This casualty was near a drone explosion that occurred 9 minutes ago. You started by providing Care Under Fire, where you didn’t see any massive hemorrhage. Then you moved the patient to safety and completed a blood sweep which was normal. You did see a leg fracture that was not bleeding. You heard stridor and gurgling airway sounds and it looked like the patient was having a hard time getting air in or out. You were being careful with the patient’s spine because of the blast mechanism of injury so you didn’t do a Head-Tilt-Chin Lift. You tried a Jaw Thrust which worked a little but was not enough. You considered an NPA but it looks like there is mid face trauma so you didn’t want to cause a brain injury by placing one. You tried an OPA but the patient gagged. You considered sitting the patient up or moving them into the recovery position, but the patient wasn’t able to hold that position and you are a little worried about the patient’s spine. You tried using a BVM, which kind of worked, but you heard a lot of gurgling airway sounds and it didn’t seem like this was helping. You already have gloves on. You are at a casualty collection point that has one oxygen tank.
The primary learning objective is to review more advanced ways to manage a patient’s airway at the Tier 3 level including suctioning, oxygen administration, and combined methods. The estimated time to complete this scenario is 5 minutes. This scenario occurs in the Tactical Field Care Phase. Equipment Available: Combat Medic Bag. Evacuation/Disposition can be done on the tablet. Selecting the patient’s disposition will end the exercise.
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
After oxygen, suctioning, and while holding a jaw thrust the patient’s airway and breathing seem better.
Good job remembering to document care. In the field, it would be important to record specific injuries and treatments provided. For this simulator, completing the documentation step is considered sufficient
When performing this assessment, it is critical to avoid rocking the pelvis or putting any strain on the pelvis. The action you performed only checks for evidence of pelvic pain or gross instability. When in doubt, you can liberally place a pelvic binder.
Airway: Jaw thrust maneuver
Airway: Suction Catheter Use
Patient disposition: Medical Evacuation
