Tier 2 Course 005

Tier 2 Respiration Assessments and Treatments: You are in a SAFE and SECURE location – The primary learning objective is to show you how to identify more subtle chest wall injuries that can affect respirations. The estimated time to complete this scenario is 5 minutes. This scenario occurs in the Tactical Field Care Phase. Equipment Available: Combat Life Saver Pack. Evacuation/Disposition is possible through the tablet. Selecting the patient’s disposition will end the exercise.

Patient Communication

Patient: Can you tell me your name?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Do you remember what happened?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Do you feel any pain?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Do you have any medical problems?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Do you have any allergies?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Do you take any medications?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Are you feeling dizzy or confused?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Are you having trouble breathing?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Can you see clearly?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Do you feel any swelling in your throat?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Are your lips or tongue swollen?
Response: The patient is sleepy and looks confused
Location: Head
Patient: Is your voice hoarse or different?
Response: The patient is sleepy and looks confused
Location: Head

Audio Triggers

Good job cleaning around the wound.
Good job doing a thorough exposure to search for subtle injuries. It is important to be as respectful as the situation allows.
Good job doing a thorough examination to search for subtle injuries. It is important to be as respectful as the situation allows. A common approach for this examination is to use the ‘back’ of your hand to displace the breast tissue.
Good job doing a thorough examination to search for subtle injuries. It is important to be as respectful as the situation allows. A common approach for this examination is to use the ‘back’ of your hand to displace the breast tissue.

Scoring Details

Exam: Assessment: Remove the patient's shirt
Exam: Assessment: Roll the patient over
Exam: Assessment: Remove the patient's underbra
Displace mammary tissue (right side)
Place Chest Seal Back Right
Place Chest Seal Breast Right
Patient disposition: Medical Evacuation

Scenario Details

Scenario Package
TCCC Tier 2 Curriculum
Learner type
  • militaryMedic
Patient severity at start
Serious
Patient severity overall
Fair
Duration to complete
5-10 minutes
Scenario difficulty
Standard
Environment
POI
Equipment
  • Trauma shears
  • Eye Guard
  • Intravenous cannula
  • Decompression needle
  • BVM
  • BVM Face Mask
  • Blanket
  • Nasopharyngeal airway
  • Combat Application Tourniquet (1)
  • Combat Application Tourniquet (2)
  • Combat Application Tourniquet (3)
  • Combat Application Tourniquet (4)
  • Chest Seal Package
  • Pressure Bandage
  • Bandage
  • Ambu Bag
  • Hemostatic Gauze
  • Gloves box
  • Combat Gauze
  • Radio
  • Triage Tag (Minimal)
  • Marker
  • SAM splint
  • Non-Adherent Dressing
  • Medication Pouch
Available medications
  • Acetaminophen Pills
  • Moxifloxacin 1 g
  • Meloxicam 15mg
Injury type
  • Bruise behind right ear
  • Chest wound (posterior right)
  • Chest wound below the right breast
  • Eye cornea trauma, right side
Pathologies
  • pneumothorax, open, right
Scoring summary
  • M-Exposure
  • R-Displace Mammary Tissue
  • R-Treat Open Pneumothorax
  • Disposition