grand canyon clinic

1. “You are not at Disneyland”
James Mitchell, M.D.

5. The Basics
 Seven Natural
Wonders
 Located in Arizona
 Visited by 4+ Million
People a year
 Geological Interest
 270 miles in Length
 Native American
Sacred Place

6. Ansel Adams

11. Common Medical Encounters
 Electrolyte Disturbances
 Orthopedic
 Rhabdomyolysis
 Hypoxia
 Heat Injuries
 Acute Renal Failure

19. Electrolyte Disturbances
 Hyponatremia – Na < 134 meQ/L
 Acute
 Causes – too much water, no salts
 Symptoms – Vomiting, weakness, confusion, headache
 Risk associated – Seizures
 Treatment – slow correction to avoid Central Pontine
Myelinolysis if greater than 48 hours duration
 Isotonic Normal Saline - Monitor electrolytes/ urine
output

23. Orthopedic
 Ankle Sprain/Fracture
 Foot Injuries
 Falls – Forearm Fractures
 Dislocations
 Diagnosis/Treatment
 X-ray / Splint / Crutches / Pain Medications
 Reduce if needed – shoulder/elbow

28. Rhabdomyolysis
 Muscle Breakdown
 Symptoms – Cramping, pain
 Diagnosis – CK level
 Treatment – Hydration, Monitor Electrolytes,
Monitor Urine Output

33. Hypoxia
 High Altitude – 6,800 ft / 2072 m
 Risks – Underlying Cardiovascular/Pulmonary Dz,
Sea level dwellers, Elderly
 Symptoms – Shortness of breath, DOE, Chest
Discomfort
 What to do?
 History, Medications, Vital Signs, EKG, PE, Oxygen
 Diagnosis ?
 Treatment – Portable Oxygen, Move to Lower
Altitude

38. Heat Injuries
 Heat Cramps
 Check Vital Signs, Labwork
 Hydrate, Monitor Urine Output
 Heat Exhaustion
 Vitals, Labwork
 Hydrate, Urine Output, Cool Patient, Monitor
Electrolytes
 Heat Stroke
 Medical Emergency
 IV Access, Reduce Core Temperature, Transfer

44. Acute Renal Failure
 Medical Emergency
 Vomiting, Confused, Muscle Pain
 Vital Signs, Labwork, EKG prn, IV Access
 ABC’s
 Treatment – IV fluids, Monitor Electrolytes,
Monitor Urine Output, Transfer (air vs ground)