Sweet View – It is 5 pm on a late June day up in the Central Rockies. You and your BFF are on a hiking trail at about 8500 feet when you come across a gentleman sitting alone, right in the middle of the trail. As you approach you say hello, but he doesn’t respond. Something isn’t right.
Scene and Primary Assessment: The scene appears very safe; the thunderstorms moved off to the east about an hour ago. Nothing above you. The patient appears to be alone and his ABCs look good.
Secondary Physical: You introduce yourself and ask if you can help and he says “Isn’t the view sweet?” You think about implied consent and examine him, finding no evidence of trauma and no injuries. But something is wrong; this guy is out of it.
SAMPLE: You are not able to get anything from the patient, except something about how sweet the view is and how pretty the wildflowers are. He appears to be in his 50s, or maybe 60. You look in his daypack to see if that is helpful. You see a half empty water bottle and what looks like a full brown bag lunch. His name is apparently Bob, but that is all you learn. You look but he does not appear to have a cell phone.
Vitals: Round 1- HR 76, RR 18, He is confused and AO x 1 on AVPU scale. Round 2, 5 minutes later – Same.
Setting: 8500 feet on USFS trail, about 2 miles from and 500 feet above trailhead. You and your buddy each have small daypacks with a raincoat, a sweater, an extra candy bar, a small first aid kit, some water, and not much else. Your patient has basically the same. Your cell phone gets no service. The weather is just about perfect, maybe 70 degrees, no wind, blue skies.