What Is DOTS?
DOTS is a systematic physical assessment tool used in wilderness first aid to identify injuries and medical conditions during a head-to-toe patient exam. The acronym stands for:
- D — Deformities: Abnormal shapes, angulations, or asymmetry compared to the opposite side of the body.
- O — Open wounds: Cuts, lacerations, abrasions, punctures, or any break in the skin.
- T — Tenderness: Pain or discomfort when pressure is applied to a specific area.
- S — Swelling: Localized or generalized puffiness, which may indicate inflammation, fracture, or internal injury.
Why DOTS Matters in the Backcountry
In a wilderness setting, you may be hours — or even days — from definitive medical care. A thorough, systematic assessment using DOTS helps rescuers and first responders identify hidden injuries that a patient may not immediately report, especially in high-stress or altered mental status situations.
By working through DOTS methodically from head to toe, you reduce the risk of missing a critical injury and improve your ability to make sound evacuation decisions.
How to Use DOTS in a Head-to-Toe Exam
During a patient assessment, use your eyes and hands together. Look and feel for each component of DOTS at every body region — head, neck, chest, abdomen, pelvis, and all four extremities. Always compare one side of the body to the other when possible.
- Start at the head and work systematically downward.
- Verbally communicate what you're doing to keep the patient calm and informed.
- Document your findings so you can track changes over time.
- Reassess regularly — conditions in the wilderness can change quickly.
DOTS in S&S Training Solutions Courses
DOTS is a core skill taught across our wilderness first aid courses. Students practice the head-to-toe exam in realistic scenario-based training, building the muscle memory needed to perform a thorough assessment under pressure.
Ready to learn DOTS and other essential wilderness medicine skills? Explore our upcoming courses and register today.