Tier 2 Respiration Assessments and Treatments: You are in a SAFE and SECURE location – The primary learning objective is to show you how to identify more subtle chest wall injuries that can affect respirations. The estimated time to complete this scenario is 5 minutes. This scenario occurs in the Tactical Field Care Phase. Equipment Available: Combat Life Saver Pack. Evacuation/Disposition is possible through the tablet. Selecting the patient’s disposition will end the exercise.
Patient Communication
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
Guided Steps
The patient was injured in a blast from a drone attack about 30 minutes ago and other soldiers dragged them to your location. You already washed your hands, put on your gloves, and did a search for massive hemorrhage, which was normal. The patient's airway is clear. Next, assess respirations (chest). What do you find on your exam? Press and hold [B] to proceed to the next step.
If you found the open chest wounds on the right anterior (front) chest and on the right posterior (back) chest, good job! The wound on the patient's right front chest is hard to find since it requires removing the patient's undergarments and displacing (moving) the patient's mammary tissue (breast) upward. Next, if not already done, treat both wounds with chest seals.
Informational Step: Life threatening wounds can be very subtle. Commonly missed wounds include wounds below the breasts, in the armpits, in the groin, or on the back. A pro tip is to use a ‘raking’ motion to put tension on the skin and assess the patient's entire body searching for these more subtle injuries. In female and male patients it is important to be respectful but remember missing these injuries can be fatal.
This concludes your scenario. Next, open your tablet [X], select the disposition tab, and select Medical Evacuation.