ASM 026

Head Injury, Eye Injury, Fracture, and Burn Management Essentials in TCCC – Tier 1 – You are in a SAFE and SECURE location – The primary learning objective is to describe, review, and practice Head Injury, Eye Injury, Fracture, and Burn management after completing the core M A R C H algorithm. The estimated time to complete this scenario is 10 minutes. This is your first time taking care of this casualty. The casualty was near a drone explosion that occurred 10 minutes ago. The massive hemorrhage, airway, respiratory, circulation, and hypothermia phases of care have been completed. The patient did not have any massive bleeding, airway obstruction, respiratory, or circulation injuries. You already have personal protective equipment (gloves) on. The patient’s clothes were put back on for hypothermia prevention. No other interventions have been performed. This scenario occurs in the Tactical Field Care Phase and covers the MARC[H] portion(s) of care. Equipment Available: Individualized First Aid Kit (IFAK) U.S Version (x2). Evacuation/Disposition is possible through the tablet. Selecting the patient’s disposition will end the exercise. (This is Scenario 026).

Dynamic Physiology Disclaimer:
To obtain the most accurate and effective training experience, we recommend completing each scenario in one uninterrupted session. The virtual patients used in this training are powered by highly realistic physiological models that continuously adjust vital signs and overall condition. The scenarios have been modified to give you time to review instructional materials, and you will not lose points for delays in scenarios with instructional content. However, it is still possible that, depending on your completion pace, the scenario may not progress in perfect alignment with the guided prompts, and for critically injured patients, even moderate delays may result in deterioration or death before the scenario concludes. This is not meant to indicate you did not perform well; rather, it is because of how the high-fidelity engine performs.

Ongoing Development Disclaimer: In this package wording has not been updated to reflect new functionality to time and date tourniquets or for the non-adhesive burn bandage functionality. Additionally, it is possible other small updates or changes are not reflected in the wording. All grading is set to the current standard described in this package.

Patient Communication

Patient: Hey, I am here to take care of you.
Response: I can't see well out of my right eye and my leg really hurts.
Location: Head
Patient: Can you tell me your name?
Response: I don't know. I can't remember.
Location: Head
Patient: What happened?
Response: There was an explosion. Everything is hurting.
Location: Head
Patient: Are you hurting anywhere?
Response: My right leg really hurts, my right arm is so painful, and my head is pounding
Location: Head
Patient: Does your throat hurt or feel tight?
Response: No. But I feel really weak.
Location: Head
Patient: Are you having a hard time breathing?
Response: I feel weak, but my breathing feels okay
Location: Head
Patient: Does your chest hurt?
Response: No. Just my arm and leg.
Location: Head
Patient: Did you pass out (lose consciousness)?
Response: I don't know. Everything feels foggy.
Location: Head
Patient: Do you have any numbness or weakness?
Response: My right leg feels heavy, it hurts, I don't think I can move it
Location: Head
Patient: Does your head hurt?
Response: Yes, my head is throbbing and I can’t remember things clearly.
Location: Head
Patient: Does your neck hurt?
Response: No, but my head really hurts.
Location: Head
Patient: Does your back hurt?
Response: No I don't think so.
Location: Head
Patient: Does your abdomen hurt?
Response: No it feels ok.
Location: Head
Patient: Do you have any allergies?
Response: No, I don’t have any allergies.
Location: Head
Patient: Do you take any medications?
Response: No I don't take any medications.
Location: Head
Patient: Do you have any medical problems?
Response: No, I am healthy.
Location: Head
Patient: Have you ever had any surgeries?
Response: No, I haven’t had any surgeries.
Location: Head
Patient: When did you last eat or drink something?
Response: I drank some water about an hour ago.
Location: Head
Patient: Do you smoke, drink, or use recreational drugs?
Response: No, I don’t use any of those.
Location: Head
Patient: I am here to take care of you.
Response: Thank you, I appreciate you
Location: Head
Patient: Any changes in vision?
Response: I cannot see out of my right eye.
Location: Head
Patient: I've called a medic for help. They will be here soon.
Response: Thank you.
Location: Head

Scoring Details

Exam: Assessment: Remove the patient clothing around right arm
Exam: Assessment: Remove the patient clothing around left arm
Exam: Ask patient
Exam: Ask patient to move right arm
Exam: Ask patient to move right leg
Exam: Ask patient to move left leg
Exam: Ask patient to move left arm
Place eye patch on the right side
Place eye guard on the right side
Move the patient into a sitting position
Send 9-liner
Place bandage on the left lower arm (deep wound)
Patient disposition: Medical Evacuation

Scenario Details

Scenario Package
TCCC Course
Learner type
  • militaryMedic
Patient severity at start
Serious
Patient severity overall
Serious
Duration to complete
5-10 minutes
Scenario difficulty
Standard
Environment
POI
Equipment
  • Bandage
  • Combat Application Tourniquet (1)
  • Combat Application Tourniquet (2)
  • Trauma Shears
  • Blanket
  • FoilBlanket
  • Nasopharyngeal airway
  • Chest Seal Package
  • Packing Gauze
  • Gloves
  • Eye Guard
  • Non-Adherent Dressing
  • Medication Pouch
  • Radio
  • Marker
  • Triage Tag (Minimal)
Available medications
  • Acetaminophen Pills
  • Moxifloxacin 1 g
  • Meloxicam 15mg
Injury type
  • Bruise behind right ear
  • Eye cornea trauma, right side
  • Left lower hand burn
  • Open fracture of the right thigh with visible bone
Pathologies
  • airway obstruction
Scoring summary
  • M - Exposure
  • H-Assess Neuro and response
  • Place Eye Shield
  • Elevate Head
  • Radio Medic
  • Bandage Burn
  • Disposition