A. pregnant female (first pregnancy, 8 ½ months along), sitting on the ground, a small cut on nose, broken teeth, swollen right ankle, having abdominal contractions (pain) every 10 minutes.

B. bus driver, slumped over the steering wheel, unconscious, pupils dilated and fixed, no carotid pulse detectable. Respirations irregular and slow, chest wall soft and deformed.

C. male adult, lying in the aisle, pain in the right thigh, right foot turned outward, no external bleeding of the thigh, alert, pale, thirsty.

D. male adult, lying under the seat, pupils dilated and fixed, carotid pulse not detectable, slight dry blood from nose and ears, swollen side of the head, respirations 4 per minute.

E. child, age three, deep laceration of the right leg, oozing blood, deformity of the same leg, crying in mother’s lap.

F. mother of “E”, nervous, no complaints, sitting on the ground.

G. male adult in US Navy uniform, medical insignia on the sleeve, cut tongue, alert and ambulatory.

H. female adult lying on the ground, a large piece of glass in the chest, pupils dilated and fixed, no carotid pulse, no respirations.

I. male adult, husband of “H”, hysterical, walking around the area, no obvious injuries.

J. female adult, scratches on hands and knees, alert, ambulatory, calm, severe bleeding from scalp laceration.

K. baby in diapers, crying in mother’s arms, mother says a child is not hurt.

L. female adult, mother of “K”, no injuries obvious or reported, sitting in the bus.

M. male adult, lying on the side with knees bent towards the abdomen, hands holding abdomen, moaning, strong alcohol odor, won’t answer questions, pupils constricted, good carotid pulse and vomited once.

N. female teenager, painful, deformed and swollen right humerus and elbow and hand cold and bluish, can’t move fingers of the right hand.

O. elderly male approximately 60, sitting in the bus, says he has a heart condition, complains of chest pain, pale, sweaty skin, pupils normal, left radial pulse absent, alert, left chest hurts when he moves, lifts an arm or takes a deep breath.

P. two elderly sisters, complaining of poor bus service, fast driving and demanding that the trooper arrest the bus driver at once.

Q. female adult, pain in right shoulder and neck, hurts to move the right arm, head tilted to the right, alert, ambulatory, right hand warm and fingers move well.

R. male adult, deformed jaw, can’t talk, pupils react to light, good pulse, very swollen neck, subcutaneous emphysema of front and sides of the neck, some difficulty breathing.

S. female adult, tangled in seats, complaining of severe pain in the back, cannot move legs.

T. female teenager, standing outside experiencing difficult and labored breathing, a crowing sound heard on expiration, hands grasping throat, no obvious injuries.

Part 2: Please designate which patients will be sent in which order.

Per your local disaster protocols, each ambulance trip can include up to two stretchers and one sitting patient.

The scene is as follows: Multiple engine crews arrive and set up incident command and a landing zone. Two more officers have arrived, a deputy sheriff and another state trooper.

There are approximately 25 bystanders, including an off-duty EMT from your agency.

You are in ambulance “A”. Assume you are with another paramedic.

Ambulances “B” and “C” have been called to assist but have not yet arrived.

There is one helicopter available, which is en-route to the scene with a short ETA.

For this scenario, you do not need to worry about overloading hospitals - assume their capacity is whatever you need it to be. You can also assume there is another officer coordinating with the hospital specialists, so you do not need to consider hospital specialties such as burn or trauma in this assignment. Your only focus is the order in which patients leave the scene.

Answer the following Questions

1. If you were assigned this task at a real MCI, which ICS "role" would you most likely be filling?

2. You assign the off-duty EMT from your agency and your paramedic partner to Ambulance "A." How many, and which patients would you place in Ambulance “A” for its first trip and why?

Stretcher 1Stretcher 2Sitting

3. How do you assign work to the other first responders, useful bystanders or patients?

4. Which patient should go via helicopter?

5. How many, and which patients would you place in Ambulance “B” for its first trip and why?

Stretcher 1Stretcher 2Sitting

6. How many, and which patients would you place in Ambulance “C” for its first trip and why?

Stretcher 1Stretcher 2Sitting

7. The first ambulance to return to the scene, second trip.

Stretcher 1Stretcher 2Sitting

8. The next ambulance to return to the scene, second trip.

Stretcher 1Stretcher 2Sitting

9. What additional trips are necessary?

10. Which victims would not need to be seen at the hospital?

Question

swiftbl4ck swiftbl4ck

11-08-2024
Medicine

Answered

A. pregnant female (first pregnancy, 8 ½ months along), sitting on the ground, a small cut on nose, broken teeth, swollen right ankle, having abdominal contractions (pain) every 10 minutes.

B. bus driver, slumped over the steering wheel, unconscious, pupils dilated and fixed, no carotid pulse detectable. Respirations irregular and slow, chest wall soft and deformed.

C. male adult, lying in the aisle, pain in the right thigh, right foot turned outward, no external bleeding of the thigh, alert, pale, thirsty.

D. male adult, lying under the seat, pupils dilated and fixed, carotid pulse not detectable, slight dry blood from nose and ears, swollen side of the head, respirations 4 per minute.

E. child, age three, deep laceration of the right leg, oozing blood, deformity of the same leg, crying in mother’s lap.

F. mother of “E”, nervous, no complaints, sitting on the ground.

G. male adult in US Navy uniform, medical insignia on the sleeve, cut tongue, alert and ambulatory.

H. female adult lying on the ground, a large piece of glass in the chest, pupils dilated and fixed, no carotid pulse, no respirations.

I. male adult, husband of “H”, hysterical, walking around the area, no obvious injuries.

J. female adult, scratches on hands and knees, alert, ambulatory, calm, severe bleeding from scalp laceration.

K. baby in diapers, crying in mother’s arms, mother says a child is not hurt.

L. female adult, mother of “K”, no injuries obvious or reported, sitting in the bus.

M. male adult, lying on the side with knees bent towards the abdomen, hands holding abdomen, moaning, strong alcohol odor, won’t answer questions, pupils constricted, good carotid pulse and vomited once.

N. female teenager, painful, deformed and swollen right humerus and elbow and hand cold and bluish, can’t move fingers of the right hand.

O. elderly male approximately 60, sitting in the bus, says he has a heart condition, complains of chest pain, pale, sweaty skin, pupils normal, left radial pulse absent, alert, left chest hurts when he moves, lifts an arm or takes a deep breath.

P. two elderly sisters, complaining of poor bus service, fast driving and demanding that the trooper arrest the bus driver at once.

Q. female adult, pain in right shoulder and neck, hurts to move the right arm, head tilted to the right, alert, ambulatory, right hand warm and fingers move well.

R. male adult, deformed jaw, can’t talk, pupils react to light, good pulse, very swollen neck, subcutaneous emphysema of front and sides of the neck, some difficulty breathing.

S. female adult, tangled in seats, complaining of severe pain in the back, cannot move legs.

T. female teenager, standing outside experiencing difficult and labored breathing, a crowing sound heard on expiration, hands grasping throat, no obvious injuries.

Part 2: Please designate which patients will be sent in which order.

Per your local disaster protocols, each ambulance trip can include up to two stretchers and one sitting patient.

The scene is as follows: Multiple engine crews arrive and set up incident command and a landing zone. Two more officers have arrived, a deputy sheriff and another state trooper.

There are approximately 25 bystanders, including an off-duty EMT from your agency.

You are in ambulance “A”. Assume you are with another paramedic.

Ambulances “B” and “C” have been called to assist but have not yet arrived.

There is one helicopter available, which is en-route to the scene with a short ETA.

For this scenario, you do not need to worry about overloading hospitals - assume their capacity is whatever you need it to be. You can also assume there is another officer coordinating with the hospital specialists, so you do not need to consider hospital specialties such as burn or trauma in this assignment. Your only focus is the order in which patients leave the scene.

Answer the following Questions

1. If you were assigned this task at a real MCI, which ICS "role" would you most likely be filling?

2. You assign the off-duty EMT from your agency and your paramedic partner to Ambulance "A." How many, and which patients would you place in Ambulance “A” for its first trip and why?

Stretcher 1Stretcher 2Sitting

3. How do you assign work to the other first responders, useful bystanders or patients?

4. Which patient should go via helicopter?

5. How many, and which patients would you place in Ambulance “B” for its first trip and why?

Stretcher 1Stretcher 2Sitting

6. How many, and which patients would you place in Ambulance “C” for its first trip and why?

Stretcher 1Stretcher 2Sitting

7. The first ambulance to return to the scene, second trip.

Stretcher 1Stretcher 2Sitting

8. The next ambulance to return to the scene, second trip.

Stretcher 1Stretcher 2Sitting

9. What additional trips are necessary?

10. Which victims would not need to be seen at the hospital?

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