256Re: [E-Chir] Scenario One
- Jan 6, 2009At 10:29 PM 1/5/2009, you wrote:
>Greetings everyone,Did someone get shot by an arrow? Where's a cell phone? How far is
>Here is the first of the training/discussion scenarios I was talking
>about. I am starting off fairly simple in order to help everyone
>become comfortable with the concept of these scenarios. As you will
>see, I have given a description of the incident and then some
>questions for you to answer. You are free to answer these questions
>on this list or, if you are more comfortable, send them privately to
>me. As discussion continues, I will add more questions as needed or,
>if necessary, some answers. In some cases there are no right or
>wrong answers. However, in some cases there are.
>The purpose of these scenarios is to inspire discussion and to keep
>our training percolating in our heads. Please remember that as
>chirugeons we provide first aid. I am basing the treatments on Heart
>& Stroke standards, as well as first aid standards.
>If anyone has any questions please feel free to contact me and I
>will do my best to answer you. Good luck and have fun with this.
>You are sitting in your camp at War of the Trilliums enjoying a bit
>of a break from the mid day heat and the event activities when you
>hear a call for a chirugeon. Looking around you spot someone coming
>up to you. They don't look panicked but they do look like they're in
>a bit of a hurry. Spotting you they yell out that someone's been
>hurt at the archery field and that you're needed. You grab your kit
>and start making your way to the archery field.
>1. What kind of things should you be thinking about at this point?
the archery field from the road? hmm This guy who found me isn't
>2. What do you think should be in your basic first aid kit?Bandaids to stop bleeding, splints to hold things in place, latex
gloves, sugar, quarters, paper, pencil, air valve for rescue
breathing. I'm sure there's more, hard to think of a list at once :-)
>As you approach the archery field you see a group of 2-3 peopleAny other dangers around? Is the Archery Marshal still watching the
>kneeling around someone sitting on the ground. They are sitting in
>the open field but are behind the archery line by a good 15 feet.
>Coming closer you see a male about 25-30 years of age sitting on the
>field holding on to his left ankle. He is breathing normally. He
>appears a bit flushed but you suspect that could be due to the
>midday sun. When he sees you approach he grins up at you as he
>explains that he wasn't paying attention to where he was walking and
>stumbled into a hole in the ground and turned his ankle. He states
>he tried to get up and did managed a couple of steps before the pain
>got the better of him and he sat down again. When you look at the
>ankle you see some minor swelling on the lateral side but no
>bruising or deformities are noted. He states the pain is lessening
>and his ankle movement is increasing as he rests.
>3. As you get closer to the scene, what should you be looking for?
archery field? Nothing else seems likely to be dangerous at this
point, the archery field is rarely so near other activities that
people would trip over us by accident.
>4. Once you are at the casualty, what's the first thing you shouldIs he breathing well? If he's grinning at me and talking easily the
>assess? How would you do that?
answer is yes. Is there any chance of a brain injury? If his
conversation makes sense, and there's no pain in his head, he's
Is he bleeding anywhere else? Ask him if it hurts anywhere else than
the ankle. Make sure I can see the front of the leg where he would
have banged it in the hole and ask him to lift up high enough to
check the back of the leg.
>5. What do you believe has happened to the casualty? How would youAs long as I can see the whole he stepped in, and the others around
him aren't concerned about what he said, I'll believe his story. I'd
like to see the hole, see how deep it is, and see how many steps
there are to where he's sitting. Friends might have helped him move
somewhere more comfortable though.
>6. What kind of treatment would you give?I'd get him some ice and help him raise the ankle up so that his legs
are flat, or his ankle up a little higher than his bum. I'd ask him
to poke and prod and tell me where it seems to hurt the worst, if it
looked like he missed any injured areas, I'd ask him to poke those
and tell me how it felt. I'd clean and bandage any spots that were
scraped and bleeding. I'd explain that I have only basic first aid
training, and no experience with real ankle injuries. I can wrap it
up so he can't damage it further and have someone help him to the
hospital. He can arrange for some friends to take him, or an
ambulance, but if the first check says breathing, bleeding, and
brains are normal I don't think an ambulance is necessary. Or, he
can ask around for someone who's familiar with ankles, get it wrapped
up that way, and sit for the afternoon with it elevated. I'd explain
that the ice should go on for 10 minutes then off for 10, repeating
for the next few hours. If the ankle ever felt worse he should go to
the ER, if it didn't feel much better by the next day he should go to
the ER, if it didn't feel all better in a couple days he should go
see his family doctor.
My training says I should advise that he see a doctor right away, but
his demeanour suggests that he probably doesn't think it's
necessary. If he shows any sign of wanting an ER check, I'll
encourage it. Otherwise, I'd rather he think I was reasonable, and
would take the advice to go to the ER if it got worse, seriously. If
it was my ankle, and it had started feeling better with just a few
minutes of rest, I wouldn't have gone to the ER either.
started first aid training to be a life guard 20 years ago, for the
last 10 years or so Red Cross Standard First Aid. Currently lapsed
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