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Scenario: Beaten Up and Stabbed


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
The patient has been at a party that was gatecrashed by some not-so-nice guests. This particular patient has been asked to give over their wallet but refused so 3 of the gatecrashers have attacked with fists and a knife. The patient has backed into the corner and collapsed. The first aiders have been covering an event at a community hall next door and have been called in to see the patient.
Difficulty:
First Aider Difficult
How the scenario should progress:
If bleeding is not controlled get the casualty to deteriorate and eventually stop breathing. If this is the case you will need to change the observations to match. If the first aiders try to control the breathing and get help on the way then get the patient to stay unresponsive but still breathing until the ambulance arrives.
Patient 1:
Name: Ted Clarke    Age: 20    Sex: Male
Medication: Taking anti-depressants (Prozac)
Allergies: Penicillin
Past medical/family/social history: Broken right femur 2 years ago. Last ate and drank an hour or so ago.
Findings on examination: O/E: Unresponsive, airway clear although blood pouring down from face. Patient has multiple stab wounds, one to lower abdomen, one to the chest (creating open pneumothorax) and one across the face. The patient has evident bruising all over the place. The first aiders will find unequal chest expansion and the patient's skin pale. There are no obvious bony deformities. Pupils are equal and reactive to light.
Possible treatment from first aiders: Primary survey - repeated regularly. Apply pressure to wounds and dress. Request further assistance rapidly. Consider treatment for shock.
Time after start: 0mins 2min 5mins 10mins
Response: U U U U
Airway: Yes Yes Yes Yes
Breathing? yes Yes Yes Yes
Respirations: 28, laboured 27, laboured 25, laboured 26, laboured
Pulse: 135 136 138 142
Oxygen Sats: 85% on air 87% 88% 88%
Blood Pressure: 95/65 95/68 97/65 96/67
Temperature: 37 37 37 37
Blood Glucose: 6 6 6 6



Tips for the patient actors:
You need to be willing to get a bit messy in this one to get the most out of it! Try to remain unresponsive throughout and stay in character if you can!

Scenario submitted by: Anonymous