TREK MEDICAL CHART WW
Trek: Dates: Start Finish
Number of World Wide Trekking Guests:
Important Contacts: Owner:
Dean Cardinale | 1.801.230.9089 | dean@wwtrek.com
Global Rescue
Elise Allan | 1.617.459.4200 |eallan@GlobalRescue.com GlobalRescue.com | 1.800.381.9754 | Operations@GlobalRescue.com
Travel Guard TravelGuard.com | 1.800.826.4919 | 1.715.345.0505 | webmaster@travelguard.com Medical Advisors:
Dr. Phil Levy | 1.248.840.0169 | phillevy_2000@yahoo.com Dr. Scott Macintosh | 1.435.640.2535 | scott.mcintosh@hsc.edu
Eye Doctor:
Dr. Geoff Tabin | 1.435.729.9610 | geoffrey.tabin@hsc.utah.edu
Medical Terms: STOP
Stop Think Observe Plan
ABC / BSS Airway Breathing Circulation Bleeding Shock Spine
MOI or NOI
Mechinism of Injury or Nature of Illness
SAMPLE history
S - Signs and Symptoms A - Allergies M - Medications P - Past History (Pertaining to the Present Illness) L - Last Oral Intake E - Events Leading up to the Event
OPQRST (With Relation to Pain) O - Onset P - Provokes Q - Quality R - Radiation S - Severity (1-10) T - Time (How long?)
DCAP-BTLS (Trauma)
D - Deformities C - Contusions A - Abrasions P - Penetrations/Perforations B - Burns T - Tenderness L - Lacerations S - Swelling
WORLD WIDE TREKKING MEDICAL CHECKLIST Name: Age:
Medications:
Comments:
Height: Weight:
1
Pulse O²: 2
Pulse O²: 3
Pulse O²: 4
Pulse O²: 5
Pulse O²: 6
Pulse O²: 7
Pulse O²:
Date: Diamox:
Location: Head:
Date: Diamox:
Head:
Head:
Head:
Head:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
Location: Head:
Date: Diamox:
Bathroom:
Location:
Date: Diamox:
Sleep:
Location:
Date: Diamox:
Eating:
Location:
Date: Diamox:
General:
Location:
Date: Diamox:
Body:
Body: Location:
Head:
Body:
8
Pulse O²: 9
Pulse O²: 10
Pulse O²: 11
Pulse O²: 12
Pulse O²: 13
Pulse O²: 14
Pulse O²:
Date: Diamox:
Location: Head:
Date: Diamox:
Head:
Head:
Head:
Head:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
Location: Head:
Date: Diamox:
Bathroom:
Location:
Date: Diamox:
Sleep:
Location:
Date: Diamox:
Eating:
Location:
Date: Diamox:
General:
Location:
Date: Diamox:
Body:
Body: Location:
Head:
Body:
Comments:
Key:
ü = Yes ø = No
G = N = F = P =
Good Normal Fair Poor
1 2 3 4
= = = =
No Pain Mild Pain Moderate Pain Severe Pain
WORLD WIDE TREKKING MEDICAL CHECKLIST Name: Age:
Medications:
Comments:
Height: Weight:
1
Pulse O²: 2
Pulse O²: 3
Pulse O²: 4
Pulse O²: 5
Pulse O²: 6
Pulse O²: 7
Pulse O²:
Date: Diamox:
Location: Head:
Date: Diamox:
Head:
Head:
Head:
Head:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
Location: Head:
Date: Diamox:
Bathroom:
Location:
Date: Diamox:
Sleep:
Location:
Date: Diamox:
Eating:
Location:
Date: Diamox:
General:
Location:
Date: Diamox:
Body:
Body: Location:
Head:
Body:
8
Pulse O²: 9
Pulse O²: 10
Pulse O²: 11
Pulse O²: 12
Pulse O²: 13
Pulse O²: 14
Pulse O²:
Date: Diamox:
Location: Head:
Date: Diamox:
Head:
Head:
Head:
Head:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
Body:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
General:
Eating:
Sleep:
Bathroom:
Location: Head:
Date: Diamox:
Bathroom:
Location:
Date: Diamox:
Sleep:
Location:
Date: Diamox:
Eating:
Location:
Date: Diamox:
General:
Location:
Date: Diamox:
Body:
Body: Location:
Head:
Body:
Comments:
Key:
ü = Yes ø = No
G = N = F = P =
Good Normal Fair Poor
1 2 3 4
= = = =
No Pain Mild Pain Moderate Pain Severe Pain
Notes
Notes