Mixed Deck — All WFR Topics Flashcards

During your primary assessment of an unresponsive adult patient, you determine they are not breathing but have a definite carotid pulse. What is the correct intervention according to WFR life support protocols?

Answer: Provide 1 rescue breath every 6 seconds.

The patient is in respiratory arrest, not cardiac arrest, because a pulse is present. The correct treatment is to provide rescue breaths to oxygenate the blood. The current guideline for an adult is to provide 1 breath every 6 seconds (10 breaths per minute). Starting chest compressions (CPR) is incorrect as the heart is still beating. An AED is only used for cardiac arrest and would not be effective.

What is the first priority when assessing a trauma patient in the wilderness?

Answer: Assessing the ABCs (Airway, Breathing, Circulation).

When assessing any trauma patient, especially in the wilderness, the absolute first priority is to assess and manage the ABCs: Airway, Breathing, and Circulation. Ensuring a patent airway, adequate breathing, and effective circulation addresses the most immediate life threats. Without these basic functions, other interventions will be ineffective, making them the foundation of all trauma care.

The standard adult epinephrine auto-injector (EpiPen) delivers which dose intramuscularly?

Answer: 0.3 mg

The standard adult EpiPen delivers 0.3 mg of epinephrine IM into the lateral thigh, the established dose for treating anaphylaxis.

When should you initiate an emergency evacuation for a patient?

Answer: When the patient's condition is life-threatening or beyond field care.

Emergency evacuation is a serious decision reserved for situations where a patient's life is in immediate danger or their injuries/illness exceed the capabilities of wilderness first aid. Attempting to manage critical conditions in the field when advanced medical care is needed can lead to worse outcomes. Therefore, evacuation is initiated when the patient's condition is life-threatening or beyond the scope of field treatment.

A climber falls and complains of severe pain in their lower leg. The leg is obviously deformed. After completing the primary survey and confirming no immediate life threats, you begin the secondary assessment. What is the most appropriate first step for assessing the injured leg?

Answer: Check for Circulation, Sensation, and Movement (CSM) distal to the injury.

During the head-to-toe physical exam of the secondary assessment, it is crucial to check for Circulation, Sensation, and Movement (CSM) in all extremities, especially distal to a known injury. This helps determine if blood flow and nerve function are compromised, which is a critical finding that influences treatment and evacuation urgency.

When packaging a patient with a suspected spinal injury in a litter for a long evacuation, what is the primary purpose of creating an "X" pattern with webbing straps over the patient's torso?

Answer: To prevent the patient from sliding up or down within the litter on inclines and declines.

The diagonal or "X" strapping pattern is crucial for securing the patient's torso to the litter and preventing longitudinal (up and down) movement. This is especially important for a patient with a potential spinal injury when the litter is tilted during an evacuation over steep terrain.

Which of the following statements best describes a primary difference in the approach to Cardiopulmonary Resuscitation (CPR) in a wilderness versus an urban setting?

Answer: In the wilderness, rescuers may have specific protocols to stop CPR after a set period if resuscitation is futile.

Due to prolonged transport times and limited resources, wilderness medicine protocols include specific criteria for terminating resuscitation efforts (e.g., after 30 minutes of CPR without a return of spontaneous circulation in certain non-hypothermic situations). In an urban setting, CPR is almost always continued until care is transferred to a higher medical authority. The compression-to-breath ratio and rate remain the same (30:2 at 100-120/min), and rescue breaths are a critical component of CPR.

You are treating a patient for anaphylaxis and have administered a dose of epinephrine via an auto-injector. Their symptoms initially improve, but 15 minutes later, their breathing becomes difficult again and the hives return. What is the correct course of action?

Answer: Administer a second dose of epinephrine.

Anaphylaxis can have a biphasic or rebound reaction, where symptoms recur after initially improving. The treatment for this rebound reaction is the same as the initial treatment: administer another dose of epinephrine. WFR protocols allow for repeating epinephrine doses every 5-15 minutes if symptoms persist or return. While antihistamines are part of the treatment, epinephrine is the primary life-saving medication. CPR is only indicated if the patient is pulseless and not breathing.

A patient has a suspected closed fracture of their forearm. Which of the following describes the most appropriate improvised splinting technique?

Answer: Using a rolled-up sleeping pad and two trekking poles to create a rigid 'sandwich' splint, secured with straps.

A good improvised splint should be well-padded, rigid, and immobilize the joints above and below the injury. Using a sleeping pad for padding and two rigid trekking poles on either side of the forearm creates a strong 'sandwich' splint. A single branch provides poor immobilization. A sling alone is insufficient for a forearm fracture as it doesn't immobilize the wrist and elbow effectively. A mud cast would be ineffective and potentially harmful.

A member of your party spills boiling water on their hand while cooking. The skin is red, painful, and has formed several small blisters. After stopping the burning process, what is the immediate and most critical treatment?

Answer: Cool the burn with cool (not ice-cold) water for at least 20 minutes.

The immediate and most important first aid for a thermal burn is to stop the burning process by cooling the area. This should be done with cool running water or compresses for a minimum of 20 minutes if possible. This action limits the depth of the burn and provides significant pain relief. Applying ointments immediately can trap heat. Tight bandages are inappropriate, and blisters should generally be left intact as they provide a sterile barrier.

When should you initiate a rapid body survey?

Answer: When life-threatening conditions are suspected

A rapid body survey is a quick, head-to-toe assessment performed to identify immediate life-threatening injuries or conditions. It should be initiated when a patient has sustained significant trauma or when life-threatening conditions are suspected based on the mechanism of injury or initial assessment. This survey helps prioritize interventions and ensures critical problems are addressed without delay.

Which of the following components is part of the secondary assessment in the Wilderness First Responder Patient Assessment System?

Answer: Obtaining a SAMPLE history from the patient.

The secondary assessment occurs after the primary assessment has ruled out or managed immediate life threats. It involves a more detailed examination, which includes obtaining a SAMPLE history (Signs/Symptoms, Allergies, Medications, Pertinent history, Last oral intake, Events leading to injury), taking vital signs, and performing a head-to-toe physical exam.

Which over-the-counter medication provides pain relief, fever reduction, AND anti-inflammatory effects, making it especially useful for musculoskeletal injuries in the wilderness?

Answer: Ibuprofen (Advil/Motrin)

Ibuprofen is an NSAID that provides analgesia, antipyresis, and anti-inflammation, making it the most versatile OTC choice for sprains, strains, and similar injuries.

How often should you reassess vital signs in a stable wilderness patient?

Answer: Every 2-4 hours

For a stable patient in a wilderness setting, reassessing vital signs every 2-4 hours is generally appropriate to monitor for any changes in their condition. While more frequent checks are needed for unstable patients, a stable patient still requires regular monitoring due to the dynamic nature of injuries and illnesses, and the challenging wilderness environment. This allows for early detection of deterioration without over-taxing resources.

You are treating a patient with a painful, swollen, and deformed ankle after they slipped on a wet log. Before and after applying a splint, you assess CSM. Which of these checks evaluates the 'Sensation' component?

Answer: Lightly touching a toe and asking the patient, 'Can you feel this?'

Assessing 'Sensation' involves checking for normal nerve function. This is typically done by lightly touching the skin distal to the injury and asking the patient if they can feel it, or if it feels the same as the uninjured side. Feeling for a pulse checks 'Circulation,' asking them to wiggle toes checks 'Motion,' and skin color/temperature is also part of the 'Circulation' assessment.

In wilderness medicine, chewable aspirin (325 mg) is most critically indicated when a patient is suspected of having:

Answer: An acute myocardial infarction (heart attack)

Aspirin's antiplatelet action inhibits further clot formation during a heart attack, potentially reducing myocardial damage while awaiting evacuation.

Which of the following is a sign of heat stroke (a life-threatening emergency)?

Answer: Confusion and lack of sweating.

Heat stroke is a life-threatening emergency characterized by a dangerously elevated core body temperature and central nervous system dysfunction. Key signs include confusion, altered mental status, and often a lack of sweating (anhidrosis) because the body's thermoregulatory mechanism has failed. Unlike heat exhaustion, profuse sweating is typically absent in heat stroke.

A hiker is bitten on the ankle by a venomous pit viper. Which of the following actions is contraindicated and should be AVOIDED in the field management of this injury?

Answer: Applying ice packs directly to the bite site to reduce swelling.

Applying ice or cold packs is contraindicated as it can cause localized tissue damage (cryotherapy) and may worsen the effects of cytotoxic venom by concentrating it in one area. The other options are all recommended WFR protocols: keeping the patient calm reduces circulation of venom, splinting immobilizes the limb, and marking swelling tracks venom progression.

How should you communicate with a panicked team member during a rescue?

Answer: Give them a simple, direct task to focus on.

When a team member is experiencing panic, providing a simple, direct, and achievable task can help redirect their focus and regain control. This gives them something concrete to concentrate on, breaking the cycle of panic and allowing them to contribute constructively. It helps to ground them and restore a sense of purpose and capability.

What is the first step in wilderness patient assessment?

Answer: Assess the scene for safety

Initial assessment focuses on identifying immediate life threats in remote environments.