Trauma Scenario Skills Evaluation #3
Instructor Information
This skill station involves an adult patient who sliced off the
distal end of his right thumb. The patient requires bleeding
control, oxygen, dressing and bandaging of the wound, and
transportation. Follow the written scenario, and provide
information to all team members as the scenario progresses
or as the team members ask.
Patient Information
Moulage: Amputation of distal portion of right thumb,
approximately 1/4 inch (0.6 cm), minimal bleeding from wound,
pale and diaphoretic skin
Position: Sitting
Actions: Anxious, gets dizzy and nauseated whenever he looks at
his thumb
Dispatch Information
You and your partners are working for a large transporting EMS system. Your service has been dispatched to a local restaurant for a cut with
severe bleeding. It is 1930 hr on a summer Friday evening. The outside temperature is 66°F (19°C). From the scene, you are 7 minutes away
from the closest hospital and 13 minutes away from the closest level II trauma center.
Scene Assessment/General Impression
As you arrive on scene, you are escorted through the kitchen area of a busy restaurant to an office. Your patient is sitting in an office chair
with his right hand wrapped in a bloody kitchen towel. A coworker is with the patient.
Primary Survey
Treatments/Critical Actions
X:
A:
B:
C:
D:
E:
•
•
•
43-year-old male, approximately 250 lb (113 kg)
No more external bleeding
Patent
22, no distress
104, strong radial pulses; skin is pale
15 (E-4, V-5, M-6)
Wound right thumb
Initial Patient Impression: Noncritical/Rapid Transport
Secondary Survey
Initial Vital Signs
BP:
164/94 (MAP 117)
P:
104, strong radial pulse
R:
22, LS clear and equal
Skin:
Pale, diaphoretic
Spo2:
95%/RA
GCS:
15 (E-4, V-5, M-6)
Glucose:
114 mg/dl (6.3 mmol/l)
etco2:
38 mm Hg
Pain:
7/10
Temp:
97.8°F (36.6°C)
*Note: ★ icon indicates a Critical Action
Control hemorrhage
Pain relief
Routine transport ★
Reassessment Vital Signs
Critical actions done
Critical actions NOT done
BP:
158/94 (MAP 117)
BP:
164/94 (MAP 117)
P:
100, strong radial pulse
P:
104, strong radial pulse
R:
18, LS clear and equal
R:
22, LS clear and equal
Skin:
Pale
Skin:
Pale, diaphoretic
Spo2:
95%/RA
Spo2:
95%/RA
GCS:
15 (E-4, V-5, M-6)
GCS:
15 (E-4, V-5, M-6)
Glucose:
114 mg/dl (6.3 mmol/l)
Glucose:
114 mg/dl (6.3 mmol/l)
etco2:
38 mm Hg
etco2:
38 mm Hg
Pain:
7/10
Pain:
7/10
Temp:
97.8°F (36.6°C)
Temp:
97.8°F (36.6°C)
Sample
Signs/symptoms:
Minor bleeding from right thumb
Allergies:
NKA
Medications:
None
Past medical history:
None (hypertension NYD)
Last oral intake:
Sandwich 45 minutes ago
Event leading to incident:
Cutting vegetables during meal preparation and cut off end of thumb,
felt light-headed and collapsed to floor after seeing the blood
Body Systems
Head:
Unremarkable
Neck:
Unremarkable
Chest:
Symmetrical
Abdomen:
Soft, nontender
Pelvis:
Stable
Extremities:
Wound to right thumb
Back:
Unremarkable
Notes
Transport and Destination
Transport Timing: Routine transport
Destination: Closest hospital
Discussion Points
•
•
•
Was this a critical patient?
On what did you base your decision?
How should the amputated body part be managed?