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Scenario: Family Trauma


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:
You called to a scene where a gardener was with his granddaughter. His neighbour heard a loud scream and called for someone to help. You arrive at the scene.
Difficulty:
Ambulance Crew (non HCP)
How the scenario should progress:
As the scenario progresses, the patient with the suspected fractured ulna and a femoral artery haemorrhage will develop signs of shock, due to severe blood loss and from the fracture. They will deteriorate in level of response only responding to pain, on AVPU scale. They eventually go into cardiac arrest.
Patient 1:
Name: Tomasz Derda    Age: 74    Sex: Male
Medication: Ramipril Paracetemol Morphine Sulfate (oramorph) Simvastatin Clopidogrel
Allergies: NKDA
Past medical/family/social history: Hypertension Hyperlipidemia TIA 2 Years Ago PMR Rheumatoid Arthritis Carpel Tunnel Syndrome ACS 3 Years
Findings on examination: Large leg laceration Suspected closed fracture Haemorrhagic Shock Suspected Spinal Injury Cardiac Arrest
Possible treatment from first aiders: Immediate Pressure Over Bleed Immobilisation of Limb and Body Treatment of Shock Resuscitation using CPR and AED
Time after start: 2 Mins 5 Mins 10 Mins 12 Mins 14 Mins 16 Mins 18 Mins 20 Mins
Response: Voice Pain Pain Pain Pain Unresponisve Unresponsive Unresponsive
Airway: Clear, Patent Clear, Patent Clear, Patent Clear, Patent Clear, Patent Clear, Patent Clear, Patent Clear, Patent
Breathing? Tachypneic Shallow Tachypneic Shallow Tachypneic Shallow Tachypneic Shallow Tachypneic Shallow Apnea Apnea Bradypneic
Respirations: 29 29 31 27 29 0 0 9
Pulse: 133 139 144 148 136 0 0 44
Oxygen Sats: 91 89 90 87 88 84 80 89
Pain Score: 10 9 8 0 0 NA NA NA
Blood Pressure: 88/41 83/40 79/40 72/46 69/40 0/0 0/0 55/27
Temperature: 36.7 36.5 36 35.9 35.7 35.7 35.6 36
Blood Glucose: 5.5mmol 5.4mmol 5.4mmol 5.4mmol 5.3mmol 5.4mmol 5.4mmol 5.4mmol
GCS: 9 9 9 9 9 9 3 3



Tips for the patient actors:
Remember Medical Conditions

Scenario submitted by: Anonymous