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🏔 WFR Patient Assessment
Wilderness First Responder — Field Form
Scene
Initial
Head-to-Toe
Vitals
History
Plan
SOAP Note
Date
Time
Location / Description
1
Scene Hazards
Check all hazards present or cleared:
Rescuer safety — scene clear for approach
Bystander safety — non-responders moved back
Patient safety — no immediate environmental threat
Hazard notes
2
Mechanism of Injury (MOI)
MOI type
Fall
Impact / Trauma
Environmental
Medical
Unknown
MOI description
Spine injury MOI?
YES — Protect Spine
No
3
BSI & Resources
Gloves on
Eye protection if needed
# Patients
# Rescuers
Available resources
4
General Impression
Patient appears:
Very sick / very hurt
Uncertain
Not seriously injured
Approach sequence:
ABC (Airway first)
CAB (Compressions first)
Next: Initial Assessment →
⚠️ Spine MOI flagged — maintain spinal protection throughout assessment
1
Consent
Identified self and level of training
Obtain consent to treat (implied if unconscious)
2
Responsiveness
Initial responsiveness
A
CONSCIOUS — Responsive, able to speak
V
Responds to voice
P
Responds to pain only
U
Unresponsive
Spine protection established (if MOI)
3
A — Airway
Mouth opened and inspected
Obstructions cleared
Airway status
Open & Clear
Needs positioning
Obstructed
4
B — Breathing
Look / Listen / Feel for breathing
Chest exposed and inspected
Breathing
Present & adequate
Shallow / labored
Absent
5
C — Circulation
Pulse checked — signs of life assessed
Life-threatening bleeding identified & controlled
Circulation status
Pulse present
Weak / thready
No pulse
Bleeding / wounds
6–7
D & E — Decide & Expose
Spine MOI decision confirmed
Life-threatening injuries exposed and treated
Immediate interventions
← Back
Next: Head-to-Toe →
Look (bruising, bleeding, swelling) · Ask (pain, tenderness) · Feel (deformity, hardness) · Listen (breath sounds) · Smell (unusual odors)
Head / Face / Neck
⚑ Flag
Shoulders
⚑ Flag
Chest
⚑ Flag
Abdomen
⚑ Flag
Pelvis
⚑ Flag
Groin
⚑ Flag
Lower Extremities
⚑ Flag
Upper Extremities
⚑ Flag
Spine & Back
⚑ Flag
CSM
Circulation / Sensation / Motion
Hands (CSM)
Normal
Abnormal
Feet (CSM)
Normal
Abnormal
CSM notes
← Back
Next: Vital Signs →
⏱ Stamp Current Time
VS1
Vital Signs — Set 1
Time
LOR — Level of Responsiveness
Normal: A+O×4
— select —
A+O×4 — Person, Place, Time, Events
A+O×3 — Person, Place, Time
A+O×2 — Person, Place
A+O×1 — Person only
A+O×0 — Awake, not oriented
V — Responsive to Verbal
P — Responsive to Pain
U — Unresponsive
HR — Heart Rate
Normal: 50–100 / regular / strong
Rhythm
Regular
Irregular
Quality
Strong
Weak
Bounding
Thready
RR — Respiratory Rate
Normal: 12–20 / regular / easy
Rhythm
Regular
Irregular
Effort
Easy
Labored
Shallow
Deep
SCTM — Skin
Normal: pink / warm / dry
Color
Pink
Pale
Red
Ashen
Temp
Warm
Cool
Hot
Moisture
Dry
Moist
Wet
BP — Blood Pressure
(later changing sign)
Normal: ~120/80 · Strong radial pulse = adequate BP
Method
Auscultation
Palpation
Estimation
P — Pupils
(later changing sign)
Normal: PERRL
PERRL
Unequal
Sluggish
Fixed / Dilated
T° — Temperature
(later changing sign)
Normal: 97–99°F (36.1–37.2°C)
°F
°C
+ Add Another Vital Signs Set
← Back
Next: History →
👤
Patient Info
Age
Sex
—
Male
Female
Other / Unknown
Patient name / how to address
CC
Chief Complaint — OPQRST
Chief complaint
O — Onset
Sudden
Gradual
P — Provokes / Palliates
Q — Quality
Sharp
Dull
Burning
Constant
Erratic
Pressure
R — Radiation / Region / Referred
S — Severity (0–10)
1
2
3
4
5
6
7
8
9
10
T — Time / Trend
Getting better
Same
Getting worse
S
SAMPLE — Symptoms
Additional symptoms
Headache
Dizziness
Nausea
Vomiting
Cold
Hot
Anxious
Weakness
A
SAMPLE — Allergies
M
SAMPLE — Medications
P
SAMPLE — Pertinent Medical History
Felt this way before?
Heart problems
Breathing problems
Seizure history
Diabetes
L
SAMPLE — Last Intake / Output
Last food
Last water
Last urination
Vomiting / other
E
SAMPLE — Events Preceding
← Back
Next: Plan →
Ax
Problem List (Assessment)
List each identified problem. Number them.
Rx
Treatment Plan
Address each problem from the list above.
⚠
Anticipated Problems
♥
Psychological First Aid
Safety
— reduced chaos, patient away from perceived threats
Calm
— rescuer calm; emphasizing present, practical, possible
Efficacy
— patient involved in self-care decisions
Connection
— on-scene relationship built
Hope
— accurate, positive, realistic steps communicated
👁
Monitor
Record ongoing observations, changes in condition, interventions.
← Back
View SOAP Note →
📋
Written SOAP Note
Auto-generated from your entries. Review and edit below.
↻ Regenerate from Form Data
S — Subjective
O — Objective (Exam + Vitals)
A — Assessment (Problem List)
P — Plan
Copy Full SOAP Note
Clear Form
← Back to Plan
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