- The nice weather has finally arrived and to celebrate your local group has decided to hold their regular meeting at a local member's small farm in order to facilitate an A&S discussion/demonstration on campfire cooking. The results are going to the pot-luck at the end of the meeting. The initial discussion on campfire cooking has wrapped up, the firepit is ready and a variety of people are now moving towards setting up the actual cooking. As you're helping set up tables for food preparation, you hear someone cry out behind you. Turning you notice a young lady (mid-20s) sitting on the ground, crying and holding onto her left hand. She appears very distraught and panicked. Taking a look you see that she has a metal skewer impaled through her hand. The skewer goes through the left hand in the meaty area under the forefinger and off to the side of the thumb. There is some bleeding though it is not severe. She is able to move her fingers though she complains loudly of pain when she does. She does not have any loss of feeling in her fingers. The skewer is about 8-9 inches in length. You hear someone say that she wasn't looking where she was going and tripped over some firewood on her way to the firepit.
- Scenario 6 Response
The first task is to assess for my own safety.
For this scenario it includes my own cooking fire. In this situation I have a definite injured vs a possible injured from the fire. Assuming my cooking fire is moderate in size then I can leave it. If it's a bonfire then I must make sure someone will look after it my absence.
Now on the approach to the patient things to look for:
- the size of their fire
- the direction smoke is going (is it coming onto the patient?)
- is there loose objects on the ground?
- Is their anything cooking on the fire?
- Is the tripod holding their cooking in good condition or is it about to fall over onto someone?
In assessing the patient the first item is their ABCs. Giving that they are crying that is all in good orders. While blood loss is occurring the amount lost through a still impaled object is not yet life threatening. If the blood was squirting out in pulses that would be an artery strike which is quite serious.
On arrival I would first identify myself by name and as a first aid responder. I will attempt to move the patient away from all the other objects on the ground. Preferably to a place to sit her down.
While doing so I will ask someone to call 911 and to stay near me as my hands will be busy. I will ask if she travelled here with someone. If yes to a travel companion I will send someone to quietly get them.
Now is a good time to be glad of the chirugeon belt favour. Inside is latex gloves which I will put on due to blood exposure. There is also 1 or 2 gauze pads and normal bandages. If there is only one gauze it will to be split to make a sterile pad on each side of the impalement. The few band aids in the belt favour are going to be used to hold down the edges of the gauze.
For an impaled object the desired first aid is to stabilize the object leaving extraction to occur in medical facilities. The gauze pads will be pressed around it on both sides. I will ask for a clean napkin if available to augment the gauze pad. If necessary the belt favour itself can be used as a wrapper.
The patient can be the best one to apply pressure for various reasons. One is that they will be able to know how much pain they feel. Secondly they are already exposed to their own blood so no one else is exposed to blood exchanges.
While this is going on I will try to sort out between 911, the patient and their travel companions how they will be going to the hospital. Preferably by the ambulance with the travel companions following in another vehicle with the person's belongings.
If a travel companion has not been found I will send someone to start asking the SCA "chain of command" from canton mates, to baronials to royals in hopes of someone being able to identify those familiar with the patient.
At this point I will send someone to find if another chirugeon is present and if so to have them bring more gauze. It isn't just a matter of skill but also a matter of supplies. I have more in my vehicle but would need to search around for it.
To help hold in the dressing place I really need some tape. This being the SCA duct tape should be findable. Care is to be taken to avoid getting the tape gunk into the wound. Only the sterile gauze I had should be put in direct contact with the wound.
I will now start to escort the patient, and any travel companions, to the ambulance or where the ambulance will be coming. The EMS need to be queried as to what hospital they are going to.
The event steward and kingdom chirugeon should be informed as soon as possible.
When taking the gloves off I will be careful to twist the edge so I get no exposure to the blood. The sandwich bag I kept them in within the pouch is used to hold them for disposal in a garbage or with the EMS medical disposal.
Once the gloves are off the paperwork begins.