Wilderness Patient Assessment

This is a preview of tomorrow's UNM Wilderness Medicine lecture: Patient Assessment. We will start by explaining the general approach to wilderness medicine patients: The Scene size-up. The scene size-up has three components: First - Check the scene safety - Is it safe for rescuers to approach and attend to victims. Second - Assess the mechanism of injury - Consider what injury patterns might arise from such a mechanism. Third - Find how many victims are involved - the number of injured persons has large consequences for the rescue effort.

Organize your thoughts (and your report) with the SOAP note setting.

But lets change the SOAP note from its traditional format. Those who are familiar with hospital and clinic use of SOAP notes will understand this acronym as Subjective, Objective, Assessment, and Plan. But who knows what is subjective in the wilderness anyway? I have never liked this, so we are going to change it!

Our new scheme:

"S" stands for Setting, Scene size up and scene Safety.
"O" stands for major Organ system functioning. (ABCDEs)
"A" is the "ample" history and secondary survey.
"P" will remain "plan", but will include plans for contingencies and anticipated problems.

I hope this will be an easier way to understand the Wilderness SOAP note.

We will discuss this in more detail soon!

Joe Alcock MD