Tier 2 Practice Pack 004

You are providing care near the frontline. Once you have performed all life-saving interventions indicated for this phase of care, you can select [Disposition] in the tablet and select [Medical Evacuation to Higher Level of Care, Return to Duty, or Pronounce Dead], which will end your case. Note, unfortunately, just like in real life, it is not possible to save all patients. The treatment policy for THIS TRAINING ONLY is to pronounce a patient dead if there is no pulse for more than two minutes. In this combat theater, it is not possible to transfer a patient who requires active cardiopulmonary resuscitation.

Patient Communication

Patient: Can you tell me your name?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Do you remember what happened?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Are you feeling dizzy or confused?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Are you having trouble breathing?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Do you take any medications?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Where is the pain worst?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Are you coughing up any blood?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Do you feel any pain?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Do you have any medical problems?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Do you have any allergies?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head
Patient: Do you feel pain in your stomach?
Response: This patient's breathing is noisy and they are having difficulty talking
Location: Head

Audio Triggers

After placing a cricothyroidotomy it is appropriate to consider confirming placement with assisted breaths and end tidal CO2 however this is not currently possible in this simulator. The patient can only be bagged through facial mask placement. The procedure does clear the airway. Overall the same physiologic impact is achieved.
The system currently does not allow you to give this medication slowly in real life you would give over 5 to 10 minutes

Scoring Details

PPE: Blue Gloves (right side)
PPE: Blue Gloves (left side)
PPE: Blue Gloves (right side)
PPE: Blue Gloves (left side)
Exam: Assessment: Remove the patient's shirt
Exam: Assessment: Remove the patient's underpants
Exam: Assessment: Remove the patient clothing around left leg
Exam: Assessment: Remove the patient clothing around right leg
Exam: Assessment: Remove the patient's underpants
Exam: Assessment: Roll the patient over
Exam: Assessment: Roll the patient back
Exam: Assessment: Roll the patient over
Exam: Assessment: Roll the patient back
Exam: Assessment: Remove the patient's shirt
Exam: Assessment: Remove the patient's underpants
Exam: Assessment: Remove the patient clothing around left leg
Exam: Assessment: Remove the patient clothing around right leg
Roll patient into recovery position
Blood Sweep (groin)
Blood Sweep (right chest, back) (Gunshot Wound Back Right)
Blood Sweep (right lower leg) (Deep Wound Leg Right)
Blood Sweep (left lower thigh) (Left Leg Ampute)
Blood Sweep (right lower thigh) (Right Leg Ampute)
Blood Sweep (left upper arm) (Left Arm Ampute / Shrapnel Arm Left)
Blood Sweep (right upper arm) (Right Arm Ampute / Shrapnel Arm Right)
Blood Sweep (left arm) (Deep Wound Arm Left)
Blood Sweep (right arm) (Deep Wound Arm Right)
Blood Sweep (left lower leg) (Deep Wound Leg Left)
Blood Sweep (left upper thigh) (Left Leg Ampute / Shrapnel Leg Left)
Blood Sweep (right upper thigh) (Open Fracture / Open Fracture Blood / Shrapnel Leg Right)
Blood Sweep (right chest, front) (Gunshot Wound Chest Right)
Blood Sweep (left chest, front) (Gunshot Wound Chest Left)
Blood Sweep (stomach) (Shrapnel)
Place bandage on the right lower leg (deep wound)
Fill right leg wound with wound packaging
Apply pressure to right leg
Place bandage on the left groin
Fill left groin wound with wound packaging
Apply pressure to groin
Exam: Ask patient
Airway: Jaw thrust maneuver
Listen for breathing
Airway: Jaw thrust maneuver
Airway: Place Nasopharyngeal Airway
Head-tilt-chin lift
Attach BVM to Face mask
Breathing: Needle Decompression right side placement
Place Chest Seal Back Right
Exam: Assessment: Check Carotid Pulse Right
Exam: Assessment: Check Carotid Pulse Right
Exam: Assessment: Check Carotid Pulse Left
Exam: Assesment: Check Radial Pulse Right
Exam: Assesment: Check Radial Pulse Left
Exam: Assesment: Check Femoral Pulse Right
Exam: Assesment: Check Femoral Pulse Left
Exam: Assesment: Check Pedial Pulse Right
Exam: Assesment: Check Pedial Pulse Left
Lift right eyelid
Lift left eyelid
Lift right eyelid
Lift left eyelid
Place eye guard on the right side
Place eye patch on the right side
Place bandage on the left lower arm (deep wound)
Exam: Ask patient
Exam: Ask patient to move right leg
Exam: Ask patient to move left leg
Exam: Ask patient to move right arm
Exam: Ask patient to move left arm
Exam: Ask patient
Hypothermia Management: Place Blanket
Hypothermia Management: Put Back All Clothes
Exam: Assessment: Palpate Thorax (Right)
Exam: Assessment: Palpate Thorax (Left)
Exam: Assessment: Palpate Lower Left Abdomen
Exam: Assessment: Palpate Lower Right Abdomen
Exam: Assessment: Palpate Upper Left Abdomen
Exam: Assessment: Palpate Upper Right Abdomen
Exam: Assessment: Palpate Right Arm
Exam: Assessment: Palpate Right Palm
Exam: Assessment: Palpate Left Arm
Exam: Assessment: Palpate Left Palm
Exam: Assessment: Palpate Right Leg (Proximal)
Exam: Assessment: Palpate Right Leg (Medial)
Exam: Assessment: Palpate Right Leg (Distal)
Exam: Assessment: Palpate Left Leg (Proximal)
Exam: Assessment: Palpate Left Leg (Medial)
Exam: Assessment: Palpate Left Leg (Distal)
Exam: Assessment: Palpate along back
Exam: Assessment: Palpate Head (Left)
Exam: Assessment: Palpate Head (Right)
Exam: Assessment: Palpate Trachea
Exam: Assessment: Palpate Jaw
Exam: Assessment: Complete TCCC card
Complete NATO Field card
Patient disposition: Medical Evacuation

Scenario Details

Scenario Package
TCCC Tier 2 Practice Pack
Learner type
  • militaryMedic
Patient severity at start
Critical
Patient severity overall
Serious
Duration to complete
<5 minutes
Scenario difficulty
Challenging
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
  • Abdominal internal bleeding
  • Deep wound on the right leg
  • Eye cornea trauma, right side
  • Groin junctional wound, left side
  • GunshotEntrancesWoundInBackRight
  • Left lower hand burn
Pathologies
  • internal hemorrhage, vena cava
  • pneumothorax, open, right
  • airway obstruction
  • external hemorrhage, right leg
  • external hemorrhage, left kidney
Scoring summary
  • PPE
  • M-Exposure
  • M-Blood Sweep
  • M-Bandage laceration
  • M-Stop groin wound bleed
  • A-Assess Airway
  • A-Airway Intervention
  • R-Treat Tension Pneumothorax
  • R-Treat Open Pneumothorax
  • C-Check Peripheral/Central Pulse
  • H-Pupil Assessment
  • H-Treat Eye Injury
  • H-Treat Burn
  • H-Assess Consciousness
  • H-Assess Neurologic Deficit
  • H-Hypothermia Management
  • OP-Extended Assessment
  • Documentation
  • Disposition