Sudden and Severe Illnesses Flashcards

A member of your hiking party, a known diabetic, becomes confused, irritable, and starts stumbling. Their skin is pale and sweaty. Which of the following is the most appropriate immediate action?

Answer: Provide them with a sugary drink or food, like fruit juice or candy.

The patient is exhibiting classic signs of hypoglycemia (low blood sugar), which include altered mental status (confusion, irritability), pale and sweaty skin, and poor coordination. The most critical intervention is to rapidly raise their blood sugar. Providing a simple sugar that can be quickly absorbed is the priority. Administering insulin would further lower their blood sugar, which could be fatal. Water will not address the low blood sugar, and a secondary assessment, while important, is not the immediate life-saving action required.

You are leading a group on a multi-day trip when a participant is stung by a bee. They quickly develop hives all over their body, start wheezing, and complain of a tight throat. What is the most critical intervention for this patient?

Answer: Assisting the patient with their prescribed epinephrine auto-injector.

This patient is experiencing anaphylaxis, a severe, life-threatening allergic reaction. The signs include systemic hives, respiratory distress (wheezing), and airway compromise (tight throat). The definitive and life-saving treatment for anaphylaxis is the prompt administration of epinephrine. While antihistamines are a secondary treatment and evacuation is necessary, neither is the most critical first step. A cold compress only addresses the local reaction.

During a lunch break on a trail, a 60-year-old man suddenly complains of a severe headache, slurs his speech, and has a noticeable facial droop on one side. Which sudden illness should you suspect, and what is a key part of your management plan?

Answer: Stroke; note the exact time of symptom onset and prepare for evacuation.

The unilateral facial droop, slurred speech, and severe headache are classic signs and symptoms of a stroke (Cerebrovascular Accident - CVA). A critical piece of information for definitive medical care is the time of symptom onset, as it can determine treatment options like thrombolytics. Management in the field includes protecting the patient's airway, providing comfort, and preparing for urgent evacuation. While aspirin is used for heart attacks, it's contraindicated for certain types of strokes. Restraining a seizure patient is not recommended, and the symptoms are not typical for hypoglycemia.

A fellow backpacker suddenly collapses, becomes rigid, and begins to convulse. The seizure lasts for approximately 90 seconds. After the convulsions stop, the patient is groggy and disoriented. Which of the following is NOT an appropriate action in managing this patient?

Answer: Placing a bite stick or wallet in the patient's mouth to prevent them from biting their tongue.

During a seizure, the primary goal is to protect the patient from harm. This involves clearing the area of dangerous objects and cushioning their head. However, you should never force anything into the patient's mouth. This can cause broken teeth, jaw injuries, or an airway obstruction. Timing the seizure and placing them in a recovery position afterward to manage the airway are both appropriate and important actions.

Which of the following scenarios is the clearest indication for immediate evacuation for a patient experiencing a sudden illness in the wilderness?

Answer: A patient complains of crushing chest pain that is not relieved by rest and radiates to their left arm.

Crushing chest pain unrelieved by rest and radiating to the arm are classic signs of a myocardial infarction (heart attack). This is a time-sensitive medical emergency that requires immediate definitive care that is unavailable in the wilderness. The other scenarios, while requiring monitoring, do not represent the same level of immediate life threat requiring urgent evacuation. A patient returning to baseline after a typical seizure, a localized allergic reaction, and a resolved hypoglycemic event can often be managed in the field while assessing the overall situation.

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.