The smell of the morning coffee your co-instructor is brewing wakes you from a great sleep. This is immediately followed by a loud scream from one of the student camps.  It’s a fall morning in the Gila Wilderness in New Mexico, and you’re about to earn your pay.

You bolt out of your sleeping bag, stumble and fall in the process, and curse your clumsiness. Your co-leader runs to the sound of the howls and commotion. You grab the first-aid kit, pull on your shoes and a layer of clothes. While walking to the scene you keep your breathing under control and your head up while your eyes scan the camp.  You mentally review the scene size-up and initial assessment.  

You find one of your students, 25-year-old Daniel, howling in pain and trying to pull off his polypro long johns. Another student is pouring water onto the student on the ground. At the same time one of the students is standing to the side sobbing, “I’m sorry.  It was an accident.” Apparently, he tripped while carrying a pot of hot water and spilled the water into the patient’s boot.

You quickly figure out that this is a spilled hot water burn and continue the cool water irrigation and help the patient to pull off polypro, socks, and shoes. After 20 minutes of water irrigation, which required several relays of people back and forth to the stream (which of course was more than 200 meters from the camp) you decide it’s time for a complete patient assessment.