Backpacker Magazine – September 2011

Saving Lives: Prioritize, Plan, Protect, and Monitor

Once you've stabilized a backcountry injury or illness, the next step is to prevent the patient from worsening. Here's some key steps to take.

by: Steve Howe

Tags:
• Survival
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• First aid
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Monitor | Prioritize, Plan, and Protect

Continue care to prevent complications.

Prevent relapses and problems like infection and dehydration by checking your patient’s vitals for signs of shock:
Measure Key Vital Signs
Trends are key, so record vitals every five minutes (see left). After three rounds of stable results, double the time between monitoring. Here’s how to gauge two tricky vitals that can indicate worsening conditions.
>> Level of responsiveness (LOR) This changes quickly and indicates possible brain injuries and the severity of other conditions.
Check If the patient is alert, ask him four questions: What’s your name? Where are you? What day is it? What happened? Fewer than three correct answers is abnormal. A verbally responsive patient reacts to loud noises. A pain-responsive one winces or groans when you pinch him. If a victim is not alert, maintain the airway, check for breathing and circulation, and manage life-threats while monitoring LOR improvements.
>> Blood pressure (BP) No radial pulse—or one that’s weakening? That could indicate a dropping BP and a seriously worsening patient.
Check In the backcountry, alertness, a strong radial pulse, and normal skin color/temperature/moisture together indicate adequate BP. If you suspect BP is dropping, look for and treat the possible cause.




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