Tuesday, 13 October 2015
rendezvous - Beta 0.3
Case Study 19 May 2011
Article Index
Case Study 19 May 2011
Page 2

The Settingmain.jpg

Five days into sea kayaking with friends in Prince William Sound, Alaska you feel lousy; some diarrhea, some vague abdominal cramping, not much appetite.  You assume it's a touch of the flu and don't say anything.  The next day you feel better and paddle all day.


That night you wake with the worse abdominal pain you have ever experienced.  You endure it quietly and it subsides after 30 minutes.  At breakfast you tell your companions about it.  The Wilderness First Responder (WFR) in the group begins a series of questions which he writes into a document he calls a SOAP report.  You don't think you're very ill, but he's your friend, so you allow him the chance to do his "patient assessment."


SOAP Report


Patient is a 26 year old male whose chief complaint is "I don't feel great, but I've felt worse."   He appears pale, with normal mental status and can walk.  He states he has been feeling poor for the past 2 days with occasional diarrhea.  He has been able to paddle his sea kayak on several long days.  Last night he had 30 minutes of the "worst hard cramping pain he has ever experienced."  "I have a new 10 on a 1-10 scale."   He also reported his "belly was hard as a rock".  The episode subsided and the patient was able to sleep the remainder of the night. 



Patient Exam: Patient denies any recent injury and we have been together and have not witnessed any injury.  He refuses a head-to toe exam, but agrees to an abdominal exam.  He has some tenderness throughout his abdomen, no localized pain, but sharp pain in his lower right belly on a tap on his right foot.


Vital Signs

7/23 8:30 AM

7/23 9:30AM





90 strong, regular

94 strong, regular


15 regular, easy

15 regular, easy


pale, warm, dry

pale, warm, dry


strong radial pulse

strong radial pulse


not taken

not taken

98.4°F (36.8°C) oral

not taken






At present he has constant and dull generalized abdominal pain that is a 2 compared to last night's 10.  States he has general feeling of being "sick".




Has been taking 400mg ibuprofen 4x a day for the past week for shoulder aches.

Pertinent Hx:

None.  Patient has his appendix.

Last in/out:

Has been well hydrated with clear yellow urine past several days,  Drank several cups of water this morning,  No BM.  He ate a light breakfast.


Feeling ill past several 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

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