Wilderness First Aid — Field Assessment Reference
Page 1 of 21 · Scene size-up — before you approach (you are priority #1)
- Hazards: what hurt them can hurt you — rockfall, water, traffic, weather, animals. Don't become patient #2.
- Gloves on (Standard Precautions): treat all blood and body fluids as infectious.
- How many patients? Loudest is rarely sickest — quiet patients first.
- Mechanism of injury: high energy (fall >3× height, vehicle, diving) = suspect hidden injury.
- Consent: ask a responsive adult; unresponsive = implied consent.
2 · First look — 10-second general impression
AppearanceAlert? Interacting? Posture normal?
BreathingEffort? Noise? Position to breathe?
SkinPink? Pale, mottled, blue?
Any side abnormal → treat as sick: move fast to the primary survey.
AVPU — level of responsiveness
AAlert — awake, oriented
VResponds to Voice
PResponds to Pain only
UUnresponsive
V, P, or U — or any decline — is a red flag. Recheck often; the trend matters most.
3 · XABCDE primary survey — find and fix life threats, in order
XExsanguinating hemorrhage — severe bleeding first: direct pressure; tourniquet for limb bleeding that pressure can't control.
AAirway — open and clear it (jaw thrust if spine concern). Talking = open airway.
BBreathing — look, listen, feel. Not breathing normally → begin CPR/rescue breathing per your training.
CCirculation — pulse rate and quality, skin color/temp/moisture, treat for shock (keep flat, keep warm).
DDisability — AVPU, pupils, protect the spine if the mechanism suggests injury.
EExpose / Environment — expose to examine injuries, then protect from heat/cold. Hypothermia worsens everything.
SAMPLE — history
SSigns & symptoms
AAllergies
MMedications
PPast history
LLast oral intake
EEvents leading up
OPQRST — pain / complaint
OOnset — sudden or gradual?
PProvocation — better/worse?
QQuality — sharp, dull, crampy?
RRadiation — does it travel?
SSeverity — 0–10 now vs. before
TTime — when did it start?
Head-to-toe exam — DCAP-BTLS, feel for:
Deformity · Contusions · Abrasions · Punctures · Burns · Tenderness · Lacerations · Swelling
Compare side to side. Check CSM (circulation, sensation, movement) beyond every injured limb — before and after splinting.
Normal adult vitals
| Pulse | 60–100/min (count 15 s × 4) |
|---|---|
| Breathing | 12–20/min (count 60 s) |
| Skin | Pink, warm, dry · cap refill < 2 s |
| Recheck | Stable q15 min · unstable q5 min |
Evacuation urgency — judge the trend, not just the snapshot
- URGENT (within hours): life threats · deteriorating patient · altered mental status · shock signs · spine injury · severe hypothermia or heat stroke · suspected heart attack/stroke · anaphylaxis · open fractures. Activate rescue immediately.
- NON-URGENT (12–24 h): stable closed fractures · early infection · controlled bleeding · wounds needing closure. Litter or assisted walk.
- SELF-EVACUATE / STAY: minor sprains (can bear weight) · superficial wounds · fatigue. Know the red flags that change the plan.
Wilderness First Aid — free online course · openwfa.com
Educational use only — not a substitute for hands-on training or professional care.
Patient SOAP Note — Field Form
Page 2 of 2S · Subjective — chief complaint, SAMPLE, OPQRST
Allergies askedMeds askedPast historyLast intakeEvents
O · Objective — serial vital signs (stable q15 min · unstable q5 min)
| Time | AVPU | Pulse | Breaths | Skin (color/temp/moist) | Pain 0–10 / notes |
|---|---|---|---|---|---|
Exam findings (head-to-toe, DCAP-BTLS, CSM):
A · Assessment — what do you think is going on?
P · Plan — treatment + evacuation
UrgentNon-urgentSelf-evac / stay
Calling for help — MIST report
Also give: your location · party size · terrain/weather · resources on scene. Helicopter needs ~100 × 100 ft clear, level area.
Hand this form to rescuers or medical providers when you transfer care.
Wilderness First Aid — free online course
← Back to the course · Full detail lives in Lesson 2: Patient Assessment and Lesson 13: Evacuation.