Tier 3 Course 008

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. The patient had a burn on their face, and you noticed soot in the nose and mouth. You heard stridor and gurgling airway sounds. 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 tried oxygen and suctioning, but that didn’t seem to help either. You already have gloves on. You are at a casualty collection point that has one oxygen tank. You also have a CO2 colometry device. It will take at least two hours to get the patient to a higher level of care.

The primary learning objective is to review more advanced ways to manage a patient’s airway at the Tier 3 level including cricothyroidotomy and end tidal CO2 Monitoring. The estimated time to complete this scenario is 10 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.