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Scenario: Speech Issues


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 first aiders have been called to a patient who has been punched in the head whilst covering a city centre on the 'booze bus'. They were called by police. The assailant had ran away. The patient has a potential head injury and is unable to speak which means that the first aiders will need to find some other way of communicating with the patient. This scenario tests communication skills along as well as head injury management.
Difficulty:
First Aider Moderate
How the scenario should progress:
The patient will remain fairly stable throughout until the ambulance arrives.
Patient 1:
Name: Chris Ball    Age:     Sex: Male
Medication: None Known
Allergies: None Known
Past medical/family/social history: Not really known as if will be difficult to communicate and the patient doesn't have any friends around.
Findings on examination: Patient will be voice responsive on arrival. They are unable to speak as a result of the blow to the head. They lost conciousness after the punch although no-one really knows how long for. Patient is able to moves limbs and hands and has sensation in all of them. Pupils are even although slightly slow to react. Patient appears a bit confused although will be able to communicate with the first aiders with hand gestures etc. to some extent. Patient doesn't feel sick but does feel dizzy and one eye seems a bit fuzzy. Swelling is present on the side of the head but no bleeding. Skull appears intact. There is no sign of any fluid coming from ears or nose. Patient will be a bit panicked about the fact that they can't speak. Pain in head which is worse at the sight of swelling. No pain in neck or elsewhere.
Possible treatment from first aiders: Good assessment of the injury. Find a way to ask questions. Request ambulance assistance. Monitor.
Time after start: 0 mins Will stay about the same
Response: V
Airway: Yes
Breathing? Yes
Respirations: 20
Pulse: 125
Oxygen Sats: 94



Tips for the patient actors:
Be a little confused and voice responsive but respond enough so that the first aiders can try and work out a way of communicating with you.

Scenario submitted by: Scenario Library