First Aid chapter 24 – Flashcards

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wilderness
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a remote geographical location more than 1 hour from definitive medical care
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CPR has a limited use
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in a wilderness setting, esp if severe trauma + cardiac arrest
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stop CPR in a cardiac arrest if 1
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if victim revives
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stop CPR in a cardiac arrest if 2
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rescuers are exhausted
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stop CPR in a cardiac arrest if 3
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if rescuers are in danger
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stop CPR in a cardiac arrest if 4
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victim turned over to higher trained personnel
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stop CPR in a cardiac arrest if 5
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victim does not respond to prolonged (30 min) resuscitation efforts
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CPR should not be started if 1
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victim submerged in cold water for more than an hour
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CPR should not be started if 2
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victim's core temp is lower than 50F
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CPR should not be started if 3
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victim has obvious signs of death or fatal injuries
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CPR should not be started if 4
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victim is frozen
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CPR should not be started if 5
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victim's chest wall is too stiff to perform compressions
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CPR should not be started if 6
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rescuers are exhausted or in danger
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CPR should not be started if 7
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definitive care is not available within 3 hours
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CPR for hypothermia victims 1
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victim must be handled gently
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CPR for hypothermia victims 2
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if victim unresponsive and not breathing, start CPR
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CPR for hypothermia victims 3
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do not wait to check the victim's temp or until victim is rewarmed, start CPR
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CPR for hypothermia victims 4
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remove the wet clothes
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most common cause of avalanche death
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suffocation, injury, or hypothermia
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CPR for drowning
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immediate rescue breaths
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rescue breaths can begin
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in shallow water or when out of the water
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for drowning victim
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do not try to remove water by performing abdominal thrusts
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for drowning victim, asap
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open airway and check for breathing, if none, give 2 breaths, then 30 chest compressions & 2 rescue breaths
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main cause of death for lightning strike victims
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cardiac arrest
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for lightning strike victim
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begin CPR, an AED should be used asap
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in a wilderness location, with a dislocation
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reducing dislocated joints is recommended
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reducing
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aligning a dislocated joint
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1st reason for reducing a joint dislocation quickly
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reduction is easier if done immediately, before swelling
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2nd reason for reducing a joint dislocation quickly
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easier to transport victim after reduction
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3rd reason for reducing a joint dislocation quickly
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the joint can be stabilized and better protected
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4th reason for reducing a joint dislocation quickly
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reduction lessens possibility of jeopardizing circulation
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5th reason for reducing a joint dislocation quickly
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simple dislocations can be reduced using simple and safe techniques
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a dislocation is considered simple if it involves
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anterior part of shoulder, a finger, the patella (kneecap),
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do not attempt to reduce
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a dislocated elbow or hip
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anterior shoulder dislocations
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account for more than 90% of shoulder dislocations
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recognizing shoulder dislocation 1
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victim in extreme pain
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recognizing shoulder dislocation 2
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victim can identify dislocation if it happened before
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recognizing shoulder dislocation 3
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upper arm is held away from the body & cannot be brought next to the body
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recognizing shoulder dislocation 4
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victim is unable to touch the uninjured shoulder with injured hand
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recognizing shoulder dislocation 5
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compare injured with uninjured shoulder
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1st care for shoulder dislocation
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2 methods for reducing shoulder dislocations
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2nd care for shoulder dislocation
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do not pull on injured arm with your foot
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3rd care for shoulder dislocation
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Traction and external rotation - 1st method
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1st care for shoulder dislocation
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gently pull arm to side while another rescuer provides countertraction against the chest wall, just below the arm pit using straps, clothing, or sleeping bag
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2nd care for shoulder dislocation
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tell victim to relax
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3rd care for shoulder dislocation
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as you pull, gently rotate arm half to 2/3 of the way up, keep it there till muscles fatigue, slip joint back into place
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4th care for shoulder dislocation
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after successful reduction, stabilize arm with a sling and swathe
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2nd shoulder dislocation method
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simple hanging traction
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simple hanging traction 1
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lay victim down on a surface high enough for injured arm to hang down
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simple hanging traction 2
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place cushioning under the armpit
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simple hanging traction 3
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attach a 5-10 lbs weight to lower arm, b/w elbow & wrist
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simple hanging traction 4
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it may take up to 60 min to stretch and tire muscles, allowing joint to pop back in place
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simple hanging traction 5
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after successful reduction, stabilize arm with sling and swathe
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simple hanging traction 6
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if available, place padding under the armpit, secure with sling and swathe
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recognizing a finger dislocation 1
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deformity & inability to use or bend the finger
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recognizing a finger dislocation 2
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pain and swelling
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recognizing a finger dislocation 3
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an abnormal position of the two adjoining bones
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1st care for finger dislocation - method 1
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hold end of finger in one hand, he rest of the finger in the other hand
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2nd care for finger dislocation - method 1
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gently hyper-extend the finger (bend it backwards)
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3rd care for finger dislocation - method 1
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pull gentle traction
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4th care for finger dislocation - method 1
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push dislocated bone into place
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5th care for finger dislocation - method 1
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unbend the finger
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6th care for finger dislocation - method 1
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buddy tape it to the next finger
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7th care for finger dislocation - method 1
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splint the finger in the position of function
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1st care for finger dislocation - method 2
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hold one end of finger with one hand, the rest of the finger with the other
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2nd care for finger dislocation - method 2
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pull end of finger in the direction it is pointing, then gently back into proper anatomical position
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3rd care for finger dislocation - method 2
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stabilize the joint in the position of function
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kneecap dislocation
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only apply ice pack & use splint to stabilize leg as you found it
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recognizing a kneecap dislocation 1
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patella has moved outside of knee joint
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recognizing a kneecap dislocation 2
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the victim is in pain
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recognizing a kneecap dislocation 3
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compare the injured portion with the patella on other leg
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1st care for kneecap dislocation
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straighten the knee as you gently push the kneecap back into normal position
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2nd care for kneecap dislocation
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stabilize the leg straight
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3rd care for kneecap dislocation
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with knee extended & stabilized, the victim may be able to walk to self-evacuate
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all spinal fractures have at least 1
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midline neck tenderness
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all spinal fractures have at least 2
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altered mental status
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all spinal fractures have at least 3
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evidence of intoxication
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all spinal fractures have at least 4
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a separate painful injury away from the neck
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recognizing possible spinal injury 1
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is victim alert and oriented or been drinking or on drugs
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recognizing possible spinal injury 2
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does victim have a major painful injury
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recognizing possible spinal injury 3
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is the victim reporting neck pain
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recognizing possible spinal injury 4
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does victim have numbness, tingling, or weakness in the extremities
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recognizing possible spinal injury 5
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check for neck tenderness by pressing firmly on bony part of the spine
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recognizing possible spinal injury 6
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determine if victim has sensation in hands and feet, and can move fingers and toes
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protocol for clearing spinal injury in the wilderness 1
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completely alert
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protocol for clearing spinal injury in the wilderness 2
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not intoxicated
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protocol for clearing spinal injury in the wilderness 3
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no distracting injuries
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protocol for clearing spinal injury in the wilderness 4
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does not report neck pain
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protocol for clearing spinal injury in the wilderness 5
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can feel normal touch
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protocol for clearing spinal injury in the wilderness 6
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can move fingers and toes
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guidelines to assess a suspected spinal injury 1
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determine if injury was a violent impact capable of damaging the bony spinal column
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guidelines to assess a suspected spinal injury 2
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does neck or back hurt, can you move hands, feet, can you feel me touching your fingers, toes
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guidelines to assess a suspected spinal injury 3
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look and feel for DOTS ( deformity, open wounds, tenderness, swelling) along the bony spinal column
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guidelines to assess a suspected spinal injury 4
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assess the equality of strength of the extremities
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guidelines for suspected spinal injury of unresponsive 1
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determine the mechanism of injury
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guidelines for suspected spinal injury of unresponsive 2
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look for deformity, open wounds, swelling along spinal bones
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guidelines for suspected spinal injury of unresponsive 3
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feel for deformity and swelling along the spinal bones
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guidelines for suspected spinal injury of unresponsive 4
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obtain information at the scene from others to assess mechanism of injury and mental status before arrival
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1st care for spinal injury
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improvise blanket supports by placing garbage bag of dirt or rolled up clothing, securing on on both sides of the head
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2nd care for spinal injury
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avoid moving the victim, log roll to place insulating material under victim
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victims of a femur fracture
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can lose 2 quarts of blood in the thigh and develop massive swelling
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with femur fractures
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it is best to let EMS apply traction splints
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avalanche deaths per year
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20 in US, 10 in Canada
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most avalanche victims die of
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suffocation
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survival of buried victim of avalanche
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speed of extrication and air pocket
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avalanches kill and injure in two ways
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tumbling down mountain, snow burial
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1/3 deaths from avalanche
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trauma from tumbling down
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2/3 deaths from avalanche
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snow burial
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1st care for avalanche victim
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during first 15 min, more found alive, 16-30 min 50% found alive, after 30 min, more found dead than alive
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when found the avalanche victim 1
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quickly free the victim's head, chest and stomach
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when found the avalanche victim 2
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send for help
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when found the avalanche victim 3
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clear airway & check for breathing
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when found the avalanche victim 4
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if not breathing, start CPR
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when found the avalanche victim 5
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check for severe breathing
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when found the avalanche victim 6
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examine for and stabilize a spinal injury
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when found the avalanche victim 7
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treat for hypothermia
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hypoxia
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altitude sickness
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hypoxia occurs
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when body's tissues do not have enough oxygen
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altitude sickness includes 1
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acute mountain sickness AMS
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altitude sickness includes 2
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high altitude pulmonary edema HAPE
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altitude sickness includes 3
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high altitude cerebral edema HACE
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the least serious altitude sickness
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acute mountain sickness
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acute mountain sickness affects
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1 in 4 peeps in 6000 to 12000 feet above sea level
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at least 4 factors determine altitude sickness or not
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speed of ascent, altitude reached, health, individual & genetic differences
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Why does altitude sickness occur?
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oxygen levels decrease as elevation increases
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altitude sickness is caused by
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blowing off more carbon dioxide than normal, creating a more alkaline body condition
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recognizing altitude sickness 1
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usually strikes during first 12 hours
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most common symptom of altitude illness
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headache
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other symptoms of altitude illness
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loss of appetite, nausea, insomnia, fatigue, shortness of breath with exertion
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3/4 of all peeps above 8000 feet
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have at least one symptom, the rest have 2 or more
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many mistake altitude illness for
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a cold, flu, hangover
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1st care for altitude sickness
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recognize symptoms ant treat it
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2nd care for altitude sickness
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if not recognized and treated, it may progress to HAPE or HACE, and can be fatal in less than 12 hours
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seek medical help if altitude sickness advances to
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persistent cough, shortness of breath while resting, noisy breathing, loss of balance, confusion, or vomiting
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most peeps who have altitude sickness
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get better with rest
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AMS symptoms
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headache, sleep disturbance, fatigue, shortness of breath, dizziness, loss of appetite, vomiting
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AMS at elevation
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8000 ft
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HAPE at elevation
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above 10,000 ft
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HACE at elevation
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above 12,000 ft
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HAPE symptoms
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fluid in lungs, shortness of breath, dry cough, mild chest pain, weakness, insomnia, rapid pulse, cyanosis, rales, girgling sounds
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HACE symptoms
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increased fluid and pressure on the brain, severe headache, vomiting, Cheyne-Stokes breathing, ataxia, unconsciousness
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AMS usually occurs
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1-2 days later
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HAPE usually occurs
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3-4 or more days later
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HACE usually occurs
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4-7 or more days later
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first aid care for AMS 1
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stop ascending or return to lower altitude
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first aid care for AMS 2
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drink fluids
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first aid care for AMS 3
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rest
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first aid care for AMS 4
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take aspirin or ibuprofen
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first aid care for AMS 5
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take acetazolamide
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first aid for HAPE
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descend at least 2000 feet, seek medical attention asap
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first aid for HACE
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descend 4000 ft, seek medical attention asap
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at 11,500 feet
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65% less oxygen
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acute altitude illness
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usually improves after a few days of rest
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to relieve HACE or HAPE
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early descent, then breathe extra oxygen
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human ceiling of altitude
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18,000 feet
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person taken quickly to 20,000 feet
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incapacitated, death soon after
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the higher the altitude
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the faster a person sunburns
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other altitude related illnesses
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pharyngitis, bronchitis, peripheral edema
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death from lightning strikes
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30%
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lightning strikes involving one person
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70%
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lightning strikes involving 2 peeps
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15%
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more lightning deaths occur
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during the day, June thru Sept
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1st way lightning injures
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direct strike
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2nd way lightning injures
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splash (lightning strikes a tree or building & splashes onto a victim)
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3rd way lightning injures
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contact (person is holding an object that is struck)
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4th way lightning injures
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ground current (lightning hits the ground, spreads like a pond)
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5th way lightning injures
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shock wave (injured by the explosive force)
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lightning contact with the body
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instantaneous
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exposure to household electricity
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more prolonged, victim freezes to the circuit, severe tissue damage can result
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30/30 rule
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seek shelter if flash to bang is 30 seconds or less and stay until 30 min after last clap
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most are struck by lightning
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before and after storm has peaked
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do not wait for the rain to start
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before seeking shelter
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do not leave the shelter
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just because the rain has stopped
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recognizing a lightning injury 1
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breathing may be absent
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recognizing a lightning injury 2
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seizures, paralysis, loss of responsiveness may occur
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recognizing a lightning injury 3
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minor burns
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most lightning strike burns
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punctate (small, circular), and feathering or ferning from ignited clothing and heated metal
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1st care for a lightning injury
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if more than one struck, go to the quiet, motionless first, and if no breathing, begin CPR
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2nd care for a lightning injury
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if breathing but unresponsive, place on their side
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3rd care for a lightning injury
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stabilize the spine
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4th care for a lightning injury
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check for injuries
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5th care for a lightning injury
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evacuate all victims to medical care
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animal attack deaths in US
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1-2 per year
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if encountering a wild animal
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remove yourself from the scene quietly
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in most cases of an animal attack
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fight back if attacked
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do not fight back, lie down, play possum if
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grizzly bear or mother black bear with cubs
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recognizing animal related injuries
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puncture wounds, bites, lacerations, bruises, fractures, rupture of internal organs, evisceration
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determining level of wilderness evacuation 1
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severity of illness or injury
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determining level of wilderness evacuation 2
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rescue and medical skills of rescuers
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determining level of wilderness evacuation 3
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physical and psychological condition of rescuers and victims
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determining level of wilderness evacuation 4
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availability of equipment and aid
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determining level of wilderness evacuation 5
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time it would take to evacuate by other means
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determining level of wilderness evacuation 6
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cost
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when requesting outside assistance
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consider safety of incoming rescuers, their time commitment, cost of the rescue
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delay travel plans or start evacuating if 1
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victim not improving
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delay travel plans or start evacuating if 2
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debilitating pain
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delay travel plans or start evacuating if 3
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victim unable to travel at a reasonable pace b/c of injury
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delay travel plans or start evacuating if 4
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victim passing blood
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delay travel plans or start evacuating if 5
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signs of serious altitude illness
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delay travel plans or start evacuating if 6
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infections not improving
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delay travel plans or start evacuating if 7
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chest pain not caused by rib cage injury
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delay travel plans or start evacuating if 8
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severe wounds require medical care
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delay travel plans or start evacuating if 9
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dysfunctional psychological condition impairing safety of others
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immediate evacuation (in 30-60 min) 1
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open fractures
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immediate evacuation (in 30-60 min) 2
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extremity injuries with deformity
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immediate evacuation (in 30-60 min) 3
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extremity injuries without circulation
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immediate evacuation (in 30-60 min) 4
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spinal injuries with inability to move fingers or toes or no sensation in fingers or toes
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immediate evacuation (in 30-60 min) 5
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severe altitude sickness
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immediate evacuation (in 30-60 min) 6
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decreased level of consciousness
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immediate evacuation (in 30-60 min) 7
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signs of shock
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immediate evacuation (in 30-60 min) 8
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severe bleeding
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delayed evacuations 1
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medical care within 6-24 hrs
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delayed evacuations 2
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limb injuries with deformity, severe pain, or inability to walk
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delayed evacuations 3
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severe frostbite
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delayed evacuations 4
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open wounds that can be sutured within 6 hrs for hand or foot, 24 hrs for head or trunk
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delayed evacuations 5
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mild hypothermia + normal mental status + shivering
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guidelines for ground evacuation 1
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if victim walking out, at least 2 peeps accompany
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guidelines for ground evacuation 2
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if victim carried out, one should go ahead to alert authorities
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helicopters not beneficial if
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ground transport can get victim to hospital within 30-60 minutes
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guidelines for helicopter evacuation 1
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victim's life saved or better chance at full recovery
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guidelines for helicopter evacuation 2
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pilot believes conditions safe enough for helicopter evacuation
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guidelines for helicopter evacuation 3
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ground evacuation dangerous or prolonged
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signaling aircraft 1
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large V for immediate assistance
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signaling aircraft 2
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large X for immediate medical assistance
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signaling aircraft 3
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make letters as big as possible
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signaling aircraft 4
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contrast is key
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signaling aircraft 5
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series of 3 indicate help needed
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signaling aircraft 6
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smoke by day, flame by night
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using mirror for help 1
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hold mirror to sun, stretch other hand out in front, use finger or thumb to block the target
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using mirror for help 2
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hit your extended finger or thumb with a reflection of the sun from the mirror
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using mirror for help 3
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repeatedly flick the spot of light across the finger or thumb and the target
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using mirror for help 4
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try to hit the aircraft with the flash as much as possible
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