Tier 2 Circulation and Tourniquet Conversion: You are in a SAFE and SECURE location – The primary learning objective is to review tourniquet assessment and conversion. The estimated time to complete this scenario is 10 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 placed two tourniquets and dragged them to your location. You already washed your hands, put on your gloves, and did a search for massive hemorrhage, which was normal while noting two functioning tourniquets. The patient's airway is clear. You assessed the patient’s chest and found an open chest wound but no obvious pneumothorax. You placed a chest seal.
Next, treat the injuries below the tourniquets like you would if they were still bleeding.
For the right leg laceration, if you packed it, held direct pressure, and placed a pressure bandage, good job! For the left leg amputation, if you placed a pressure dressing around it, good job!
Informational Step: To help save people's arms and legs it’s important to try taking tourniquets down within a goal of two hours and at a maximum of six hours. After six hours they should only be taken down somewhere that has laboratory and close monitoring capabilities. While this can help save arms and legs if there is still severe hemorrhage, it is important to keep the tourniquet in place.
Next, we will try to take the tourniquets down. In real life we would slowly loosen the tourniquet over 1 minute, and if any hemorrhage started to present itself, you would quickly tighten it again. In this simulator, the only option is to completely remove it suddenly and place a new tourniquet if needed. To do remove and replace a tourniquet, get a tourniquet ready in one controller, then use the other controller to remove the tourniquet on the patient by pressing the [GRIP] button. Do this for both sides.
The right leg should be stable without a tourniquet, but the left leg needs a tourniquet! Doing this step could help save the patient’s left leg. It would be very important to watch the left leg dressing closely.
Informational Step: In real life, it would be important to place a new right leg tourniquet as close the the actual amputation as possible to minimize limb damage. You would do this by placing one to two tourniquets a few inches above the amputation and tightening and securing them (to prevent them from falling off). Then you would try to remove the upper tourniquet by slowly loosening and monitoring. Removig tourniquets slowly is not currently possible in this simulator.
This concludes your scenario. Next, open your tablet [X], select the disposition tab, and select Medical Evacuation.