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Scenario: Catastrophic Bleed Resus


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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(Average: 5, Number of raters: 1)
Number of downloads: 3672
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Scenario Overview:
This scenario tests the first aiders in a resuscitation scenario where there is an obvious cause of the arrest (a catastrophic bleed) to show that CPR isn't always the only thing that should be done in a resus - we should be looking for any reversible causes of arrest. On arrival, the first aiders will find the patient in a large pool of blood with no-one else around.
Difficulty:
First Aider Easy
How the scenario should progress:
Prior to the ambulance arriving there will be no change in status for the patient. After ambulance arrival (or if the skill level of those tested is ambulance level) you could add in positive results from any treatment (for example fluids) or your could just leave the patient as not breathing throughout.
Patient 1:
Name: Unknown    Age: 47    Sex: Male
Medication: Unknown
Allergies: Unknown
Past medical/family/social history: Unknown
Findings on examination: Patient is lying in large pool of blood and appears very pale. Patient still slightly warm to touch. Large laceration is present in right arm. Patient is unresponsive and not breathing. A top to toe survey will find some grazes to head but no other injuries. Patient does not have any medic alert bracelets or similar. If CPR is carried out before something has been applied to the wound to stem further bleeding, the first aiders will see blood coming out the wound in time with their CPR.
Possible treatment from first aiders: Good primary survey, Normal resuscitation protocols but also treating the major bleed so that blood doesn't just come out when doing CPR.
Time after start: Throughout
Response: Unresponsive
Airway: When managed
Breathing? No



Tips for the patient actors:
If you've got a full body manikin which has arms, this would be useful for this scenario as you can get the arm wound shown as well as not having to swap anything around to let the first aiders do CPR. If you don't have this, you could either change the position of the bleed to somewhere else (perhaps neck?) or use a patient actor to begin with and then swap in a CPR doll for them to continue the resus.

Scenario submitted by: Anonymous