Turn Left Adventures & Education

Turn Left Adventures & Education Real wilderness medicine. Real scenarios. Real skills. Training outdoor leaders and adventurers to handle emergencies when help is far away.

08/26/2026

WHO GETS TREATED FIRST?

MY ANSWER: C

Lightning is one of the rare situations where reverse triage may apply.

In many mass-casualty situations, a patient with no pulse and no breathing may not receive the first available resources when other patients are still alive.

Lightning can change that decision.

A patient in cardiopulmonary arrest after a lightning strike may respond to immediate BLS.

First, protect yourself and reduce the group’s continued exposure to lightning. Move toward the safest available location when necessary.

Once it is safe enough to act:

- Begin CPR.
- Apply an AED as soon as one is available.
- Activate rescue.

The patient is safe to touch. A lightning victim does not retain an electrical charge.

Patients A and B still need rapid assessment and care. Check every patient for respiratory failure, burns, blunt or penetrating trauma, and neurologic impairment. If other rescuers are available, assign them to those patients while BLS begins on Patient C.

After a lightning strike, the patient who appears dead may be the one you treat first.

What did you choose?

This is a training simulation. This post is for education and does not replace hands-on training, medical direction, or professional care.

08/22/2026

WHO GETS EVACUATED FIRST?

A. Decompression sickness

B. Facial barotrauma

C. Fire coral sting

MY ANSWER: A

The facial barotrauma may look the worst.

The fire coral sting may hurt the most.

But the patient with decompression sickness needs to be evacuated first.

Decompression sickness occurs when gas bubbles form in the tissues or bloodstream following a change in pressure. It can affect the nervous system and other parts of the body. This patient may need specialized evaluation and recompression treatment that cannot be provided on the dock.

Emergency oxygen is important first aid, but improvement while receiving oxygen does not mean the problem is gone or that the evacuation can be canceled.

Start oxygen if trained and equipped. Activate emergency services. Contact a dive-medicine resource such as DAN and coordinate the evacuation. Because this is an island, do not arrange routine air travel without medical guidance.

Why not Patient B?

This patient has facial barotrauma from mask squeeze, with slight tenderness around the eyes and no other concerning findings described. It may look dramatic, but the patient is currently stable.

Why not Patient C?

This fire coral sting is causing localized redness, swelling and intense burning. Treat the injury, monitor the patient and continue reassessing.

If either patient develops an airway problem, breathing difficulty, altered mental status or another life threat, the evacuation order changes.

Based on the information provided, Patient A goes first.

Who did you choose?

This is a training simulation. This post is for education and does not replace hands-on training, medical direction or professional care.

08/21/2026

WHAT IS THE MOST WORRYING FINDING?

A. A cut on her head with no exposed skull
B. The worst headache of her life
C. Cuts to her hand from broken glass
D. Sensitivity to light

MY ANSWER: B

The head wound and bloody hand may grab your attention first. Sensitivity to light is also important. But the worst headache of her life is the biggest warning sign among these choices.

After a suspected traumatic brain injury, watch for three major early warning signs:

1. The worst headache of their life
2. Altered mental status
3. Persistent or repeated vomiting

Altered mental status can be easy to miss. For this patient, it appears as difficulty staying awake.

That means she is already showing two concerning findings: the worst headache of her life and an altered mental status.

The injury you can see is not always the most dangerous one.

What grabbed your attention first?

This is a training simulation. This post is for education and does not replace hands-on training, medical direction, or professional care.

08/20/2026

High risk wounds deserve attention!

MY ANSWER: C & D

More specifically, irrigate the wound with drinking-quality water under pressure. For a high-risk wound, add a 1% povidone-iodine solution made by diluting povidone-iodine with water.

According to WMA wound-care guidance:

- Wash the skin around the wound with soap and drinking-quality water.
- Except for puncture wounds, irrigate the wound with drinking-quality water under pressure.
- Remove any visible foreign material.

So why use 1% povidone-iodine?

For high-risk wounds, it is an important additional step that may help reduce the risk of infection.

Why not hydrogen peroxide or rubbing alcohol?

Neither is recommended for irrigating wounds. They can damage healthy tissue, interfere with healing, and they hurt!

High-risk wounds may also need medical evaluation for prescription antibiotics. Be sure to check the patient’s tetanus status. If it is not current, WMA recommends evacuation within 24 hours.

The blood gets everyone’s attention. But once the bleeding is controlled, properly cleaning the wound may prevent the next problem.

What did you choose before reading the answer?

This is a training simulation. This post is for educational purposes and does not replace hands-on training, medical direction, or professional medical care.

08/19/2026

What would you do?

ANSWER: C

Begin CPR with rescue breaths and chest compressions.

During the airway assessment, no water was found in the patient’s mouth or upper airway. There was nothing obstructing the airway and no reason to roll the patient over simply to “drain” them.

If water or vomit had been present in the upper airway, we could briefly roll the patient onto their side and allow gravity to help it drain. Clear the airway, return the patient to their back, and immediately continue CPR.

That is very different from trying to drain water from the lungs.

Water cannot be effectively drained from the lungs. Do not use abdominal or chest thrusts to force water out. They delay CPR and can cause vomiting, potentially creating an actual upper-airway obstruction. American Heart Association first-aid guidance

This patient had no pulse and was not breathing. Drowning-related cardiac arrest is generally caused by severe oxygen deprivation. That is why trained rescuers should provide CPR with both breaths and compressions, not compression-only CPR.

The airway was clear. The patient needed oxygen and circulation. Immediately.

08/18/2026

First, this is definitely a joke...

But the truth behind the joke is that WFRs are trained to work when definitive care is delayed, the environment is hostile, or resources are limited.

Sometimes that means improvising how we care for, package, protect, and transport a patient using the equipment available. A sleeping pad may become insulation or part of a splint. Clothing may provide padding. Trekking poles and a tarp might become part of a patient-carry system.

Improvisation does not mean making up medicine as we go. It means applying solid medical and rescue principles when the perfect equipment is not available.

It may look like magic, but it is really training, problem-solving, and understanding what the patient needs during a potentially long evacuation.

What is the most creative piece of patient packaging you have used or seen?

08/17/2026

WOULD YOU GIVE THEM MORE TO DRINK?
**This is a medical training - for educational purposes only**
Your group is on day 2 of a 5-day sea-kayaking trip.

The temperature is 96°F / 36°C. You are on a remote beach, 22 miles by water from the nearest takeout. There is no cell service, but your group has a satellite communication device.

Before launching that morning, one paddler decided to “get ahead of dehydration.” She drank nearly one gallon, or 3.8 liters, of water in about two hours. She continued drinking throughout the paddle, even when she was not thirsty.

When the group stops for lunch, she says she does not feel well. She is nauseated and decides not to eat anything.

Her symptoms continue to worsen. She now has a headache, dizziness, unusual fatigue, bloating, and noticeably puffy hands.

She is currently alert and oriented. Her temperature is normal.

You suspect hyponatremia.

What are your treatment principles?

Would you give her:

Water?
A sports drink?
Salty food?
Nothing to drink?

What about evacuation?

Would you monitor her on the beach, have her paddle 22 miles to the takeout, or activate rescue?

Most importantly, what change in her condition would make this an urgent or emergent evacuation?

Do not just say, “Give her electrolytes.” Tell me exactly what you would do and why.

08/16/2026

ALTERED MENTAL STATUS? THINK STOPEATS.

When a patient’s mental status changes, STOPEATS is a quick way to work through possible causes:

S: Sugar
T: Temperature
O: Oxygen
P: Pressure
E: Electricity
A: Altitude
T: Toxins
S: Salt

Each of these can affect how a person thinks, speaks, behaves, or responds. Once you identify the likely cause, treatment is often fairly simple. Sometimes the patient’s response can be surprisingly quick.

Have you treated a patient whose altered mental status was caused by one of these?

What was causing it?
What did you do to treat it?
How did the patient respond?
Were you successful?

Share your experience in the comments, without including identifying information.

08/14/2026

Would you stay or would you go?

RECAP: It is day 2 of a 6-day backpacking trip. You are 6 miles from the trailhead. Your hiking partner has a clean partial-thickness burn on their forearm. It is red, blistered and painful, but smaller than their entire hand and not circumferential. Movement, circulation and sensation remain normal.

MY DECISION: STAY AND MONITOR.

“Partial thickness” tells us the depth of the burn. It does not determine the evacuation decision by itself. We also need to consider its size, location, the body systems involved and whether we can properly care for it.

First, stop the burning with cool water. Clean the area with drinking-quality water. For burns smaller than 1% of the patient’s total body surface area, antibiotic ointment may be used.

Cover the burn with non-stick gauze or a clean dressing. Elevate the arm, manage pain and prevent hypothermia. Reassess regularly and monitor for infection.

I would promptly evacuate for:

• Partial-thickness burns to the face, palms, soles or ge****ls
• Likely smoke inhalation
• Partial-thickness burns covering more than 10% of the body

The patient’s entire hand, including the fingers, represents approximately 1% of their body surface area.

Assuming we can properly care for this burn and nothing changes, I would not call for rescue or automatically end the trip.

Would you stay, walk out or call for rescue?

There is nothing better than hearing that a student left a course feeling confident, challenged, and ready to use their ...
08/13/2026

There is nothing better than hearing that a student left a course feeling confident, challenged, and ready to use their skills.

Jake recently completed his first Wilderness First Responder course with Turn Left Adventures. He shared that he appreciated the thoroughness of the course and the opportunity to adapt these skills to different environments.

Our wilderness medicine courses are active, hands-on, and built around realistic situations. You will not spend the entire course sitting in a classroom. You will practice assessing patients, making difficult decisions, and providing care when help may be hours away.

Turn Left Adventures offers:

Wilderness First Aid
Wilderness Advanced First Aid
Wilderness First Responder
WFR Recertification
CPR and BLS
Private and workplace training

Want to be better prepared for your next adventure?

View upcoming courses or contact us about hosting a course at

www.turnleftadventures.com


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1385 E 1650 N
Heber City, UT
84032

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