Wilderness Medical Society snowmass 2005 Page 15
The most apparent non-verbalized sign that something is going wrong is for a person to
have a change in personality or for them to begin to complain or show evidence of loss of
coordination. NOLS calls these signs "grumble, mumble, and stumble". Loss of appetite
and inability to sleep are subtle signs that something is wrong. Other symptoms are not so
subtle, such as dyspnea, diarrhea, and vomiting. Regardless, it will be up to the trip
leadership to identify problems as they initially develop and provide a change in
environment or work activity level that allows the participant to have a safe and
enjoyable (if possible) conclusion to the trip. This is where compassion and the art and
science of medicine come together. Hopefully, by the conclusion of this elective, you will
have gained insight on what to look for and how to respond.
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