Case Analysis & Practical Application Flashcards

A skier collides with a tree and is found unconscious with gurgling respirations. After opening the airway with a jaw thrust, the gurgling persists. What is your next action?

Answer: Suction the airway to clear secretions

Gurgling respirations indicate fluid in the upper airway; suctioning is required to clear the obstruction before effective ventilation can occur.

During a wilderness trip, a patient with a known bee allergy is stung and begins showing hives, throat tightness, and hypotension. Epinephrine has been administered. What is the next priority?

Answer: Prepare for a second epinephrine dose and arrange rapid evacuation

Anaphylaxis can be biphasic; after epinephrine the patient must be evacuated rapidly and a second dose prepared because effects may wear off before definitive care is reached.

A snowboarder reports severe knee pain after a fall with a twisting mechanism. The knee is swollen and he cannot bear weight. Which assessment finding would most suggest a ligamentous injury versus a fracture?

Answer: Audible pop heard at time of injury with instability on valgus stress

An audible pop followed by joint instability on stress testing is a classic presentation of ligamentous rupture, particularly the ACL.

A hiker is found alert but confused after a long summer hike in 95°F heat with minimal water intake. Skin is hot and dry, HR 120, BP 90/60. What condition does this presentation most likely represent?

Answer: Exertional heat stroke

Hot dry skin with altered mental status, tachycardia, and hypotension after exertion in heat indicates exertional heat stroke, a life-threatening emergency requiring immediate cooling.

You are assessing a rock climber who fell 15 feet onto a ledge. He is ambulatory and denies back pain but has a small scalp laceration. Under what circumstance should you still apply spinal precautions?

Answer: Mechanism alone (significant fall) warrants precautions even without symptoms

A fall of significant height is a high-risk mechanism; OEC protocols recommend applying spinal precautions based on mechanism even when initial symptoms are absent.

A cross-country skier presents with a white, waxy, hard patch of skin on her cheek that does not blanch with pressure. She reports no sensation in the area. What stage of frostbite is this most consistent with?

Answer: Deep frostbite

White, waxy, hard skin with absent sensation and failure to blanch indicates deep frostbite involving full skin thickness and underlying tissues.

A patient in a remote canyon has a femur fracture from a rockfall. Before splinting, you assess PMS distally. What does PMS stand for and why is it critical in this scenario?

Answer: Pulse, Motor function, Sensation — to detect neurovascular compromise

PMS (Pulse, Motor, Sensation) assessment detects neurovascular compromise from the fracture or splint, which can lead to permanent limb damage if unrecognized.