WFR - Wilderness First Responder Evacuation and Litter Packaging Questions and Answers — Questions and Answers
Question 1: When constructing an improvised litter with a tarp and two long, rigid poles, what is the most effective method for creating a secure patient platform?
- Lacing a rope through the tarp's grommets to the poles.
- Placing the poles inside sleeves made by folding and sewing the short ends of the tarp.
- Folding one-third of the tarp over each pole towards the center, relying on the patient's weight and friction to secure it. (Correct answer)
- Simply laying the tarp over the poles and placing the patient on top.
Correct answer: Folding one-third of the tarp over each pole towards the center, relying on the patient's weight and friction to secure it.
The standard and most secure method for a tarp and pole litter relies on tension and friction. By folding the tarp over the poles towards the center, the patient's weight tensions the fabric, creating a strong and secure platform. Using grommets will cause them to rip out, and simply laying the tarp on top provides no security.
Question 2: You are leading a six-person litter carry over steep and uneven terrain. To ensure the safety of the patient and the team, which of the following is the most critical leadership action?
- Enforcing silence so rescuers can concentrate on their footing.
- Assigning the person at the front right position to be the team leader who calls out commands and upcoming hazards. (Correct answer)
- Rotating carriers only when they explicitly state they are tired.
- Moving at the fastest possible safe pace to reduce exposure time.
Correct answer: Assigning the person at the front right position to be the team leader who calls out commands and upcoming hazards.
A designated leader, typically positioned at the patient's right shoulder or front right handle, is essential for coordinated and safe movement. This person has the best view of the terrain ahead and is responsible for communicating commands for lifting, lowering, and navigating obstacles, ensuring the entire team moves as a single unit. Silence prevents necessary communication, reactive rotations lead to exhaustion, and speed increases the risk of mistakes.
Question 3: When packaging a patient with a suspected spinal injury in a litter for a long evacuation, what is the primary purpose of creating an "X" pattern with webbing straps over the patient's torso?
- To serve as the primary lifting points for the patient.
- To provide compression to the chest in case of rib fractures.
- To act as a pelvic binder for a suspected pelvic fracture.
- To prevent the patient from sliding up or down within the litter on inclines and declines. (Correct answer)
Correct answer: To prevent the patient from sliding up or down within the litter on inclines and declines.
The diagonal or "X" strapping pattern is crucial for securing the patient's torso to the litter and preventing longitudinal (up and down) movement. This is especially important for a patient with a potential spinal injury when the litter is tilted during an evacuation over steep terrain.
Question 4: A member of your group has a stable, isolated, and well-splinted ankle fracture. They are non-ambulatory. Your group is strong, the weather is good, and you are 4 miles from the trailhead on a clear trail. What is the most appropriate evacuation decision?
- Send one person to run ahead for help while the rest of the group waits.
- Leave the patient with a small care team and send the majority of the group for help.
- Construct an improvised litter and begin a slow, careful carry-out with the entire group. (Correct answer)
- Insist the patient try to walk on the splinted ankle to speed up the evacuation.
Correct answer: Construct an improvised litter and begin a slow, careful carry-out with the entire group.
Given a strong group, good weather, a clear trail, and a moderate distance, a self-evacuation via an improvised litter is a reasonable and efficient plan. This keeps the group together and initiates progress toward the trailhead without splitting the party or waiting for external resources, which may be unnecessary in this stable situation.
Question 5: Which of the following patient conditions presents the MOST urgent need for an immediate and rapid evacuation from a wilderness setting?
- A closed, angulated tibia fracture with good distal circulation, sensation, and motion (CSM).
- Signs and symptoms of severe hypothermia, including lethargy and cessation of shivering. (Correct answer)
- A large laceration on the thigh where bleeding has been controlled with a pressure dressing.
- A simple shoulder dislocation in an otherwise healthy and alert individual.
Correct answer: Signs and symptoms of severe hypothermia, including lethargy and cessation of shivering.
Severe hypothermia with a decreasing level of consciousness is an immediate life-threat that cannot be definitively managed in the field. This condition requires rapid evacuation to a hospital for advanced rewarming. While the other conditions are serious, they are either stable (controlled bleeding, simple dislocation) or can be managed with splinting before a more controlled evacuation.
Question 6: When creating a "hypothermia wrap" or "burrito" for a patient in a litter, what is the correct layering sequence, starting from the layer closest to the patient and moving outwards?
- Patient, vapor barrier, sleeping bag (insulation), insulating pad, tarp.
- Patient, sleeping bag (insulation), vapor barrier (tarp), insulating pad.
- Insulating pad, patient, sleeping bag (insulation), vapor barrier (tarp).
- Patient in dry layers, inside a sleeping bag (insulation), with an external vapor barrier (tarp) wrapped around everything. (Correct answer)
Correct answer: Patient in dry layers, inside a sleeping bag (insulation), with an external vapor barrier (tarp) wrapped around everything.
The correct hypothermia wrap insulates the patient and protects them from the elements. The patient (ideally in dry clothes) provides the heat. The sleeping bag provides insulation to trap that heat. The external tarp acts as a vapor barrier to protect the insulation from wind and moisture (convective and evaporative heat loss). An insulating pad is placed underneath all of this to prevent conductive heat loss to the ground or litter.
WFR - Wilderness First Responder Evacuation and Litter Packaging Questions and Answers
When constructing an improvised litter with a tarp and two long, rigid poles, what is the most effective method for creating a secure patient platform?