You are receiving this patient from another medic. This casualty was near a drone explosion that occurred 25 minutes ago. The initial medic started by providing Care Under Fire, and treated MASSIVE HEMORRHAGE from both of the patient’s legs. They placed two hasty high and tight tourniquets. Then they moved the patient to safety and were able to treat the right lower extremity hemorrhage and take the tourniquet down. They 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. The medic identified that the patient’s pelvis was unstable and placed a pelvic binder. They identified that the patient was going into shock, saw the patient’s identification tags listing A+ blood, and started a unit of A+ packed red blood cells about 10 minutes ago. The patient vomited a couple of minutes ago, feels warm, appears to be getting even more distressed, and perhaps is having increased flank pain. The previous medic did not get a chance to check the patient’s blood type.
The primary learning objective is to review how to manage severe reactions to blood products in the CIRCULATION section of MARCH. The estimated time to complete this scenario is 10 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.
Events: Medication Administration: Give Epinephrine 1mg
Events: Medication Administration: Give Diphenhydramine 50mg/mL
Patient disposition: Medical Evacuation
