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Head (including eye, ear, nose, throat, and mouth)

Headache In general, particularly worrisome headaches include a single headache that is the “first” or “worst” of a person’s life; headache with a fever that is not explained by an obvious illness; headache with vomiting that is not explained by an obvious illness; headache associated with a neurologic sign, such as weakness or altered speech; headache associated with altered mental status; headache associated with neck pain…

General symptoms

Fainting Fainting is defined as sudden brief (usually less than 1 minute) loss of consciousness not associated with a head injury. The medical term for fainting is “syncope.” The term for feeling like you are going to faint, but remaining conscious, is “presyncope.” There are innumerable causes of fainting, but most episodes are associated with decreased blood flow (oxygen and/or glucose) to the brain. This might…

Infectious diseases

Wilderness enthusiasts and travelers are exposed to numerous pathogens, vectors (carriers, such as mosquitoes or ticks) and diseases that are not indigenous to their home, placing them at risk of exposure to infectious diseases. This section addresses some of the more common and worrisome infectious diseases associated with travel and outdoor activities. Information regarding these infectious diseases, including recognition, prevention and treatment, is based on what…

Stroke

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Emergency childbirth

When a woman is ready to give birth, the contractions of labor are usually intense and uninterrupted, or separated by intervals of less than 3 to 5 minutes. If the child to be born is not the woman’s first, labor can progress very quickly, so do not wait until the last minute to set up. On the other hand, do not deliver a baby in the…

Problems of the penis and testicles

Painful testicle If a male complains of a painful testicle, examine both testicles. Look for discoloration or swelling. If a testicle has been injured by a blow, provide support with an improvised jockstrap and apply cold packs. If a testicle suddenly becomes painful, particularly in an adolescent, and appears swollen and/or discolored, usually without a penile discharge, it might be twisted, or “torsed.” If a painful…

Disorders of the kidneys, bladder, and prostate

Bladder infection Bladder infection (cystitis, sometimes called urinary tract infection [UTI]) occurs more frequently in females than in males, because the shorter female urethra does not protect the bladder from bacteria as efficiently as does the male organ. A person with a bladder infection complains of discomfort (sharp pain, cramping, or burning) on urination, urge to urinate (“urgency”), frequent urination, difficulty initiating urination, lower abdominal cramping,…

Problems of ovaries and vagina

Ovarian infection The ovaries and fallopian tubes ( Figs. 141 and 142 ), which carry eggs from the ovaries to the uterus, might become infected, commonly with Mycoplasma genitalium , or with the bacteria ( Neisseria gonorrhea ) that cause gonorrhea or by other infectious agents, such as Chlamydia trachomatis. This is sometimes called pelvic inflammatory disease (PID). Symptoms include abdominal pain in the lower quadrants…

Inhalation injuries

Inhalation injuries include thermal (heat) and chemical (smoke, noxious gas) inhalations. A third type of inhalation injury is aspiration (inhalation) of stomach contents; blood; or ocean, river, lake, or pool water into the lungs. The severity of the injury is determined by the chemical nature of the substance, temperature, volume of inhaled material, and underlying health of the victim. In a likely scenario, such as a…

Burns

Definitions ( Fig. 132 ) First-degree burn (superficial). This is a burn that involves the outermost layer of skin, the epidermis. It is often quite painful. The skin is reddened, but there is no blister formation. When a large surface area is involved, as with an extensive sunburn, the victim might become quite ill, with fever, weakness, chills, and vomiting. Second-degree burn (partial thickness). This is…

Fractures and dislocations

A bone fracture (break) can be simple (one clean break) or comminuted (multiple breaks or shattered) ( Fig. 58 ). Furthermore, it might be closed (skin intact) or open (“compound,” with the skin broken, often with the bone visible in the wound). An open fracture is highly prone to infection. A fracture might be associated with injuries to adjacent nerves and blood vessels. Open full size…

Head injury

Victims of head injury (when it involves the brain, commonly referred to as “traumatic brain injury” or TBI) can be roughly divided into two groups, according to whether they have lost consciousness or not. In addition to loss of consciousness, other risk factors for a serious brain injury include high suspicion for a skull fracture (e.g., boggy swollen area on the head, indicative of a collection…

Shock

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Chest pain

Chest pain can be a manifestation of a variety of disorders, ranging from a harmless chest cold or heartburn to an acute coronary syndrome that is a harbinger of a life-threatening heart attack. To try to attain a diagnosis, it is important to ask these questions: 1. Where is the pain? 2. What is the nature of the pain? 3. How severe is the pain? 4.…