Tier 2 Head Injury and Alert, Verbal, Pain, and Unresponsive (AVPU) Assessment Part 3: You are in a SAFE and SECURE location – The primary learning objective of this (and the next couple of scenarios) is to review the Alert, Verbal, Painful, and Unresponsive (AVPU) assessment. 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 only appears to be responding to pain
Location: Head
Patient: Do you remember what happened?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Do you feel any pain?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Do you have any medical problems?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Do you have any allergies?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Do you take any medications?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Are you feeling dizzy or confused?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Are you having trouble breathing?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Can you see clearly?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Do you feel any swelling in your throat?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Are your lips or tongue swollen?
Response: The patient only appears to be responding to pain
Location: Head
Patient: Is your voice hoarse or different?
Response: The patient only appears to be responding to pain
Location: Head
Guided Steps
This patient has the same injuries as the previous scenario, he was injured in a blast from a drone attack about 45 minutes ago. However, there was a delay in getting a tourniquet on his amputation. Other soldiers eventually placed the tourniquet 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 the functioning tourniquet. 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. You tried to take the tourniquet down, but the bleeding resumed. A deliberate lower tourniquet is not possible in this simulator, but is considered as being done.
Next, you need to assess his neurological status.
In this patient, since he is not responding to voice or commands, you should perform a sternal rub. Place your hand near the middle top part of his chest, you will see the option to perform a sternal rub, then pull the [TRIGGER].
This patient would be considered PAINFUL on the Alert, Verbal, Painful, Unresponsive AVPU scale.
This concludes your scenario. Next, open your tablet [X], select the disposition tab, and select Medical Evacuation.