Tier 2 Basic Fracture Management: You are in a SAFE and SECURE location – The primary learning objective of this scenario is to briefly review fracture management and splinting. 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: I think it's Robert?
Location: Head
Patient: Do you remember what happened?
Response: There was an explosion. People were screaming so I ran.
Location: Head
Patient: Do you feel any pain?
Response: Yes. My legs are killing me.
Location: Head
Patient: Do you have any medical problems?
Response: No. I don't think I have any medical problems.
Location: Head
Patient: Do you have any allergies?
Response: No. I don't think I have any allergies.
Location: Head
Patient: Do you take any medications?
Response: No. I don'tt hink I take any medications.
Location: Head
Patient: Are you feeling dizzy or confused?
Response: Yeah. I'm not really sure where I am right now.
Location: Head
Patient: Are you having trouble breathing?
Response: No. I think I can breathe normally.
Location: Head
Patient: Can you see clearly?
Response: For the most part yes.
Location: Head
Patient: Do you feel any swelling in your throat?
Response: No. I don't think so.
Location: Head
Patient: Are your lips or tongue swollen?
Response: No. My lips is normal.
Location: Head
Patient: Is your voice hoarse or different?
Response: I think it sounds normal.
Location: Head
Patient: Do you have any numbness or tingling in your toes?
Response: No. I don't think so.
Location: Head
Guided Steps
The patient was injured in a blast from a drone attack about 30 minutes ago and other soldiers placed a 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. The patient responds to voice. We will treat his leg fracture and then will get him covered up to prevent hypothermia.
Next, you need to assess the patient's right leg fracture.
If you palpated the patients leg, and assessed the pulse on the patients foot, good job! If not, please complete those now.
Next, we will place a splint on the patient’s leg. Grab the rolled up green splint, and pull the [TRIGGER] near the leg to place. Then place any gauze next to it and pull the [TRIGGER] to secure the splint in place. Next, reassess the pulse on the patient's foot to make sure it is still present and ask the patient to move that leg to check neurovascular status, and ask the patient if there is any numbness or tingling in their toes.
Informational Step: In the real world, if you had training, you could try to reduce this fracture to get the exposed bone back under soft tissue and skin. This is possible in this simulator. If you did perform this, it is critical to repeat the assessment of the patients pulse and motor status below the injury. If the pulse disappeared, consider trying to realign the leg or proceed with even more urgent evacuation for more advanced treatment.
Informational Step: You can use a similar splinting technique for both legs or arms. The goal is to support the extremity and stabilize the fracture by molding and securing the splint above and below the fracture site. It is important to reassess distal pulses, specifically pulses further down the extremity from the fracture or splint, and to watch for pressure points created by these interventions.
This concludes your scenario. Next, open your tablet [X], select the disposition tab, and select Medical Evacuation.