Tier 4 Practice Pack 005

Ви надаєте допомогу в передовому медичному пункті поблизу лінії фронту. Після того, як ви виконали всі життєво важливі втручання, зазначені для цього етапу догляду, ви можете вибрати [Висновок] на планшеті та вибрати [Медична евакуація / Транспортування], [Повернення до служби / Лікування та направлення] або [Констатувати смерть], що завершить вашу справу. Зверніть увагу, що, на жаль, як і в реальному житті, неможливо врятувати всіх пацієнтів. Політика лікування ТІЛЬКИ ДЛЯ ЦЬОГО НАВЧАННЯ полягає в тому, щоб оголосити пацієнта мертвим, якщо пульс відсутній більше двох хвилин. На цьому театрі бойових дій неможливо перевести пацієнта, який потребує активної серцево-легеневої реанімації. У вас є цільна кров з низьким титром O, яку можна використовувати для будь-якого пацієнта, якого ви оцінюєте в цих симуляціях. Симулятор наразі не має методу перевірки групи крові.

Patient Communication

Patient: Can you tell me your name?
Response: I can't really remember, and its hard to talk
Location: Head
Patient: Do you remember what happened?
Response: I think there was explosion. Then gunfire.
Location: Head
Patient: Do you feel any pain?
Response: Yes my chest and head are killing me
Location: Head
Patient: Do you have any medical problems?
Response: No, I don’t have any medical problems I know of
Location: Head
Patient: Do you have any allergies?
Response: No, I don't have any allergies I know of
Location: Head
Patient: Do you take any medications?
Response: No, I don't take any medications
Location: Head
Patient: Are you feeling dizzy or confused?
Response: A little it’s getting hard to focus.
Location: Head
Patient: Are you having trouble breathing?
Response: I think the pain is making it hard to breath
Location: Head
Patient: Can you see clearly?
Response: Everything seems a little blurry
Location: Head
Patient: Do you feel any swelling in your throat?
Response: No, I think its okay
Location: Head
Patient: Are your lips or tongue swollen?
Response: No, I think they are doing okay
Location: Head
Patient: Is your voice hoarse or different?
Response: It seems like it is about the same as usual
Location: Head
Patient: Any numbness or tingling?
Response: No. Everything feels normal.
Location: Right Arm
Patient: Any numbness or tingling?
Response: No. Everything feels normal.
Location: Left Arm
Patient: Any numbness or tingling?
Response: No. Everything feels normal.
Location: Right Leg
Patient: Any numbness or tingling?
Response: No. Everything feels normal.
Location: Left Leg

Audio Triggers

Good job ensuring hemorrhage control. In real life you might starting thinking converting this tourniquet to a deliberate tourniquet or performing a tourniquet takedown. This simulator does not currently support those steps.
Laboratory values are still a beta feature and final results should be interpreted with caution
This is not the correct NDC placement. Try again.

Scoring Details

PPE: Blue Gloves (right side)
PPE: Blue Gloves (left side)
PPE: Blue Gloves (right side)
PPE: Blue Gloves (left side)
Exam: Assessment: Remove the patient's shirt
Exam: Assessment: Remove the patient's underpants
Exam: Assessment: Remove the patient clothing around left leg
Exam: Assessment: Remove the patient clothing around right leg
Exam: Assessment: Roll the patient over
Exam: Assessment: Roll the patient back
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
Roll patient into recovery position
Blood Sweep (right chest, front) (Gunshot Wound Chest Right)
Blood Sweep (right chest, back) (Gunshot Wound Back Right)
Blood Sweep (right lower leg) (Deep Wound Leg Right)
Blood Sweep (left lower thigh) (Left Leg Ampute)
Place bandage on the left leg amputation
Place bandage on the right lower leg (deep wound)
Fill right leg wound with wound packaging
Place bandage on the right lower leg (deep wound)
Fill right leg wound with wound packaging
Hold Hands Over Bleeding Injury
Apply pressure to right leg
Exam: Ask patient
Airway: Jaw thrust maneuver
Listen for breathing
Breathing: Needle Decompression right side placement
Breathing: Chest Tube right side placement
Put On Chest Drain (right side)
Breathing: Needle Decompression right side placement
Breathing: Chest Tube right side placement
Place Chest Seal Front Right
Place Chest Seal Back Right
Exam: Assessment: Check Carotid Pulse Right
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
Exam: Assesment: Place EKG leads
Exam: Assesment: Place SPO2 pleuth
Exam: Assessment: Place Thermometer
Exam: Assesment: Obtain blood pressure
Exam: Assesment: Place EKG leads
Exam: Assesment: Place SPO2 pleuth
Exam: Assessment: Place Thermometer
Exam: Assesment: Obtain blood pressure
Exam: Assessment: Palpate Pelvis/Check Pelvis Stability
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
Circulation/Resuscitation: Give IV fluids Whole Blood (500ml)
Circulation/Resuscitation: Give IV fluids Whole Blood (1000ml)
Events: Medication Administration: Give Calcium Gluconate 100mg/mL
Events: Medication Administration: Give Tranexamic Acid 100mg/mL
Events: Medication Administration: Give Acetaminophen 10 500mg
Events: Medication Administration: Give Acetaminophen 100 500mg
Events: Medication Administration: Give Ketamine 50mg
Events: Medication Administration: Give Fentanyl 50mg/mL
Place foley catheter
Events: Laboratory: Draw Blood For Laboratory Tests
Events: Laboratory: Review Labs
Exam: Assesment: Check right pupil
Exam: Assesment: Check left pupil
Exam: Assessment: Check Left Tympanic Membrane
Exam: Assessment: Check Right Tympanic Membrane
Exam: Ask patient
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
Hypothermia Management: Place Blanket
Procedure: Exam: Ultrasound abdomen pericardial
Procedure: Exam: Ultrasound abdomen right upper quadrant
Procedure: Exam: Ultrasound abdomen left upper quadrant
Procedure: Exam: Ultrasound pelvic view
Procedure: Exam: Ultrasound right lung
Procedure: Exam: Ultrasound left lung
Procedure: Exam: Ultrasound abdomen pericardial
Procedure: Exam: Ultrasound abdomen right upper quadrant
Procedure: Exam: Ultrasound abdomen left upper quadrant
Procedure: Exam: Ultrasound pelvic view
Procedure: Exam: Ultrasound right lung
Procedure: Exam: Ultrasound left lung
Exam: Assessment: Palpate Head (Right)
Exam: Assessment: Palpate Thorax (Left)
Exam: Assessment: Palpate Lower Left Abdomen
Exam: Assessment: Palpate Lower Right Abdomen
Exam: Assessment: Palpate Upper Left Abdomen
Exam: Assessment: Palpate Lower Right Abdomen
Exam: Assessment: Palpate Right Arm
Exam: Assessment: Palpate Right Palm
Exam: Assessment: Palpate Left Arm
Exam: Assessment: Palpate Left Palm
Exam: Assessment: Palpate Right Leg (Proximal)
Exam: Assessment: Palpate Right Leg (Medial)
Exam: Assessment: Palpate Right Leg (Distal)
Exam: Assessment: Palpate Left Leg (Proximal)
Exam: Assessment: Palpate Left Leg (Medial)
Exam: Assessment: Palpate Left Leg (Distal)
Exam: Assessment: Palpate along back
Exam: Assessment: Palpate Head (Left)
Exam: Assessment: Palpate Head (Left)
Exam: Assessment: Palpate Trachea
Exam: Assessment: Palpate Jaw
Lift Patients Head Using Stretcher
Exam: Assessment: Complete TCCC card
Complete NATO Field card
Patient disposition: Medical Evacuation

Scenario Details

Scenario Package
TCCC Practice Pack
Learner type
  • militaryMedic
Patient severity at start
Serious
Patient severity overall
Serious
Duration to complete
5-10 minutes
Scenario difficulty
Moderate
Environment
Tent
Equipment
  • Cardiac electrodes
  • Trauma shears
  • Penlight
  • Otoscope
  • Ultrasonography probe
  • Glucometer
  • Stethoscope
  • Intravenous cannula
  • Decompression needle
  • Surgical scalpel
  • Chest tube
  • Axial peripheral thermometer
  • Oxygen saturation device
  • Blood pressure cuff
  • Simple oxygen mask
  • Blanket
  • FoilBlanket
  • Yankauer suction tip
  • Nasopharyngeal airway
  • Endotracheal intubation tube
  • Laryngoscope
  • Cricothyrotomy Tube
  • C spine Collar
  • Combat Application Tourniquet
  • Defibrillator
  • Pelvic Binder
  • Ambu Bag
  • Intraosseous drill
  • Vacutainer tube
  • Foley Catheter Kit
  • Chest Drainage System
  • Nasogastric tube
  • Oral Airway
  • Chest Seal Package
  • Pressure Bandage
  • Hemostatic Gauze
  • Laryngeal mask airway
  • Bandage
  • SAM splint
  • Combat Gauze
  • Eye Guard
  • Gloves box
  • Tape
  • Sanitiser
  • Junctional Tourniquet
  • Radio
  • Triage Tag - Minimal
  • Triage Tag - Immediate
  • Triage Tag - Expectant
  • Triage Tag - Delayed
  • BVM
  • BVM Face Mask
  • Marker
  • Triage Tag - Dead
Available medications
  • Lidocaine 10mg
  • Tetanus Vaccine
  • TXA 1G over 10min
  • TXA 1G over 8H
  • Morphine 4mg
  • Fentanyl 100mcg
  • Meropenem 1G
  • Cefazolin 2G
  • Epinephrine 1mg
  • Norepinephrine Drip
  • Amiodarone 300mg
  • Amiodarone 150mg
  • Propofol 2mg/kg
  • Propofol Drip
  • Ketamine 1.5mg/kg
  • Etomidate 0.3mg/kg
  • Succinylcholine 1.5mg/kg
  • Rocuronium 1.0mg/kg
  • Propofol 0.75mg/kg
  • Mannitol 1g/kg
  • Hypertonic Saline
  • Acetaminophen 1000mg
  • Midazolam 4mg
  • Atropine 0.4mg
  • Pralidoxime 25mg
  • Calcium Gluconate 1g
  • Naloxone 1 mg
  • Zofran/Ondansetron 4mg
  • Acetaminophen Pills
  • Morphine 10mg
  • Fentanyl 800mcg lollipop
  • Ketamine 3mg/kg
  • TXA 2G
  • Naloxone 0.4 mg
  • Moxifloxacin 1 g
  • Ketamine 2mg/kg
  • Midazolam 1mg
  • Meloxicam 15mg
  • Sodium Bicarbonate 8.4% 50ml
  • Ertapenem 1g
  • Ketamine 20mg
Available blood and fluids
  • Saline 1000
  • Saline 1000
  • Saline 1000
  • Saline 1000
  • Lactated Ringers 1000
  • Lactated Ringers 1000
  • Lactated Ringers 1000
  • Lactated Ringers 1000
  • Blood 500
  • Blood 500
  • Blood 500
  • Blood 500
Injury type
  • Amputated left leg at knee
  • Bruise behind right ear
  • Chest wound (posterior right)
  • Deep wound on the right arm
  • Groin junctional wound, left side
  • Left lower hand burn
  • No translation found for 'TRAUMA_GunshotEntrancesWoundInChestRight' in VISUALIZATION
  • Open fracture of the right thigh with visible bone
Pathologies
  • external hemorrhage, right arm
  • external hemorrhage, left leg
  • external hemorrhage, left kidney
  • pneumothorax, open, right
Scoring summary
  • PPE
  • M-Exposure
  • M-Blood Sweep
  • M-Bandage Amputation
  • M-Bandage Laceration
  • M-Apply Pressure to Bleed
  • A-Assess Airway
  • R-Treat Tension Pneumothorax
  • R-Treat Open Pneumothorax Front
  • C-Check Peripheral/Central Pulse
  • C-Vital Signs
  • C-Assess Pelvic Stability
  • C-Obtain Vascular Access
  • C-Administer Fluids
  • C-Adminsiter Calcium
  • C-Administer TXA
  • C-Administer Antibiotics
  • C-Administer Pain Management
  • C-Place Foley Catheter
  • C-Draw Blood for Labs
  • H-Pupil Assessment
  • H-Tympanic Assessment
  • H-Assess Responsiveness (LOC)
  • H-Assess for Neurologic Deficit
  • H-Hypothermia Management
  • OP-Perform Ultrasound
  • OP-Extended Assessment
  • Elevate Head
  • Documentation
  • Disposition