winter expedition - p.3
Patient Presentation (Day 6): Group members wake you early in the morning because they are concerned about the patient’s breathing. When you reach him in his tent, he has a loud wheeze and is taking short, shallow breaths.
Initial Assessment: Airway is open. You notice vomit on the patient’s sleeping bag. Breathing is shallow, rapid and loud. The patient has no visible signs of trauma. He is difficult to rouse from sleep, but is able to speak a few short words before becoming unresponsive again. The ambient temperature is -30ºF, so you ensure that the patient is fully inside his sleeping bag as you continue to monitor his condition.
Focused Assessment: Vital signs: Patient is Verbal on the AVPU scale; HR 100; RR 40 shallow with wheezes; skin is pink, cool and dry.
The patient’s breathing sounds wet and you notice bloody sputum near his mouth and nose.
You use a cell phone to call for rescue. An evacuation is initiated, but due to the temperatures, aircraft is not available.
What’s next?
Provider questions:
Initial Assessment: Airway is open. You notice vomit on the patient’s sleeping bag. Breathing is shallow, rapid and loud. The patient has no visible signs of trauma. He is difficult to rouse from sleep, but is able to speak a few short words before becoming unresponsive again. The ambient temperature is -30ºF, so you ensure that the patient is fully inside his sleeping bag as you continue to monitor his condition.
Focused Assessment: Vital signs: Patient is Verbal on the AVPU scale; HR 100; RR 40 shallow with wheezes; skin is pink, cool and dry.
The patient’s breathing sounds wet and you notice bloody sputum near his mouth and nose.
You use a cell phone to call for rescue. An evacuation is initiated, but due to the temperatures, aircraft is not available.
What’s next?
Provider questions:
- How has your assessment for this patient changed?
- How will you care for this patient as you evacuate him? What are your major concerns?
