Session Location: ARML Session: Date:
Scenario Description: Bleeding & Shock #3 Primary Attendant: Lic# Training Level:
Second: Lic# Training Level: Patient: Lic#
Scene Assessment Primary Assessment
P S Identifies Self Identifies Pt Student performed
BSI Assess mental status GCS score ______ ______ ______ all skills adequately.
Safety Airway Appropriate Intervention OPA NPA yes no
MOI/NOI ETC
C-Spine Breathing Oxygen Applied Time:_______ A/E Refused to
# of Pts Expose Chest if Indicated Assists Ventilations Participate.
Additional Circulation Blood Scan 3 Lead Identify Rhythm yes no
help Skin
Load and Go Identified Time:________
Focused Trauma Medical General Treatment Vital Signs
Assessment Initiate O2 Pulse
Identified Chief Complaint Position Pt Appropriately Rate Rhythm Quality
Hx of Events Leading Up to Incident Initiate Load and Go
Expose and Assess Affect Area Monitor and Reassess Respirations
Chest Injury or Respiratory Recognize change in Status Rate Rhythm Quality
A/E Good communication
Assess Condition or Pain Calm and Reassure BP
Onset Provokes Quality Ensure Pt comfort Systolic Diastolic
Radiates Severity Time
Allergies Identified Trauma Treatment Eyes
Medications Dress Wounds Size Reaction Equal
PMHx Manual Stabilization of Fx
LOI Check PMS before Skin
Treatment Color Temp
On-Going Assessment Appropriate Splinting Condition
Reassess Mental Status Check PMS after
Reassess ABC’s Treatment SaO2
Reassess Vitals Apply C-Collar Reading _____ _____ _____
Reassess All Interventions Immobilize
Initiate Load and Go if Temp
Applicable Time:_________ Reading _____ _____ ______
Secondary Assessment Lift/Move Verbal Report
Reassess LOC Selected Appropriate Lift/Move Patient Information
DCAP-BLS-TIC Positioned Equipment for Chief Complaint
Head Lift/Move Hx of Chief Complaint
Reassess ABC’s Stabilized the Stretcher PMHx
Face Ears Nose Ensured a Safe Lift/Move Meds
Eyes Secured Pt on Stretcher Allergies
Neck ALS Skills Physical Findings and Obs
Neck Veins Trachea Ensure Pt meets criteria Tx
Scapula Clavicles Assists/Administers meds Response to Tx
Chest Sternum Ribs correctly Changes Enroute
A/Ex4 Reassess/monitored pt Code Call Correctly
Abdomen
Pelvis (If no injury found earlier) Critical Criteria
Lower Extremities failure to take C-spine precautions
PMS ROM failure to immobilze the patient
Upper Extremities failure to administer high flow oxygen
PMS ROM
Upper Back
Lower Back
Bleeding and Shock #3
You have been dispatched to quarry to a 16 year old female who appears to have fell from a height of 12 feet to the rocky ground. Witnesses say she
attempted to ride her quad up the hill when the quad stalled and began to roll back, she tried to stop by hitting the brakes and flipped the quad. She
was not wearing a helmet. On arrival you find the pt laying supine on the ground, there are some small lacerations on her arms and legs all of which
have stopped bleeding. You also see that her hair is all matted together from dried blood, she is lying on the ground and you cannot tell how much
blood she lost as it has soaked into the ground. You find the pt to be dazed and confused (she is alert to person & place but not time or events) she
will only open her eyes when you speak to her, her respirations are rapid/shallow becoming irregular, her pulse is slow & very weak and her skin is
warm/dry/good color. Secondary Assessment reveals no movement in the arms or legs. She can feel you touching her shoulder but cannot move her
fingers or feet.
S – As above
A – Bees, Nuts
M – She has an epi-pen
P – Allergies
L – Lunch
E – As above
Complete Assessment:
Vital Signs 1st set 2nd set
GCS 14 15
Pulse 56, regular, weak, brachial only 48 weak, regular
Respirations 32 shallow 20 shallow, diaphragmatic
Blood Pressure 72/38 76/36 (no IV), 90/50 (if bolus given)
Skin Face appears pale, moist but extremities are same
warm and dry
Eyes PERL @ 3mm Same
SP02 No reading if you use the finger clip, 82% if Improves to 98% with high flow O2
they think to use the ear clip
Air Entry Clear but very quiet unchanged
3 Lead Sinus brad same
Blood Glucose 5.6 mmol/l same
Temperature 36.8 C
Tx – C-spine control, High flow oxygen. Dress the wound Immobilize. Position feet up. Field diagnosis – Neurogenic
Shock IV & Bolus. Pt will not deteriorate as long as they provide aggressive oxygen therapy and monitor the pt closely.
At no time will the patient take and OPA and an NPA should not be attempted based on the trauma to the head and she is
able to maintain her own airway. The patient will be able to answer questions regarding PMHx, meds and allergies once
her LOC improves (all Nil).
Teaching points –Discuss causes of neurogenic shock and signs and symptoms of same.
COMMENTS
______________________________ has successfully completed the practical component of the above ARML Module.
Instructor Signature
______________________________has successfully completed the practical component of the above ARML Module
Instructor Signature
