This casualty was near a drone explosion that occurred 30 minutes ago. You started by providing Care Under Fire, where you saw MASSIVE HEMORRHAGE from both of the patient’s legs. You placed two hasty high and tight tourniquets. Then you moved the patient to safety where you were able to treat the right lower extremity hemorrhage and take the tourniquet down. You replaced the left lower extremity tourniquet with a deliberate tourniquet. The patient is maintaining their AIRWAY. The patient’s chest is clear, and they do not have a RESPIRATORY injury. You identified that the patient was going into shock. You placed large bore intravenous access and gave one unit of Low-Titer O Whole Blood, a dose of Calcium, and a dose of TXA. You identified the patient has an A+ blood type and have a unit of A+ blood transfusing now. You have an electronic vital signs monitor attached, and you already have gloves on. It will take at least two hours to get the patient to a higher level of care. \n\nFor learning goals in this scenario the pelvic binder has been removed, you can consider the pelvis STABLE.
The primary learning objective is to review the management of head trauma in the HEAD INJURY section of MARCH. The estimated time to complete this scenario is 15 minutes. This scenario occurs in the Tactical Field Care Phase.
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
This site is okay to use, good job!
This site is okay to use, good job!
This site should not be used because of the pelvic injury.
This site should not be used because of the pelvic injury.
Good job remembering to document care. In the field, it would be important to record specific injuries and treatments provided. For this simulator, completing the documentation step is considered sufficient
When performing this assessment, it is critical to avoid rocking the pelvis or putting any strain on the pelvis. The action you performed only checks for evidence of pelvic pain or gross instability. When in doubt, you can liberally place a pelvic binder.
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: Assesment: Check right pupil
Exam: Assesment: Check left pupil
Cervical Spine Stabilization: Place C-Collar
Move the patient into a sitting position
Events: Medication Administration: Give IV HypertonicSaline 3mL
Hypothermia Management: Place Blanket
Wipe the access diaphragm using an alcohol wipe on the right arm
Wipe the access diaphragm using an alcohol wipe on the left arm
Exam: Assessment: Complete TCCC card
Patient disposition: Medical Evacuation
