Friday, 19 December 2014
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Case Study 6 October 2008
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Case Study 6 October 2008
The Setting: 

You and your partner are sampling some of the new north facing overhanging limestone outside the famed Wild Iris climbing area in Wyoming. This steep pocketed little gem has yet to be discovered by the general public so the approach to the crag is steep with little or no trail. It takes 45 min. to drive to the pullout from Lander, with an additional 15 min. of walking along an old two-track road to get to the crag.

While walking along the base of the cliff, a dry buzzing noise fills your ears. You react without thinking and somehow avoid stepping on the rattlesnake coiled at your feet. Your partner, distracted by the sheer cliff band, walks right into you and you both tumble to the ground. After scrambling back to your feet you watch the beautiful snake with it’s triangular head and diamond pattern quickly slide around the corner. Then you notice your partner still on the ground wailing that he is “too young to die”.

SOAP Report

Subjective/Summary/Story:

age, sex, chief complaint, OPQRST, MOI/HPI

The patient is a 25-year-old male whose chief complaint is a possible snakebite to the right forearm. Patient states, indeed insists, he was struck when he tripped and fell with outstretched arms to the ground while hiking.

Objective/Observations/Findings:

Describe position found and injuries

Patient was found lying on the ground clutching right forearm.

Patient Exam:

Head-to-toe exam revealed two puncture wounds approximately 3/4” apart on the right forearm. One puncture weeping clear fluid tinged with blood. Patient complains of persistent ache in right elbow, and states this was present prior to this event. No other injuries were found. Patient denies head neck and back pain and he did not lose consciousness. There is no bruising or swelling at the bite site, no tingling or numbness in the arm and good CSM in the right hand.

Vital Signs:

TIME 
15:40
16:00
LOC
A&O x 4
A&O x 4
HR
100 strong and reg.
72 strong and reg.
RR
22 shallow and reg
16 shallow and reg.
SCTM
P/C/C
P/W/D
BP
Strong Radial Pulse
Strong Radial Pulse
Pupils
PERRL
PERRL
Temp
N/T
N/T

 

History:

Symptoms:
Nausea, Anxiety
Allergies:
Penicillin, seansonal allergies not presently a problem
Medications:
Ibuprofen 400mg for elbow pain
Pertinent Hx:
Ache in Right elbow for last two weeks. Belived to be climbing overuse injury
Last in/out:
Energy bar @13:00, 2 L H2O today, bowel normal, urine pale yellow
Events:
Unremarkable

 

What is your Assessment and Plan? 




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