CORE Wilderness First Aid and Emergency Response — Questions and Answers
Question 1: In Wilderness First Aid, the patient assessment system (PAS) begins with scene size-up. What is the PRIMARY purpose of scene size-up before approaching a patient?
- Documenting the mechanism of injury for later legal purposes
- Ensuring the scene is safe for both rescuer and patient before entry (Correct answer)
- Counting the number of patients to request appropriate resources
- Determining whether to perform CPR or bleeding control first
Correct answer: Ensuring the scene is safe for both rescuer and patient before entry
Scene safety is always evaluated before approaching. If the scene is not safe — due to falling rock, swift water, or a dangerous animal — rescuers who rush in become additional patients. Only after confirming safety does the responder move to patient contact.
Question 2: A participant on a backcountry trip stops shivering despite being cold and wet, and becomes confused and lethargic. These signs indicate progression to:
- Mild hypothermia — manageable with extra layers
- Moderate-to-severe hypothermia — requiring aggressive warming and evacuation (Correct answer)
- Hypoglycemia — manageable with oral glucose administration
- Dehydration — treatable with oral fluid replacement
Correct answer: Moderate-to-severe hypothermia — requiring aggressive warming and evacuation
Loss of shivering in a cold, wet patient combined with altered mental status signals moderate-to-severe hypothermia. The cessation of shivering is a dangerous sign — the body can no longer generate heat — and field rewarming plus urgent evacuation are required.
Question 3: A student is stung by a bee and reports throat tightening, hives, and dizziness within minutes. The FIRST intervention by a trained outdoor educator with a prescribed auto-injector available should be:
- Administer an oral antihistamine and monitor for 30 minutes
- Administer epinephrine via auto-injector into the outer mid-thigh and call for evacuation (Correct answer)
- Apply a cold compress to the sting site and elevate the affected limb
- Have the student breathe into a paper bag to control hyperventilation
Correct answer: Administer epinephrine via auto-injector into the outer mid-thigh and call for evacuation
Throat tightening, hives, and dizziness after a sting indicate anaphylaxis — a life-threatening allergic reaction. Epinephrine (not antihistamines) is the first-line emergency treatment; the outer mid-thigh is the standard injection site, and evacuation must begin immediately afterward.
Question 4: When making a field evacuation decision using the WFA framework, which patient finding MOST clearly indicates the need for urgent (non-delayed) evacuation?
- A twisted ankle with point tenderness and mild swelling but no deformity
- An altered level of consciousness that does not return to normal within minutes (Correct answer)
- Sunburn with mild blistering on the shoulders
- A blister on the heel that has been cleaned and dressed
Correct answer: An altered level of consciousness that does not return to normal within minutes
Persistently altered mental status is a red-flag sign indicating potential serious head injury, severe systemic illness, or other life-threatening conditions. It requires urgent evacuation. The other findings are serious but manageable in the field.
Question 5: The 'STOP' mnemonic used in outdoor emergency response stands for:
- Stabilize, Treat, Observe, Prepare
- Stop, Think, Observe, Plan (Correct answer)
- Scene, Triage, Oxygen, Packaging
- Survey, Treat, Organize, Proceed
Correct answer: Stop, Think, Observe, Plan
STOP (Stop, Think, Observe, Plan) is a foundational decision-making framework taught in wilderness first aid and survival courses to prevent panic-driven mistakes. It slows the responder down to assess before acting.
Question 6: A hiker develops a severe headache, nausea, and ataxia after ascending rapidly to 11,000 feet. The outdoor educator's BEST initial intervention is:
- Administer ibuprofen and encourage the patient to drink more water
- Descend to a lower elevation immediately, even if only 1,000–2,000 feet (Correct answer)
- Have the patient rest in a sleeping bag and monitor overnight
- Administer supplemental oxygen and continue to higher elevation
Correct answer: Descend to a lower elevation immediately, even if only 1,000–2,000 feet
Headache, nausea, and ataxia (loss of coordination) at altitude indicate Acute Mountain Sickness progressing toward High-Altitude Cerebral Edema. Descent is the definitive treatment; even 1,000–2,000 feet of descent can be life-saving and should not be delayed.
CORE Wilderness First Aid and Emergency Response
In Wilderness First Aid, the patient assessment system (PAS) begins with scene size-up.
What is the PRIMARY purpose of scene size-up before approaching a patient?