twice daily, starting 1 - 2 days before ascending.
1126
What is the recommended ascent rate to prevent HAPE?
No more than 350 meters (1,155 feet) a day.
1127
What should be done if a person with HAPE shows mild symptoms?
Immediate descent is imperative.
1128
What physiological change occurs first in response to hypobaric hypoxia?
An increase in respiratory rate.
1129
What is the consequence of hyperventilation at high altitudes?
It can lead to alkalosis and decreased breathing drive.
1130
What is the Lake Louis consensus criteria for diagnosing HAPE based on symptoms?
* Dyspnea at rest
* Cough
* Weakness or decreased exercise performance
* Chest tightness or congestion
1131
What is the physiological cause believed to lead to HACE?
Local vasodilation of cerebral blood vessels in response to hypoxia.
1132
What should be done for a person experiencing AMS who is not evacuated?
Rest at the current altitude and consider medical interventions.
1133
What is a key characteristic of the progression of AMS to HACE?
It typically occurs over 1 - 3 days.
1134
What should be avoided to facilitate acclimatization?
Increases of greater than 600 meters in sleeping altitude.
1135
What is a common sign of HAPE upon physical examination?
Crackles or wheezing in at least one lung field.
1136
What is the role of bicarbonate secretion in altitude acclimatization?
It causes diuresis and metabolic acidosis with compensatory hyperventilation.
1137
What should be done for a victim with HACE after descent?
They should be evacuated.
