You are near the frontline while the rest of your team is engaged in a firefight. A casualty has just been dragged into your treatment area with no major interventions performed. The casualty has already been triaged for immediate care, and weapons and equipment have been removed.
Your team is providing security, leaving you as the only person available to treat the casualty.
You have equipment commonly found in a medic aid bag, including a unit of low titer O+ whole blood. Your task is to rapidly assess the casualty and perform all indicated TCCC Tier 3-level interventions.
Once you have completed all necessary care, select the appropriate disposition using your tablet to end the scenario.
Patient Communication
Patient: Hey, I am here to take care of you.
Response: Thank you. I'm in so much pain.
Location: Head
Patient: Can you tell me your name?
Response: It's Vitaliy.
Location: Head
Patient: What happened?
Response: There was an explosion. Please help me everything hurts.
Location: Head
Patient: Are you hurting anywhere?
Response: Yes. I am in so much pain all over.
Location: Head
Patient: Does your throat hurt or feel tight?
Response: No. My throat feels normal.
Location: Head
Patient: Are you having a hard time breathing?
Response: No. I can breathe normally.
Location: Head
Patient: Does your chest hurt?
Response: No. My chest does not hurt.
Location: Head
Patient: Did you pass out (lose consciousness)?
Response: No, I didn't.
Location: Head
Patient: Do you have any numbness or weakness?
Response: I don't have any numbness or weakness.
Location: Head
Patient: Does your head hurt?
Response: Yes! Everything hurts.
Location: Head
Patient: Does your neck hurt?
Response: Yes. My whole body hurts.
Location: Head
Patient: Does your back hurt?
Response: Yes. It hurts.
Location: Head
Patient: Does your abdomen hurt?
Response: Yes. I am in a lot of pain.
Location: Head
Patient: Do you have any allergies?
Response: I do not have any allergies.
Location: Head
Patient: Do you take any medications?
Response: I do not take any medications.
Location: Head
Patient: Do you have any medical problems?
Response: I do not have any medical problems.
Location: Head
Patient: Have you ever had any surgeries?
Response: I have never had a surgery.
Location: Head
Patient: When did you last eat or drink something?
Response: I think I had breakfast this morning.
Location: Head
Patient: Do you smoke, drink, or use recreational drugs?
Response: I don't do any of those.
Location: Head
Audio Triggers
In the real world you give Ketamine slowly or over 20 minutes. In the simulator you are not able to control the flow of administration.
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.
Scoring Details
PPE: Blue Gloves (right side)
PPE: Blue Gloves (left side)
Blood Sweep (left lower thigh) (Left Leg Ampute)
Blood Sweep (right lower thigh) (Right Leg Ampute)
Blood Sweep (left upper arm) (Left Arm Ampute / Shrapnel Arm Left)
Blood Sweep (right upper arm) (Right Arm Ampute / Shrapnel Arm Right)
Blood Sweep (left arm) (Deep Wound Arm Left)
Blood Sweep (right arm) (Deep Wound Arm Right)
Blood Sweep (left lower leg) (Deep Wound Leg Left)
Blood Sweep (right lower leg) (Deep Wound Leg Right)
Blood Sweep (left upper thigh) (Left Leg Ampute / Shrapnel Leg Left)
Blood Sweep (right upper thigh) (Open Fracture / Open Fracture Blood / Shrapnel Leg Right)
Blood Sweep (right chest, front) (Gunshot Wound Chest Right)
Blood Sweep (left chest, front) (Gunshot Wound Chest Left)
Blood Sweep (right chest, back) (Gunshot Wound Back Right)
Blood Sweep (stomach) (Shrapnel)
Blood Sweep (groin)
Exam: Assessment: Remove the patient clothing around left arm
Exam: Assessment: Remove the patient clothing around right arm
Exam: Assessment: Remove the patient clothing around left leg
Exam: Assessment: Remove the patient clothing around right leg
Exam: Assessment: Remove the patient's shirt
Exam: Assessment: Remove the patient's underpants
Exam: Ask patient
Airway: Jaw thrust maneuver
Head-tilt-chin lift
Listen for breathing
Exam: Ask patient
Perform sternal rub
Shoulder tap for response
Exam: Assesment: Place SPO2 pleuth
Exam: Assessment: Roll the patient over
Exam: Assessment: Roll the patient back
Exam: Assessment: Check Carotid Pulse Right
Exam: Assessment: Check Carotid Pulse Left
Exam: Assesment: Check Radial Pulse Right
Exam: Assesment: Check Radial Pulse Left
Exam: Assesment: Check Femoral Pulse Right
Exam: Assesment: Check Femoral Pulse Left
Exam: Assesment: Check Pedial Pulse Right
Exam: Assesment: Check Pedial Pulse Left
Circulation: Place an IV line (right side)
Circulation: Place an IV line (left side)
Create intraosseous vascular access on left leg
Create intraosseous vascular access on right leg
Create intraosseous vascular access on left shoulder
Create intraosseous vascular access on right shoulder
Hypothermia Management: Place Blanket
Hypothermia Management: Put Back All Clothes
Perform sternal rub
Exam: Ask patient to move right leg
Exam: Ask patient to move left leg
Exam: Ask patient to move right arm
Exam: Ask patient to move left arm
Exam: Assesment: Check right pupil
Exam: Assesment: Check left pupil
Events: Medication Administration: Give Moxifloxacin 400mg
Events: Medication Administration: Give Acetaminophen 10 500mg
Events: Medication Administration: Give Ketamine 50mg
Place non-adherent dressing on the left lower arm (deep wound)
Exam: Assessment: Complete TCCC card
Send 9-liner
Patient disposition: Medical Evacuation