Travel Reference
In-Depth Information
The time and circumstances in which symptoms appear and their chronological se-
quence are significant. The precise location of pain, the time it began, whether the onset
was gradual or sudden, the severity of the pain, and the quality of the pain—cramping,
stabbing, burning—should be ascertained. Symptoms must be evaluated to determine if
they are continuous or intermittent; how they are aggravated or relieved; how they are re-
lated to each other; and how they are affected by position, eating, defecation, exertion,
sleep, or other activities. Nonpainful symptoms such as tiredness, weakness, dizziness,
nausea—or their absence—may be highly significant, particularly at high altitude.
Anaccountofanypastillnessesmustalwaysbeobtained,eventhoughinthewilderness
thecurrentillnessisusuallythemostsignificantpartofthehistory.Iftheperson'sillnessis
a recurrence of a previous disease, awareness of that disorder can provide the key to its re-
cognition. Inaddition, preexisting diseases, such as diabetes orepilepsy,must be identified
so that necessary treatment can be continued; individuals with traumatic injuries can have
such disorders and should be carefully questioned about them.
MEDICAL HISTORY
Past History
Previous Illnesses: Bronchitis, asthma, pneumonia, pleurisy, tuberculosis, rheumatic
fever; any other heart or lung disease Malaria, diabetes, epilepsy, anemia; any other
severe or chronic illnesses
Operations: Date, nature of operation, complications
Injuries: Date, nature of injury, residual disability; wilderness-related injuries, particu-
larly cold injury or altitude illness
Medications: Any medications taken regularly, whether currently or in the past
Exposure: Recent exposure to infection or an epidemic
Immunizations: When administered; boosters
Allergies: Allergy to food, insect stings, or drugs, particularly penicillin and sulfa drugs
Review of Systems (Including Both Present and Past Illnesses)
Head: Headache, dizziness, hallucinations, confusion, or fainting
Eyes: Inflammation, pain, double vision, loss of vision
Nose: Colds, sinus trouble, postnasal drip, bleeding, obstruction
Teeth: General condition, abscesses, dentures
Mouth: Pain, bleeding, sores, dryness
Throat: Sore throat, tonsillitis, hoarseness, difficulty swallowing or talking
Ears: Pain, discharge, ringing or buzzing, hearing loss
Neck: Stiffness, pain, swelling, or masses
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