Friday, 19 December 2014
rendezvous - Beta 0.3
Case Study 11 May 2009
Article Index
Case Study 11 May 2009

 Rio Canoe.jpg

The Setting
You’re leading a canoe trip for a group of naturalists on the Rio Grande River in Big Bend Park.  It’s been hot, with temperatures in the 90’s day after day.  After a long morning hike up a side canyon to check out the vegetation, you're floating lazily in your canoe watching a bird.  Your observations are interrupted by yells for help downstream. You paddle to a beached canoe and several people on shore. O
ne of your participants shouts that George is having a seizure. 

George is on his back with his legs quivering.  His arms seem to be moving appropriately.  The other participant is insisting this is a seizure.  You’re not so sure.  Your sweep of the scene for safety tells you George is wet, no one is in the water and there are no obvious hazards.  You only have one patient who is obviously in pain.  You put
on your gloves and do your initial assessment.  His ABC’s are good.  There is no bleeding.  He has no obvious injuries.  George says these “spasms” started when he was kneeling in the canoe, and he fell into the water near shore when he tried to exit the canoe.  

SOAP Report
Subjective
The patient is a 43 yr old male with spasms to his legs.


Objective
Patient Exam:
The patient is lying on his back, crying out in pain with obvious spasms to his legs.  He is A+Ox4 and denies losing responsiveness or being submerged in the water.  Head-to-toe does not reveal any obvious sign of injury.


Vital Signs   

 Time  1625
 LOR  A+Ox4
 HR  100, strong, regular
 RR  28, shallow, regular
 SCTM  Pink, warm, sweaty
 BP  Radial pulses present
 Pupils  PERRL
 T  Not taken

History   

 Symptoms: 
   Patient complains of dizziness and nausea.
 Allergies:  None
 Medications:
 Denies OTC, herbal or recreational.  Takes Lopressor for high blood pressure and is on his normal dosing schedule.
 Pertinent Hx:  Mild hypertension.  Patient states he has “a cold and an upset stomach.”
 Last in/out: Patient’s hydration status is unclear.  He states he had 3 liters of water today and yesterday as well.  He did not eat today.  No bowel movement today.  Urinated twice today.  Color unknown. 
 Events:
 Paddling and hiking in hot windy weather the past three days.

What is your Assessment and Plan?  DO NOT click/peek at the next page without answering this first.
 



< Previous   Next >
Check out more photos like this one in The NOLS Photo Group at www.flickr.com

Login/Logout
User Menu

 


Home Locations Departments Faculty News and Reports Help Home Dream Sheet Blog New Employee ProDeals Who's who? Message Board Links Admission & Marketing Alumni & Development Curriculum Finance, Purchasing & Mailroom Human Resources Information Systems NOLS Professional Training Operations Public Policy Risk Management Wilderness Medicine Institute Grading Notebooks Staffing WMI Links Newsletters Managers' Notes EDT Forum Board Reports Help Desk FAQ NOLS Home About Us Courses Wilderness Medicine Institute NOLS Professional Training Alumni Store Donate Account NOLS Home About Us Courses Wilderness Medicine Institute NOLS Professional Training Alumni Store Donate Account WMI Home About WMI Courses Schedule FAQ Photos & Movies Curriculum Updates Employment Sponsors Find a Course Skills Financial Aid College Credit Photos and Movies NOLS Home About Us Courses Wilderness Medicine Institute NOLS Professional Training Alumni Store Donate Account Photos & Videos Home NOLS Photos NOLS.TV The NOLS Podcast NOLS on Flickr WMI Home About WMI Admissions Courses Schedule Host a Course Resources Gallery