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Scenario: Catch...the human


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Scenario Overview:
This scenario is a challenging two patient scenario involving a fractured femur. The first aiders are called to a couple of guys in a bar where one of them seems to be in a massive amount of pain. It turns out that one of them was jumping off a table with the aim of being caught by his mate - Unfortunately his mate wasn't really ready to catch and so has ended up squashed underneath the guy who jumped (but with not much wrong with him). The guy who jumped off the table on the other hand has a fractured femur and is in huge amounts of pain and is lying on top of his mate.
Difficulty:
First Aider Difficult
How the scenario should progress:
The patients will not deteriorate in the scenario but will be a challenge for the patients to assess both of them because if they try to move the guy with a broken leg he will be screaming in pain.
Patient 1:
Name: Nick Thomas    Age: 19    Sex: Male
Medication: Insulin. Also had two 'MDMA tablets' earlier in the evening.
Allergies:
Past medical/family/social history: Type 1 diabetic (last ate a big meal a couple of hours ago)
Findings on examination: Patient has a closed mid-shaft femur fracture. The pain radiates up and down the leg and movement massively increases the pain (from 7/10 to 10/10). Pain described as sharp and stabbing. Swelling present and an irregularity along the bone can be felt. The pain and how the patient is expressing it means that it will be very difficult to get a proper respiratory rate. No other injuries are found. The guy's mate isn't able to move from underneath because it is too painful for this guy.
Possible treatment from first aiders: Good primary survey, Assess leg injury, pain management, Immobilisation of the leg and request for ALS.
Time after start: 0mins 2mins 5 mins
Airway: Alert Alert Alert
Breathing? Yes Yes Yes
Respirations: Quite quick Quite quick Quite quick
Pulse: 120 bounding 122 strong 118 strong
Blood Pressure: 130/80 134/80 128/80
Temperature: 37.2 37.2 37.3
Blood Glucose: 5.4 5.4 5.2


Patient 2:
Name: Boris Slater    Age: 19    Sex: Male
Medication: Had a couple of MDMA tablets earlier in the evening. Also drank a lot of alcohol this evening.
Allergies: None Known
Past medical/family/social history: Usually fit and well.
Findings on examination: This patient has no major injuries - only a few minor bruises dotted around from where his mate has jumped on him. Every time he tries to move, his mate screams in agony so he has had to just lie there. Once the first aiders have moved his mate off of him, he can walk around and act normally for a slightly drunk bloke. All of the observations will be as you find them on the patient-actor.
Possible treatment from first aiders: Primary survey and general assessment to exclude any major injuries.
No Observations Given



Tips for the patient actors:
It will be good for this scenario to have two people who are willing to get a bit close (i,e. have one lie on top of the other as if the catch had gone wrong). The guy with the fractured femur needs to be committed to making noise when 'in pain'!.

Scenario submitted by: Anonymous