Sugarcane

Of course! You realize that you nearly committed the most common mistake in the head-to-toe exam: you nearly forgot to examine the patient's back. In fact, perhaps you should have done that while he was still on his side.\n\nCarefully cradling the victim's head to keep it in line with the spine, and grabbing hold of his pants at the hip, you "log roll" him up onto your thighs to get a look at this back. Lifting his shirt, you see a nasty bruise on the lower spine--and a nasty rock to match it on the ground where he was laying.\n\nWorking your fingers up the spine, you feel vertebra by vertebra. When you touch the bruise, the patient moans and opens his eyes. "Where am I?," he asks.\n\n[[Explain the situation|Vital Signs]]

You give a brief account of the situation. "Gee, that sounds serious," the ranger says. "He probably has a spinal injury. We should evacuate him first thing. Meanwhile, give him some water from this canteen--it's a pretty hot day!"\n\nWhat do you do?\n\n[[Evacuate the patient first|You missed something....]]\n\n[[Don't evacuate the patient first|Good Catch!]]

You run up the path toward the man, leaping rocks and tree branches as you go. Suddenly one of the tree branches moves, too fast for you to react, and a sharp pain runs up your leg.\n\nIt was a snake on the trail! As you writhe on the trail, you can already feel the swelling begin on your leg. You hope someone else will come along the path, because now there are two patients and no rescuers.\n\nSoon you feel too weak to move, and your face feels warm and flushed. You decide to take a nap....\n\nTHE END

The trail to the falls is beautiful this afternoon. Innumerable flowers bloom in the forest, small animals scuttle out of the way as you approach, and the sun bathes everything in a bright yellow glow--although it also heats everything up to the edge of uncomfortable.\n\nAs you turn a bend, you see ahead of you a man dressed in hiking gear lying prone on the trail. Something about the way he is positioned tells you that he is not just taking a nap.\n\nWhat do you do?\n\n[[Run to his Side|Haste Makes Waste]].\n\n[[Call 911 on your cell phone|No Help in Sight]]\n\n[[Check the area for falling rocks|All Clear]]

You scan the area for falling rocks, wildlife, or any other danger. After all, if you get hurt then there are two patients and no rescuers!\n\nAs you look around, a tree branch on the path ahead begins to move. It isn't a tree branch, but a snake! It is not close to the injured man, but you would have stepped right on it if you had rushed in without looking. Now the path to your patient is clear.\n\n[[Run to the injured man|Sizing Things Up]]

After thirty vigorous pushes on the chest, you open the mouth again and try another rescue breath, but it still doesn't work. You repeat this cycle of pushing and breathing twice more, and finally, when you open his mouth, you find a wad of chewing gum.\n\nYou should have checked his mouth for airway obstructions right away! Now you have lost precious time dealing with your mistake, and you still don't know what the patient's original injury was.\n\n[[Now examine the body for injuries|Head-to-Toe]]

Overcoming your first impulse, you put the money back in the man's wallet. After all, you hope in the end to tell the police about this whole scene, so you wouldn't want to have to explain why Joe Cronklin says he's missing $20.\n\nSo it's back to decision time. What do you do?\n\n[[Go for help|Too Little, Too Late]]\n\n[[Continue examining the body for wounds|A Clue to the Mystery]]

Methodically, you feel around his skull, his face, his neck, his shoulders, his chest, his arms, and even his legs, but you don't find any sign of injury. It's a mystery: the patient has strong vital signs and no visible wound, but he barely responds to shouting.\n\nWhat do you do?\n\n[[Leave him and go for help|Too Little, Too Late]]\n\n[[Check his pockets for drugs or medications|A Dead End]]\n\n[[Continue going over the body for wounds|A Clue to the Mystery]]

When you reach the injured man, you see his backpack laying beside him. He is on his side, with one arm flung back, and his eyes are closed. "Hello!," you say, but he does not respond. "ARE YOU HURT?," you shout, and he moans slightly but does not move.\n\nWhat do you do?\n\n[[Look in his mouth|A Potential Choking Hazard]]\n\n[[Roll him onto his back|Danger!]]\n\n[[Look it up in a First-Aid book|You're in the wilderness....]]

Silly reader! You don't carry a First-Aid book everywhere you go! You're going to have to use the one resource you do carry everywhere: your brain.\n\nSo what do you do?\n\n[[Look in his mouth|A Potential Choking Hazard]]\n\n[[Roll him onto his back|Danger!]]

You sprint back down the path to the trail head, and drive from there to the Sinks Canyon visitor's center. The good folks there call 911 on their landline.\n\nWithin an hour, paramedics are on the scene, but they do not find the same situation you did. It turns out the man had a badly injured backbone, and while you were gone he began to arouse and tried to sit up. The resulting damage to the spinal column will probably leave him paralized from the waist down for the rest of his life.\n\nYou probably should have checked his back when you did your head-to-toe examination!\n\nTHE END

You work systematically through the SAMPLE questions:\n\nS Symptoms you can't see, as opposed to observable signs\nA Allergies\nM Medicines or drugs\nP Pertinent medical history\nL Last in/out - the last food or fluid intake or output\nE Event - what led up to the accident, and what happened\n\nYour learn that the patient feels light-headed and nauseous. As his memory of the accident comes back, he remembers that he felt weak and his muscles were cramping up just before he fell.\n\nHowever, he was not taking any medications, nothing like this had ever happened before, and he was taking lots of fluids. In fact, he had been drinking a lot of water, and doesn't feel thirsty now, although he had not eaten much during the day.\n\nJust then a park ranger comes along the path. "Hey," he says, "are you guys OK?"\n\n[[Explain the situation|Stay or Go, Fast or Slow]]

You rifle through his pockets and find a wallet and a pocket knife. Looking through the wallet, you find $20 cash, a debit card, and a driver's license.\n\nThe man's name is Joe Cronkle, and he is 42 years old. That's good information, but there are no medications, drugs, or other clues about what happened to him.\n\nWhat do you do?\n\n[[Go for help|Too Little, Too Late]]\n\n[[Continue examining the body for wounds|A Clue to the Mystery]]\n\n[[Pocket the $20|Oh, no you don't!]]

"No," you say, "this patient shows symptoms of hyponatremia. We should give him a snack bar or some gatorade before we call the EMTs."\n\nGood catch. After all, he isn't in imminent danger of death, but he could get pretty uncomfortable if you don't balance out his sodium levels.\n\nExcellent job on your Wilderness First Aid!\n\nTHE END

Carefully, to avoid any damage to the spine, you support the patient's head and "log roll" him onto his back and immobilize his head. A quick check shows that he has a strong, steady pulse and is breathing smoothly and regularly. Since you don't know how far he may have fallen, you decide to continue holding the "C-spine" still.\n\nSuddenly, the patient begins to choke and gag. You wait a moment, and he stops choking--and stops breathing!\n\nSeeing nothing in his mouth, you try to give a rescue breath, but the air will not go in. You reposition his head and try to give another rescue breath, but the air still will not go in. It looks like you need to do CPR!\n\n[[Perform CPR|CPR]]

Unfortunately, there is no cell phone coverage this far back in Sinks Canyon. You shout a few times for help, but there does not seem to be anyone nearby on the trail except the injured man.\n\nWhat do you do?\n\n[[Run to his side|Haste Makes Waste]]\n\n[[Check the area for falling rocks|All Clear]]\n\n[[Sit down and have a snack|The Consequences of Sloth]]

Wishing you had rubber gloves, you pry open his mouth. There you see a wad of chewing gum, which you remove. Now you need to get this patient into the "perfect patient position."\n\n[[Roll him onto his back|Assessing the Patient]]

Within the hour, the paramedics were on the scene. Meanwhile, the patient's headache and lightheadedness grew worse, and he complained of terrible muscle cramps.\n\nOnce the professionals arrived, one of the EMTs commented to the ranger: "Hey, this guy has hyponatremia. You shouldn't have given him all that water--it just made it worse."\n\n"Gee, sorry I missed that," the ranger said, obviously embarrassed. "Will he be OK?"\n\n"Yeah, the EMT responded, "but you probably made him pretty uncomfortable."\n\nAnd you, dear reader, did an excellent job on the scene--but remember to review the symptoms of hyponatremia!

"You're on the trail through Sinks Canyon toward the water falls," you say. "You seem to have hurt yourself somehow. Do you know what happened?"\n\n"No, I don't know what happened," he replies.\n\nAs he tries to move, you hold on to his head: "Please don't move until we know whether you have hurt your spine," you say. "Hold still while I take your pulse."\n\nHis pulse is normal, and while he is quiet you go ahead and measure his breathing as well. After all, if you tell someone that you are measuring his breath rate, he will usually change his breath rate in an attempt to help out!\n\nNow you should ask the [[SAMPLE questions|The SAMPLE Questions]].

You sit down and open your bag. Probably that man is just taking a nap after all, you say; I won't get involved.\n\nSome time later, a park ranger comes along the path. He sees you sitting near the injured man. "Hey, what's going on here?!," he demands. Despite your protests, he insists that you attacked and wounded the other man on the trail. He says you are going to jail--and since he has a gun, you can't really argue.\n\nSoon a helicopter has the wounded man out, and you are on your way to the city jail. It's going to be a long day.\n\nTHE END

This whole situation is meant to prepare you to help people who are hurt, to make you a better person, and you're going to take his money?!\n\nPut that money back [[RIGHT NOW.|Decision Time]]