ASM 033

The primary learning objective is to review the fact that not every patient can be saved. Even if we do our best – sometimes a patient’s injuries are just too severe. The estimated time to complete this scenario is 5 minutes.

You may recognize this patient looks similar to PVT Danny Rivers, who you started taking care of in Care Under Fire where you identified a LEFT LOWER EXTREMITY massive hemorrhage and placed a tourniquet on the left leg and then moved the patient to safety. Next you performed a blood sweep which was normal. You then identified an airway obstruction and implemented a head-tilt-chin lift. Then you performed a respiratory assessment which was unremarkable. Your circulation assessment revealed suspected shock from internal bleeding. You managed hypothermia by replacing the patient’s clothing and gear. The patient had a possible head injury and a left side eye injury, but did not appear to have any fracture or burn injuries. You already have personal protective equipment (gloves) on. Additionally, you immediately activated a medical evacuation, but they cannot make it to your location, and it will be at least 40 minutes until they arrive. And there is no clear route for you to reach individuals with more medical skills or supplies.

For this scenario, the severity of the patient’s injuries have been increased, and the patient is not saveable.

Initially, the casualty was near a drone explosion. This scenario occurs in the Tactical Evacuation Care Phase and covers elements after the initial MARCH, head injury, eye injury, fracture, and burn 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 033).

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: The patient is not responding
Location: Head
Patient: Can you tell me your name?
Response: The patient is not responding
Location: Head
Patient: What happened?
Response: The patient is not responding
Location: Head
Patient: Are you hurting anywhere?
Response: The patient is not responding
Location: Head
Patient: Does your throat hurt or feel tight?
Response: The patient is not responding
Location: Head
Patient: Are you having a hard time breathing?
Response: The patient is not responding
Location: Head
Patient: Does your chest hurt?
Response: The patient is not responding
Location: Head
Patient: Did you pass out (lose consciousness)?
Response: The patient is not responding
Location: Head
Patient: Do you have any numbness or weakness?
Response: The patient is not responding
Location: Head
Patient: Does your head hurt?
Response: The patient is not responding
Location: Head
Patient: Does your neck hurt?
Response: The patient is not responding
Location: Head
Patient: Does your back hurt?
Response: The patient is not responding
Location: Head
Patient: Does your abdomen hurt?
Response: The patient is not responding
Location: Head
Patient: Do you have any allergies?
Response: The patient is not responding
Location: Head
Patient: Do you take any medications?
Response: The patient is not responding
Location: Head
Patient: Do you have any medical problems?
Response: The patient is not responding
Location: Head
Patient: Have you ever had any surgeries?
Response: The patient is not responding
Location: Head
Patient: When did you last eat or drink something?
Response: The patient is not responding
Location: Head
Patient: Do you smoke, drink, or use recreational drugs?
Response: The patient is not responding
Location: Head
Patient: I am here with you.
Response: The patient is not responding
Location: Head

Scoring Details

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
Exam: Ask patient
Patient disposition: Pronounce Dead

Scenario Details

Scenario Package
TCCC Course
Learner type
  • militaryMedic
Patient severity at start
Critical
Patient severity overall
Critical
Duration to complete
<5 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
  • Abdominal internal bleeding
  • Amputated left leg at knee
  • Bruise behind right ear
  • Eye cornea trauma, left side
Pathologies
  • internal hemorrhage, vena cava
  • airway obstruction
  • external hemorrhage, left leg
Scoring summary
  • Check Pulse
  • Communicate to patient
  • Disposition