Quiz Answers to: Are you prepared for a wilderness emergency?
Question 1: What is the first action to take when treating most kinds of bleeding?
- Apply a tourniquet, take it off later
- Apply a pressure dressing
- Apply a bandaid
- Apply direct pressure with a gloved hand and gauze
Question 2: You discover a small, bubbling wound on your patient’s chest. What should you do next?
Reasoning: Any opening into the chest should be sealed immediately with a gloved hand. Meaning, as soon as you find a bubbling chest wound on a patient you should reactively place the palm of your gloved hand over it to stop more air from entering. Then cover it with an occlusive dressing taped on four sides. This treatment has high priority since it directly compromises airway and breathing.
An occlusive dressing is anything that will not allow air to pass into the chest. A glove, plastic bag or wrapper is a good option.
Finger insertion may cause may cause more damage. Gauze would not be appropriate because it is not create an air proof seal.
- Insert your finger into the wound to seal it
- Cover the wound with your gloved palm to seal it
- Leave it uncovered to allow it to vent
- Cover it with gauze and tape, and monitor it for bleeding
Reasoning: Any opening into the chest should be sealed immediately with a gloved hand. Meaning, as soon as you find a bubbling chest wound on a patient you should reactively place the palm of your gloved hand over it to stop more air from entering. Then cover it with an occlusive dressing taped on four sides. This treatment has high priority since it directly compromises airway and breathing.
An occlusive dressing is anything that will not allow air to pass into the chest. A glove, plastic bag or wrapper is a good option.
Finger insertion may cause may cause more damage. Gauze would not be appropriate because it is not create an air proof seal.
Question 3: Your patient with the bubbling open chest wound needs an occlusive dressing. Your supplies are limited. Which item below would be suitable to use as an occlusive dressing?
Reasoning: The foil bag. An occlusive dressing is anything that will not allow air to pass into the chest. A glove, plastic bag or wrapper is a good option. All other items are not air occlusive.
Any opening into the chest should be sealed immediately with a gloved hand. Meaning, as soon as you find a bubbling chest wound on a patient you should reactively place the palm of your gloved hand over it to stop more air from entering. Then cover it with an occlusive dressing taped on four sides. This treatment has high priority since it directly compromises airway and breathing.
- A rolled up wool mitten
- Cloth climbing tape from your harness
- Your face buff or scarf
- The foil bag from your dehydrated backpacking meal
Reasoning: The foil bag. An occlusive dressing is anything that will not allow air to pass into the chest. A glove, plastic bag or wrapper is a good option. All other items are not air occlusive.
Any opening into the chest should be sealed immediately with a gloved hand. Meaning, as soon as you find a bubbling chest wound on a patient you should reactively place the palm of your gloved hand over it to stop more air from entering. Then cover it with an occlusive dressing taped on four sides. This treatment has high priority since it directly compromises airway and breathing.
Question 4: What is compartment syndrome?
Reasoning: Another major concern of fractures and serious injury is the potential development of compartment syndrome. Compartment syndrome occurs when pressure builds within the limb and compresses nerve and blood vessels. This pressure may be caused from swelling of the injury site, bandages that are wrapped too tightly, periods of long compression, and crush injuries. Compression of nerve and blood vessels will lead to severe damage and possible loss of limb. This can only be treated with surgery.
Signs and Symptoms of compartment syndrome include:
- Pressure build up within an injured limb that can compress blood vessels and nerves
- Pressure build up within the skull that can compress the brain and it’s nerves and blood vessels
- The loss of pressure with a limb that leads to the collapse blood vessels and nerves
- The partial amputation of a hand or foot
Reasoning: Another major concern of fractures and serious injury is the potential development of compartment syndrome. Compartment syndrome occurs when pressure builds within the limb and compresses nerve and blood vessels. This pressure may be caused from swelling of the injury site, bandages that are wrapped too tightly, periods of long compression, and crush injuries. Compression of nerve and blood vessels will lead to severe damage and possible loss of limb. This can only be treated with surgery.
Signs and Symptoms of compartment syndrome include:
- Pain out of proportion to injury
- Numbness, tingling, or shooting like pain
- Swelling and tightness of injury site
Question 5: When should you apply a pelvic splint?
Reasoning: Automatically apply a pelvic splint to any patient that has suffered a mechanism of injury capable of causing a pelvis fracture. This pelvic splint can be a commercially made product like the SAM pelvic splint or it can be improvised from a triangle bandage, jacket, scarf, blanket, or any other material that is wide enough to cradle the hips. Gently slide whatever you are using under the patient's hips, tie a knot over the center of the pelvis to create a windlass similar to the improvised tourniquet. Tighten and secure. Do not remove this once placed. To add more stability, secure the legs together and secure the patient to a backboard if available. Try your best to move the patient has a single unit. Do not to log roll the patient more than necessary, however this may not be possible if you have to clear the airway.
- Only when I find pelvic instability during my assessment
- When the patient says they have pelvic pain but can still walk
- When I have a patient that has suffered a mechanism of injury capable of causing a pelvis fracture
- A pelvic splint should never be applied
Reasoning: Automatically apply a pelvic splint to any patient that has suffered a mechanism of injury capable of causing a pelvis fracture. This pelvic splint can be a commercially made product like the SAM pelvic splint or it can be improvised from a triangle bandage, jacket, scarf, blanket, or any other material that is wide enough to cradle the hips. Gently slide whatever you are using under the patient's hips, tie a knot over the center of the pelvis to create a windlass similar to the improvised tourniquet. Tighten and secure. Do not remove this once placed. To add more stability, secure the legs together and secure the patient to a backboard if available. Try your best to move the patient has a single unit. Do not to log roll the patient more than necessary, however this may not be possible if you have to clear the airway.
Question 6: How should you treat a femur fracture if you do not have a commercial traction device?
Reasoning: Typically, traction splints are the go-to treatment in the prehospital setting. Traction is beneficial as it helps to realign and stabilize the sharp bone ends, reducing damage and pain. But in the wilderness, traction splints may not be available. Improvising a traction splint is not advised because if it is not done properly and if traction is lost, the risk of lacerating vessels and nerves is even higher. Furthermore, traction should only be used on mid-shaft femur fractures. Determining if a femur fracture is mid-shaft or not may be difficult for inexperienced medical personnel. Therefore, if you do not have a commercial traction device, then simply splint the femur to immobilize and prevent further harm. Monitor CMS closely. Again, try your best to move the patient has a single unit. Use a backboard if available.
- Create an improvised traction device out of trekking poles and para cord
- Splint the femur fracture and avoid unnecessary movement
- No other treatment options exist if a traction device is not available
- Splint the knee and ankle and do not move the patient
Reasoning: Typically, traction splints are the go-to treatment in the prehospital setting. Traction is beneficial as it helps to realign and stabilize the sharp bone ends, reducing damage and pain. But in the wilderness, traction splints may not be available. Improvising a traction splint is not advised because if it is not done properly and if traction is lost, the risk of lacerating vessels and nerves is even higher. Furthermore, traction should only be used on mid-shaft femur fractures. Determining if a femur fracture is mid-shaft or not may be difficult for inexperienced medical personnel. Therefore, if you do not have a commercial traction device, then simply splint the femur to immobilize and prevent further harm. Monitor CMS closely. Again, try your best to move the patient has a single unit. Use a backboard if available.
Question 7: Your friend is a known diabetic who suddenly went unconscious. You are not sure if they are experiencing low blood sugar or high blood sugar. What should you do?
Reasoning: Give sugar anyway. Sometimes you will not have access to a glucometer in the wilderness and differentiating between hypo and hyperglycemia can be difficult. If in doubt, administer sugar. Sugar will save the life of someone experiencing hypoglycemia and not cause much harm in hyperglycemia.
- Do not give sugar since you are not certain which it is
- Give sugar anyway since it will not cause more harm for high sugar
- Give sugar, but only a small amount to see if there is an improvement
- Do not give sugar since the patient is unconscious and can not swallow
Reasoning: Give sugar anyway. Sometimes you will not have access to a glucometer in the wilderness and differentiating between hypo and hyperglycemia can be difficult. If in doubt, administer sugar. Sugar will save the life of someone experiencing hypoglycemia and not cause much harm in hyperglycemia.
Question 8: How would you give sugar to your unconscious friend?
Reasoning: If the patient is unconscious or incapable of swallowing, rub sugar in small amounts against the inside of the cheek with a tongue depressor. Never pour anything down an unconscious patient’s throat as it can interfere with oxygenation.
- Dissolve sugar in water and slowly pour down patient’s throat
- Using a tongue depressor, rub a small amount under the patient’s tongue
- Rectally insert sugar using a tongue depressor
- Using a tongue depressor, rub a small amount at a time against the inside of the patient’s cheek
Reasoning: If the patient is unconscious or incapable of swallowing, rub sugar in small amounts against the inside of the cheek with a tongue depressor. Never pour anything down an unconscious patient’s throat as it can interfere with oxygenation.
Question 9: Why should a shock patient be treated for hypothermia even if they are not hypothermic?
Reasoning: It is very important to keep a shock patient warm. Hypothermia can potentiate the progression of shock, especially the in case of trauma.
- Because hypothermia makes shock worse
- Because hypothermia reverses shock
- Because warmth increases patient morale
- Because hyperthermia is an ideal healing state
Reasoning: It is very important to keep a shock patient warm. Hypothermia can potentiate the progression of shock, especially the in case of trauma.
Question 10: The basic components of a hypo wrap include insulation from the ground, insulation around the patient, a heat retaining layer, and…
Reasoning: A hypowrap is an effective system that prevents heat loss and encourages heat retention. It consists of 4 layers:
Insulation between the ground and the patient prevents conductive heat loss. Insulation around the patient encourages heat retention. The heat reflection layer decreases heat loss by radiation and promotes heat retention. An effective hypowrap can still be made without this layer, but should be used if available. The vapor barrier is very important for heat retention and decreasing heat loss by radiation, convection, and evaporation. It also provides protection from the wet elements of the outside environment.
- A hat on the patient’s head to prevent radiation heat loss
- Adequate ventilation for heat circulation
- Protection from the environment, like a tarp, tent, or trash bag
- Water bottles filled with water and placed inside hypo wrap
Reasoning: A hypowrap is an effective system that prevents heat loss and encourages heat retention. It consists of 4 layers:
- Ground Insulation - Insulation between the patient and the ground, like a sleeping pad
- Patient Insulation - Insulation around the patient, such as a sleeping bag
- Heat Reflection - A reflective heat layer, such as a space blanket
- Vapor Barrier - This outermost layer should be waterproof, like a tarp
Insulation between the ground and the patient prevents conductive heat loss. Insulation around the patient encourages heat retention. The heat reflection layer decreases heat loss by radiation and promotes heat retention. An effective hypowrap can still be made without this layer, but should be used if available. The vapor barrier is very important for heat retention and decreasing heat loss by radiation, convection, and evaporation. It also provides protection from the wet elements of the outside environment.
Question 11: What is the main priority when treating a heat stroke patient?
Reasoning: When treating heat stroke, aggressive cooling measures are necessary. The extent of damage is directly related to the degree and duration of hyperthermia. After removing the patient from the heat and attending to ABC, cold-water submersion is the preferred treatment option for heat stroke. This can be accomplished with an ice bath or in a natural body of water like a stream or lake. If cold-water immersion is not possible, then wet patient with water or cover with wet clothing and fan to promote evaporation and convection cooling. All heat stroke victims should be evacuated but cooling techniques take priority.
- Remove the patient from the heat and cool the body.
- Hydrate the patient to replace fluid lost.
- Evacuate the patient immediately even if it delays treatment.
- Prepare to protect the patient’s airway if they begin seizing.
Reasoning: When treating heat stroke, aggressive cooling measures are necessary. The extent of damage is directly related to the degree and duration of hyperthermia. After removing the patient from the heat and attending to ABC, cold-water submersion is the preferred treatment option for heat stroke. This can be accomplished with an ice bath or in a natural body of water like a stream or lake. If cold-water immersion is not possible, then wet patient with water or cover with wet clothing and fan to promote evaporation and convection cooling. All heat stroke victims should be evacuated but cooling techniques take priority.
Question 12: Which is the best method to cool a heat stroke victim?
Reasoning: When treating heat stroke, aggressive cooling measures are necessary. The extent of damage is directly related to the degree and duration of hyperthermia. After removing the patient from the heat and attending to ABC, cold-water submersion is the preferred treatment option for heat stroke. This can be accomplished with an ice bath or in a natural body of water like a stream or lake. If cold-water immersion is not possible, then wet patient with water or cover with wet clothing and fan to promote evaporation and convection cooling. All heat stroke victims should be evacuated but cooling techniques take priority.
- Submerging the patient in cool water or an ice bath.
- Fanning the patient.
- Soaking the patient’s clothes with water.
- Giving cool drinks to the patient to slowly sip on.
Reasoning: When treating heat stroke, aggressive cooling measures are necessary. The extent of damage is directly related to the degree and duration of hyperthermia. After removing the patient from the heat and attending to ABC, cold-water submersion is the preferred treatment option for heat stroke. This can be accomplished with an ice bath or in a natural body of water like a stream or lake. If cold-water immersion is not possible, then wet patient with water or cover with wet clothing and fan to promote evaporation and convection cooling. All heat stroke victims should be evacuated but cooling techniques take priority.
|
This learning quiz is brought to you by Base Medical. We hope you learned something new. Maybe it will save a life. Get Smart and stay safe!
Not Certified? It's okay, start here!Be sure to check out our online Outdoor Safety Course. It's for non-medical people that love the outdoors. It's only $35, then it's your resource to learn how to prepare for wilderness emergencies, forever!
|