Per the Swiss Staging system, a hypothermic patient who is conscious but no longer shivering with a core temperature of approximately 30 degrees Celsius is classified as which stage?
Wilderness Environmental Emergencies
Question · Medium
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Short
A wilderness paramedic is attempting defibrillation on a hypothermic patient in ventricular fibrillation with a core temperature of 27 degrees Celsius. After three unsuccessful shocks, what is the most appropriate action?
Question · Hard
What is the afterdrop phenomenon in hypothermia rewarming?
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Which is considered an active external rewarming technique appropriate for an HT II hypothermic patient in the field?
A hiker is found unresponsive after collapsing during exertion on a 38 degrees C (100 F) day. Core temp is 41.2 degrees C (106 F). What is the gold standard for rapid cooling in classic exertional heat stroke?
Question · Easy
What clinical feature distinguishes heat stroke from heat exhaustion?
A climber struck by lightning is found in cardiac arrest with multiple other victims who appear stunned but breathing. How does triage differ from a typical multi-casualty incident?
Keraunoparalysis after a lightning strike is best described as:
Lichtenberg figures on the skin of a lightning strike victim represent:
A drowning victim is pulled from cold water in cardiac arrest. Why is the Heimlich maneuver NOT routinely recommended during initial resuscitation?
Why do cold water drowning victims often have better neurologic outcomes than warm water drowning victims?
After a near-drowning, a patient develops worsening pulmonary edema and hypoxia 4 hours later. The most likely mechanism is:
A patient is found unresponsive in a snowbank with a core temperature of 24 degrees C, no palpable pulse, and no detectable respirations. What is the most appropriate field action?
In wilderness frostbite management, what is the recommended water temperature for rapid rewarming of frostbitten extremities?
Field thawing of a frostbitten extremity is contraindicated when:
Trench foot (immersion foot) results from:
Chilblains (pernio) classically present as:
A hypothermic patient presents with HT I findings (alert, vigorously shivering, core temp 33 C). What is the preferred initial rewarming approach?
During lightning storms in the wilderness, the safest position when caught in the open is:
Mortality in submersion drowning is determined primarily by:
A climber at 4200 m develops headache, nausea, and difficulty sleeping 12 hours after arrival. He has no ataxia and is mentating normally. The Lake Louise score is 4. The most likely diagnosis is:
High Altitude Illness
What is the single most important treatment for established HACE?
A trekker at 4500 m develops pink frothy sputum, dyspnea at rest, and crackles on lung auscultation. The most appropriate pharmacologic adjunct (in addition to descent and O2) is:
Recommended acetazolamide dose for AMS prevention in adults is:
A Gamow bag (portable hyperbaric chamber) simulates descent of approximately:
Above 3000 m, the recommended graded ascent rate to prevent AMS is:
Which symptom most strongly suggests HACE rather than AMS?
The dexamethasone regimen for HACE is:
HAPE is characterized physiologically by:
A climber at 5000 m with HAPE cannot descend immediately due to weather. In addition to nifedipine, which of the following is most appropriate?
A patient bitten by a rattlesnake develops progressive limb swelling, ecchymosis, and oozing from the bite site over 2 hours. The antivenom of choice in the United States is:
Wilderness Toxinology
A coral snake bite in the southeastern United States is best characterized by:
A patient develops severe abdominal cramping, hypertension, diaphoresis, and muscle rigidity 1 hour after a spider bite. The most likely culprit is:
The classic local lesion of a brown recluse (Loxosceles) bite is:
After a stingray injury to the foot, the most appropriate first aid is:
The first-aid agent recommended for box jellyfish (Chironex) stings is:
The toxic agent in poison ivy, oak, and sumac that causes contact dermatitis is:
The most lethal toxic mushroom worldwide and the antidote/treatment of choice are:
Indications for rabies post-exposure prophylaxis after a bat encounter in a wilderness shelter include:
For a moderate pit viper envenomation in the wilderness, which traditional intervention is now CONTRAINDICATED?
Pressure immobilization bandaging is most appropriate for which envenomation?
The most common laboratory abnormality in moderate-to-severe rattlesnake envenomation is:
After a marine envenomation by a Portuguese man-of-war, the recommended first-aid is:
Most snakebites in the United States occur in which group and circumstance?
After scorpion envenomation in the United States (Centruroides sculpturatus / bark scorpion), severe envenomation in children may present with:
A wilderness wound from a fall onto rocks is contaminated with dirt and tissue. Recommended irrigation volume is approximately:
Wilderness Trauma Austere
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