Bottom of stairway. Respond to a fall victim at. Books and papers scattered on the ground Initial Assessment: Scene Survey

Transcription

1 Trauma Objective/Teaching Points: MOI: Twisted Ankle Very first scenario Establish the need to use common sense Establishing rapport with patient (Communication) Bottom of stairway Respond to a fall victim at You were in a hurry to get to class and were rushing down the stairs. You missed the last step and fell hard on your left foot twisting your ankle. You did not hit your head at all as your fall was broken when you fell on your hands. You are in a lot of pain and feel somewhat embarrassed. After a couple minutes you insist that you are OK and attempt to get up and walk on your ankle. The pain is too intense and you sit back down. You now complain of feeling a little nauseated and lightheaded. Just then a friend sees you and approaches to see what is wrong. You ask your friend to give you a hand getting to your car so you can get home. Books and papers scattered on the ground No observable hazards Alert Manual stabilization of the injury Focused trauma Pain and bruising on the ankle Morphine Asthma Breakfast about 4 hours ago Rushing to class Expose ankle and continue to hold manual stabilization call ems Pain and discoloration on the ankle Stable 2 nd Set of Vitals Assisted by friend to car to seek medical attention

2 Medical Hyperventilation Objective/Teaching Points: Establish the need for a proper history prior to administering oxygen. Proper BSI Communication skills Prop Needed: : Baseline 2 nd Set of Vitals You are an EMT working on a BLS ambulance Respond to the parking lot for a complaint of difficulty breathing. You have just gotten into a big argument with your fiancé on a cell phone. Your fiancé wants to start seeing other people. There was a big argument and the other person just hung up You are found sitting in your car with door open in parking lot. You are very upset and your chief complaint is trouble breathing. You are becoming more scared as you can t seem to catch your breath. You are to be mostly cooperative but are very anxious and upset. Generally you do what they ask of you. If they ask, you are experiencing some numbness and tingling in your lips and eventually in your fingers and hands. If they think you are hyperventilating and attempt to treat you for it, then you begin to feel better. If the give you oxygen, you will begin to get worse, feel dizzy and eventually pass out. Scene appears safe, No obvious hazards Alert X4 Calming and reassurance Focused Trauma Assessment Upset and in moderate respiratory distress Penicillin As appropriate Argument with boyfriend Rebreathe co2 Numbness and tingling in hands and lips Depending on treatment As found Patient will respond to attempts by rescuers to calm and reassure. If high flow oxygen is administered, patient will become unconscious.

3 Medical Objective/Teaching Points: HazMat Importance of a proper scene size up Request for additional resources (HazMat) Bathroom or janitor s closet or some similar environment. Respond to the bathroom for difficulty breathing You are the janitor performing routine cleanup duties in the bathroom when you begin to have difficulty breathing and become sluggish to confused. You are sitting on the floor in the bathroom several feet from the door but you are visible from the doorway. If the team chooses NOT to enter and calls for HazMat, I will declare the scene safe and allow them to enter and begin treatment. If team or any members enter the scene they will be declared dead and the scenario will be over. Spray bottle with 3/1 water to bleach solution. Cleaning props. Distinct odor of bleach in the air very strong 40 year old male in moderate distress Alert but sluggish and confused Open Labored As Observed Contain HaxMat and call for additional resources Rapid medical Difficulty breathing and burning in the throat Allergy meds (Hay fever) Sandwich and apple 2 hours ago Cleaning bathroom Move to safe place and provide O2 Stable if removed from bathroom 2 nd Set of Vitals Recovers well

4 Trauma Objective/Teaching Points: May help to have bystander available who saw the patient fall from a height. NOI/MOI: Fall Victim Establish priority for c-spine precautions Importance of determining cause of fall Outdoor setting near the side of a building or high fence where it can appear that the person fell from a moderate height. 6 to 10 feet onto a hard surface. Respond to a fall victim with unknown injuries. You will be lying face up on the ground. You have been unconscious and will be just coming to when the responders arrive at your side. You will be moaning in pain, asking what happened in a groggy and confused state. You will slowly become more responsive as time passes and you repeatedly ask what happened and where am I. You remain cooperative throughout the scenario and do whatever they ask. A couple of times you try and sit up insisting that you are fine. If they don t let you, please cooperate and lie back down. If they ask you if you lost consciousness, tell them that you don t know. needed No hazards V on the AVPU scale Maintain c-spine Rapid trauma assessment Pain to the back of the head and right shoulder no obvious trauma Penicillin Don t remember Don t remember C-spine precautions and Oxygen by NRB Pain and tenderness to back of head and right shoulder no obvious trauma Patient remains stable and gradually improves 2 nd Set of Vitals Patient gets packaged and transported to hospital. Diagnosed with a concussion and released 4 hours later.

5 Medical Cardiac Arrest Objective/Teaching Points: Demonstrate an appropriate and timely initial assessment Initiate appropriate CPR/AED procedures Parking lot Response team please respond to the parking lot for an unknown medical problem You were driving your grandmother to her doctors appointment when she suddenly became unresponsive. You decided to pull your car over and began yelling for help. If you are asked, you state that your grandmother has a long history of heart problems however you can offer no specifics. You do know that she also has high blood pressure. She takes lots of medications but you left them all at home. You are very concerned about your grandmother and continue to ask if she is going to be all right. CPR manikin (Grandmother) belted in the front passenger seat. Vehicle is parked with engine running Open (not breathing) (no pulse) Turn engine off and remove grandma from car N/A N/A Grand daughter does not know Lots (at home) Heart problems and high blood pressure Toast and coffee one hour prior Grand daughter states that she was talking and suddenly went unconscious Pulseless and non breathing CPR AED if available N/A Unstable 2 nd Set of Vitals N/A Pulse returns after defibrillation, still non breathing

6 Trauma Fall Victim - Unconscious Objective/Teaching Points: Demonstrate the ability to assess an unconscious patient found face down Reinforce the Roll-Don t Roll decision process Any location where a patient could have fallen from a height. Typically outside next to a building. Respond to a call for a fall victim near one of the buildings You were working on the roof of a building when someone witnessed you fall to the ground. You will be found face down and unconscious. I want you to breath normally and remain unconscious until you hear me say the words Has anyone called campus police? When you hear those words from ME, I want you to begin moaning and groaning and moving a little like you are beginning to wake up. As you come to, I want you to ask what happened and where you are and who are you? Medic alert tag Safe Unconscious Open Adequate Adequate Stabilize head, O2, vitals Rapid trauma assessment Phenabarbitol Epileptic Haven t eaten today Working on roof C-spine precautions and Patient assessment Hide two or three small objects (OPA, Bite stick, Marker pen) on the patients body to simulate deformities. Unstable due to unconsciousness 2 nd Set of Vitals