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Re: [E-Chir] Scenario 2; part 1

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  • Keith Crawley
    Scenario 2. You re sitting around at an event on a Saturday enjoying the company of some friends you haven t seen for awhile. You re CiC for this event but its
    Message 1 of 9 , Feb 11, 2009
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      Scenario 2.
       
      You're sitting around at an event on a Saturday enjoying the company of some friends you haven't seen for awhile. You're CiC for this event but its been quiet all day. All around you there are activities taking place. From where you are you can smell the feast cooking in the kitchen. There are tables full of people engaging in games or some A&S activities. You know that other rooms at the event site are being used for some armoured combat, rapier combat and there was even space left over for some classes.
       
      Suddenly you hear someone yelling for a chirugeon. Getting up you head to the yelling and are met a few steps from your table by a gentlemen who states, "They've cut themself. You have to hurry. It's really bad. There's blood everywhere!"
       
      1. What do you do first?
      Ask questions.. Who is cut? How Many Victims and were exactly are they??
       
      2. What are you thinking?
      Is my belt/pocket kit big enough for this one or do I take the extra time to get something bigger or send someone else to get it? Any other chirurgeons around that can back me?
       
      3. How do you approach this incident?
      Controlled haste.. No sence panicking the populace seeing a Chirurgeon fly through the hall like a mad man. Assess situation mentally.. what location is the injured person in? Do I know ahead of time of any possible source/cause of the injury (what activities were happening in that room etc.)? Do I need to take any added precautions for my own safety going in? Due to the mention of blood I would probably be starting to glove up or at least getting them out ready for what I may see on entry.  
       
      When you arrive at the classroom you see about 10 people all crowded around someone sitting on a chair. When you finally make your way through to the casualty you see a middle-aged gentleman (approx. 40 yrs old) who is currently holding his forearm and hand close to his chest with what appears to be a white veil wrapped around his arm. You do notice blood on the veil. You notice that there is blood on the floor at his feet as well as some on his tunic. 
       
      1. What is your first assessment? What are you looking for?
      General appearance of the victim, his actions and ability to breath and converse properly etc. indications of confusion or possible shock etc. any indications of added problems other than an obvious wound someplace either on an arm or possibly chest?  Attempt to guesstimate the quantity of blood on scene as an indication of the size or severity of the wound and any pottential for victim to become faint, unconcious or shocky. What caused the injury? Did anyone witness it?
       
      2. What is your second assessment? What are you looking for?
      Vitals of victim for indications of shock or loss of circulation to the wounded extremity and any need for more than just first aid at this time and activation of 9-1-1 if required. Examination of the wound to determine severity and required treatment etc.
       
       
      3. How do you control this scene?
      Clear out un needed spectators as best possible. Ask for a couple of helpers to (a) be ready to help steady the victim in his chair in case he does faint or loose conciousness or to move him should the need arrise. (b)advise 9-1-1 and any other needed help (autocrat etc. back up first aid)if or as required. (c) control access to the room so other curious onlookers dont become a problem and for the comfort and privacy of the victim.
       
      Percival

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    • KIM MCAULEY
      Here s an interesting tidbit of information. If a patient is bleeding and on ground rather than floor, stick a finger a bit into the dirt if you can to check
      Message 2 of 9 , Feb 11, 2009
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        Here's an interesting tidbit of information. If a patient is bleeding and on ground rather than floor, stick a finger a bit into the dirt if you can to check for dampness. In some weathers, liquid will be soaked up really quickly, so while there may be no pooling blood visible, the ground may be very suspiciously wet.
         
        Kaellyn


        From: Keith Crawley <crawleys@...>
        To: E-Chir@yahoogroups.com
        Sent: Wednesday, February 11, 2009 11:38:49 AM
        Subject: Re: [E-Chir] Scenario 2; part 1

         
         

        Scenario 2.
         
        You're sitting around at an event on a Saturday enjoying the company of some friends you haven't seen for awhile. You're CiC for this event but its been quiet all day. All around you there are activities taking place. From where you are you can smell the feast cooking in the kitchen. There are tables full of people engaging in games or some A&S activities. You know that other rooms at the event site are being used for some armoured combat, rapier combat and there was even space left over for some classes.
         
        Suddenly you hear someone yelling for a chirugeon. Getting up you head to the yelling and are met a few steps from your table by a gentlemen who states, "They've cut themself. You have to hurry. It's really bad. There's blood everywhere!"
         
        1. What do you do first?
        Ask questions.. Who is cut? How Many Victims and were exactly are they??
         
        2. What are you thinking?
        Is my belt/pocket kit big enough for this one or do I take the extra time to get something bigger or send someone else to get it? Any other chirurgeons around that can back me?
         
        3. How do you approach this incident?
        Controlled haste.. No sence panicking the populace seeing a Chirurgeon fly through the hall like a mad man. Assess situation mentally.. what location is the injured person in? Do I know ahead of time of any possible source/cause of the injury (what activities were happening in that room etc.)? Do I need to take any added precautions for my own safety going in? Due to the mention of blood I would probably be starting to glove up or at least getting them out ready for what I may see on entry.  
         
        When you arrive at the classroom you see about 10 people all crowded around someone sitting on a chair. When you finally make your way through to the casualty you see a middle-aged gentleman (approx. 40 yrs old) who is currently holding his forearm and hand close to his chest with what appears to be a white veil wrapped around his arm. You do notice blood on the veil. You notice that there is blood on the floor at his feet as well as some on his tunic. 
         
        1. What is your first assessment? What are you looking for?
        General appearance of the victim, his actions and ability to breath and converse properly etc. indications of confusion or possible shock etc. any indications of added problems other than an obvious wound someplace either on an arm or possibly chest?  Attempt to guesstimate the quantity of blood on scene as an indication of the size or severity of the wound and any pottential for victim to become faint, unconcious or shocky. What caused the injury? Did anyone witness it?
         
        2. What is your second assessment? What are you looking for?
        Vitals of victim for indications of shock or loss of circulation to the wounded extremity and any need for more than just first aid at this time and activation of 9-1-1 if required. Examination of the wound to determine severity and required treatment etc.
         
         
        3. How do you control this scene?
        Clear out un needed spectators as best possible. Ask for a couple of helpers to (a) be ready to help steady the victim in his chair in case he does faint or loose conciousness or to move him should the need arrise. (b)advise 9-1-1 and any other needed help (autocrat etc. back up first aid)if or as required. (c) control access to the room so other curious onlookers dont become a problem and for the comfort and privacy of the victim.
         
        Percival

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      • sheldon@pipcom.com
        On the second #1 question, I d also add get Consent. Just because your called does not mean you can take over. Ask before doing anything else. Russ / Dafydd
        Message 3 of 9 , Feb 11, 2009
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          On the second #1 question, I'd also add get Consent. Just because your
          called does not mean you can take over. Ask before doing anything else.

          Russ / Dafydd


          >
          >
          >
          >
          > Scenario 2.
          >
          > You're sitting around at an event on a Saturday enjoying the
          > company of some friends you haven't seen for awhile. You're CiC
          > for this event but its been quiet all day. All around you there
          > are activities taking place. From where you are you can smell the
          > feast cooking in the kitchen. There are tables full of people
          > engaging in games or some A&S activities. You know that other
          > rooms at the event site are being used for some armoured combat,
          > rapier combat and there was even space left over for some classes.
          >
          > Suddenly you hear someone yelling for a chirugeon. Getting up you
          > head to the yelling and are met a few steps from your table by a
          > gentlemen who states, "They've cut themself. You have to hurry.
          > It's really bad. There's blood everywhere!"
          >
          > 1. What do you do first?
          > Ask questions.. Who is cut? How Many Victims and were exactly are
          > they??
          >
          > 2. What are you thinking?
          > Is my belt/pocket kit big enough for this one or do I take the
          > extra time to get something bigger or send someone else to get it?
          > Any other chirurgeons around that can back me?
          >
          > 3. How do you approach this incident?
          > Controlled haste.. No sence panicking the populace seeing a
          > Chirurgeon fly through the hall like a mad man. Assess situation
          > mentally.. what location is the injured person in? Do I know ahead
          > of time of any possible source/cause of the injury (what
          > activities were happening in that room etc.)? Do I need to take
          > any added precautions for my own safety going in? Due to the
          > mention of blood I would probably be starting to glove up or at
          > least getting them out ready for what I may see on entry.
          >
          > When you arrive at the classroom you see about 10 people all
          > crowded around someone sitting on a chair. When you finally make
          > your way through to the casualty you see a middle-aged gentleman
          > (approx. 40 yrs old) who is currently holding his forearm and hand
          > close to his chest with what appears to be a white veil wrapped
          > around his arm. You do notice blood on the veil. You notice that
          > there is blood on the floor at his feet as well as some on his
          > tunic.
          >
          > 1. What is your first assessment? What are you looking for?
          > General appearance of the victim, his actions and ability to
          > breath and converse properly etc. indications of confusion or
          > possible shock etc. any indications of added problems other than
          > an obvious wound someplace either on an arm or possibly chest?
          > Attempt to guesstimate the quantity of blood on scene as an
          > indication of the size or severity of the wound and any pottential
          > for victim to become faint, unconcious or shocky. What caused the
          > injury? Did anyone witness it?
          >
          > 2. What is your second assessment? What are you looking for?
          > Vitals of victim for indications of shock or loss of circulation
          > to the wounded extremity and any need for more than just first aid
          > at this time and activation of 9-1-1 if required. Examination of
          > the wound to determine severity and required treatment etc.
          >
          >
          > 3. How do you control this scene?
          > Clear out un needed spectators as best possible. Ask for a couple
          > of helpers to (a) be ready to help steady the victim in his chair
          > in case he does faint or loose conciousness or to move him should
          > the need arrise. (b)advise 9-1-1 and any other needed help
          > (autocrat etc. back up first aid)if or as required. (c) control
          > access to the room so other curious onlookers dont become a
          > problem and for the comfort and privacy of the victim.
          >
          >
          > Percival
          >
          >
          > ------------------------------------------------------------------------------
          > Looking for the perfect gift? Give the gift of Flickr!
          >
        • Jackie Wyatt
          I agree- I ve been called over by someone only to be told by the injured person that I m not needed. Medb ... From: sheldon@pipcom.com
          Message 4 of 9 , Feb 11, 2009
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            I agree- I've been called over by someone only to be told by the injured person that I'm not needed.
            Medb

            --- On Wed, 2/11/09, sheldon@... <sheldon@...> wrote:

            From: sheldon@... <sheldon@...>
            Subject: Re: [E-Chir] Scenario 2; part 1
            To: E-Chir@yahoogroups.com
            Date: Wednesday, February 11, 2009, 5:25 PM


            On the second #1 question, I'd also add get Consent. Just because your
            called does not mean you can take over. Ask before doing anything else.

            Russ / Dafydd
          • Keith Crawley
            Yup its happened to me as well but in this case I am pretty sure they will want help but asking permission is almost always a given when approaching a victim.
            Message 5 of 9 , Feb 11, 2009
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              Yup its happened to me as well but in this case I am pretty sure they will want help but asking permission is almost always a given when approaching a victim. Be it a direct question or a simple "hey what happened here? I have my first aid kit may I take a look?"  
              ----- Original Message -----
              Sent: Wednesday, February 11, 2009 12:38 PM
              Subject: Re: [E-Chir] Scenario 2; part 1

              I agree- I've been called over by someone only to be told by the injured person that I'm not needed.
              Medb

              --- On Wed, 2/11/09, sheldon@pipcom. com <sheldon@pipcom. com> wrote:

              From: sheldon@pipcom. com <sheldon@pipcom. com>
              Subject: Re: [E-Chir] Scenario 2; part 1
              To: E-Chir@yahoogroups. com
              Date: Wednesday, February 11, 2009, 5:25 PM

              On the second #1 question, I'd also add get Consent. Just because your
              called does not mean you can take over. Ask before doing anything else.

              Russ / Dafydd

            • b1laxson
              ... head to the yelling and are met a few steps from your table by a gentlemen who states, They ve cut themself. You have to hurry. It s really bad. There s
              Message 6 of 9 , Feb 11, 2009
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                Brian Goodheart's responses:

                > Suddenly you hear someone yelling for a chirugeon. Getting up you
                head to the yelling and are met a few steps from your table by a
                gentlemen who states, "They've cut themself. You have to hurry. It's
                really bad. There's blood everywhere!"
                >  
                > 1. What do you do first?

                Get up carefully from what I was doing.
                Make sure my mini-kit is on my belt.

                >  
                > 2. What are you thinking?

                Mentally reviewing contents of my mini-kit.

                Wondering who is the Chirurgeon in Charge and the Autocrat.

                Also who has a cell phone in case it is needed.

                Also... are there chirurgeons with more medical qualifications than
                myself? Xristina our Kingdom Chirurgeon for instance (and its not
                kissing ass, its looking for superior skills for the benefit of the
                patient) or Baroness Margaret a nurse.

                >  
                > 3. How do you approach this incident?
                >  

                First look for signs of ongoing risk to myself or others.
                Crowd control and cessation of near by activities may be called for.


                > When you arrive at the classroom you see about 10 people all
                crowded around someone sitting on a chair. When you finally make
                your way through to the casualty you see a middle-aged gentleman
                (approx. 40 yrs old) who is currently holding his forearm and hand
                close to his chest with what appears to be a white veil wrapped
                around his arm. You do notice blood on the veil. You notice that
                there is blood on the floor at his feet as well as some on his
                tunic. 
                >  
                > 1. What is your first assessment? What are you looking for?

                Airway, Breathing, Circulation. Is their brain getting oxygen via
                blood.
                Is the patient talking? That's a good sign.


                >  
                > 2. What is your second assessment? What are you looking for?

                Is there an imbeded object?
                Is there risk of new injuries from a stray object?


                >  
                > 3. How do you control this scene?
                >

                First instruct people to give him room to breath.

                Ask the patient what happened.

                Ask someone to look for the Autocrat and something to clean the
                floor with.

                Keep an eye on the bleeding for the volume of blood loss
                and "spurting" which would indicate an artery is cut.

                Put on the gloves from my mini-kit.

                Recommend to the patient that he goto emergency.


                Question: Should we be calling 911 to ready profesional transport
                rather (ambulance)?
              • b1laxson
                The patient talking to you largely completes the critical assessment of ABC. I would add take a moment before departing on their no to see if they are likely
                Message 7 of 9 , Feb 11, 2009
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                  The patient talking to you largely completes the critical assessment
                  of ABC.

                  I would add take a moment before departing on their "no" to see if
                  they are likely to pass out. Once they pass out... uh... the
                  assessment changes to potentially life threatening and consent is
                  assumed.

                  Brian the Green


                  --- In E-Chir@yahoogroups.com, Jackie Wyatt <jkwyatt@...> wrote:
                  >
                  > I agree- I've been called over by someone only to be told by the
                  injured person that I'm not needed.
                  > Medb
                  >
                  > --- On Wed, 2/11/09, sheldon@... <sheldon@...> wrote:
                  >
                  > From: sheldon@... <sheldon@...>
                  > Subject: Re: [E-Chir] Scenario 2; part 1
                  > To: E-Chir@yahoogroups.com
                  > Date: Wednesday, February 11, 2009, 5:25 PM
                  >
                  >
                  > On the second #1 question, I'd also add get Consent. Just because
                  your
                  > called does not mean you can take over. Ask before doing anything
                  else.
                  >
                  > Russ / Dafydd
                  >
                • shannon carswell
                  ... head to the yelling and are met a few steps from your table by a gentlemen who states, They ve cut themself. You have to hurry. It s really bad. There s
                  Message 8 of 9 , Feb 13, 2009
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                    > Suddenly you hear someone yelling for a chirugeon. Getting up you
                    head to the yelling and are met a few steps from your table by a
                    gentlemen who states, "They've cut themself. You have to hurry. It's
                    really bad. There's blood everywhere!"
                     
                     1. What do you do first?
                        Find my First aid kit and if I am with friends maybe ask a non involved third party to come with in case I need a calm person to do gopher duty (call 911, get the autocrat, etc etc).
                     
                    2. What are you thinking?
                     
                        Mostly trying to remember what ninka taught me in first aid :P.  (kidding) Seriously, mostly about how to keep everyone calm, remembering treatment for shock and about what bandages I have available.
                     
                    3. How do you approach this incident?
                     
                     Again calmly, checking for hazards, number of people, potential causes, and first impressions of injured person (are they laying down, up and talking?)
                     
                     When you arrive at the classroom you see about 10 people all
                    crowded around someone sitting on a chair. When you finally make
                    your way through to the casualty you see a middle-aged gentleman
                    (approx. 40 yrs old) who is currently holding his forearm and hand
                    close to his chest with what appears to be a white veil wrapped
                    around his arm. You do notice blood on the veil. You notice that
                    there is blood on the floor at his feet as well as some on his
                    tunic. 

                    1. What is your first assessment? What are you looking for?
                     
                     First ABC, He is concious so A, and B are covered and as to C well his heart is definetly beating... but the wound is obviously a comprimise for circulation.  I would check amount of blood , if there is a puddle, I am having my gopher call 911, better safe than sorry.  If there are a couple splashes, better to get a real bandage on and have soemone drive him if he needs stiches.

                    2. What is your second assessment? What are you looking for? 
                     
                    Signs of shcok, level of awareness, I would introduce my self ask his name, ask if I could help, ask how this happened and ensure that the hazardous object was somewhere safe.  I then with permission ask to see the wound.

                    3. How do you control this scene?
                     
                      By remaining calm myself.  By asking talking to the person injured person directly. (Assuming he is not in shock) by showing confidence.  By assigning people to tasks if they get to panicky. 
                     
                    okay there's my two cents (she adds meekly)

                     
                    anyone lived in a pretty how town with up so floating many bells down...


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