Case Analysis & Practical Application Flashcards

A mountain biker crashes and has an open chest wound that makes a sucking sound with each breath. After sealing it with a vented chest seal, his breathing worsens and neck veins become distended. What has likely occurred?

Answer: A tension pneumothorax is developing and the seal should be briefly lifted

Worsening respiratory distress with JVD after sealing an open chest wound suggests tension pneumothorax; briefly lifting the vented seal or burping a non-vented seal can relieve the pressure.

During a backcountry ski patrol assessment, you find a patient with suspected hypothermia. Core temperature is estimated at 30°C (86°F). Which rewarming strategy is most appropriate?

Answer: Active external rewarming to the core areas (axilla, groin, neck) with gentle handling

Moderate hypothermia (28–32°C) warrants active external rewarming to core heat transfer areas with extremely gentle handling to prevent afterdrop and cardiac arrhythmia.

A hiker is bitten on the hand by a rattlesnake. Which intervention should you prioritize in the field?

Answer: Immobilize the extremity at heart level and arrange rapid evacuation

Immobilizing the limb at heart level reduces venom spread while rapid evacuation to a facility with antivenom is the definitive treatment for pit viper envenomation.

A patient is found in a frozen lake after breaking through ice. She is pulseless and not breathing. Water temperature was near 0°C. What does OEC guidance say about resuscitation attempts?

Answer: Begin CPR; cold water submersion patients may survive prolonged arrest due to hypothermic protection

Cold water dramatically slows metabolism and can protect the brain; patients should receive full resuscitation efforts as survival after prolonged cold water submersion is possible.

A trail runner develops sudden severe headache, photophobia, and neck stiffness at altitude. She has no fever. Which condition should you consider first given this presentation?

Answer: Subarachnoid hemorrhage

The classic triad of sudden severe headache, photophobia, and nuchal rigidity without fever at altitude should raise concern for subarachnoid hemorrhage requiring emergency evacuation.

A patient fell from a horse and complains of left flank pain with hematuria (blood in urine). Vital signs are BP 100/70, HR 108, RR 20. What organ injury does this presentation suggest?

Answer: Renal (kidney) injury

Flank pain combined with hematuria after blunt trauma is the classic presentation of renal injury; associated hemodynamic instability indicates significant hemorrhage.

You are treating a patient with a suspected pelvic fracture after a high-speed ATV crash. Which intervention is most appropriate in the field?

Answer: Apply a pelvic binder or improvised sheet wrap at the level of the greater trochanters

A pelvic binder applied at the greater trochanters reduces pelvic volume and tamponades life-threatening internal hemorrhage from an unstable pelvic fracture.