Case 2: Secondary Survey -Training Scenario - First Aid Scenario Library

Scenario Overview:

You are on duty as part of a medical team at a large-scale music festival, there are roughly over 66,000 people in attendance and it is a warm summer's day in July with temperatures being around 27°c .You are being dispatched to a person who is struggling to breathe. When you arrive on scene you find the patient to be sat down on a chair and is a member of the event marshalling team, she is accompanied by another Marshall who was the reporting party.

Difficulty:

First Aider Easy

How the scenario should progress:

The first aider/clinician should carry out a Primary survey followed by taking a secondary survey and vitals signs of the patient, then the first aider/clinician should proceed to come up with a clinical management plan and appropriate patient care pathway. 1.This scenario will require 1x additional actors for the bystander. 2.This scenario can be run by a solo First aider/clinician or by 2 First aiders/clinicians. 3.To make it more realistic to real world applications you may wish to use equipment, props and moulage. 4.Estimated scenario time: 10-15 minutes ~ Please modify as you see fit to necessarily meet your needs- for example gender/age/names.

Patient 1:

Name: Age: 37 Sex: Female

Medication: 20mg fluoxetine - 1x tablet taken once per day.

Allergies: N/A

Past medical/family/social history: Normally fit and healthy- patient does have generalised anxiety disorder, which they still struggle with even the medication.

Findings on examination: on examination you find that there are no apparent life threats to the patient ABC, the patient is stable and Alert with no injuries- Signs: apprehensive, sweaty and visibly upset/worried- Symptoms: (patient will be complaining of) Feeling dizzy, tingling in the fingers and lips, dry mouth, struggling to breath (due to breathing fast), mild cramps. Event history: patient has had a long day on duty, due to the heat and it being more busy than last year they started to feel overwhelmed and started to hyperventilate.

Possible treatment from first aiders: ~ you should follow your local policy, guidelines and scope of practice for all scenarios~

Time after start:	5 min	10 min	15 min
Response:	A	A	A
Airway:	Yes	Yes	Yes
Breathing?	Yes - unnaturally fast	Yes - unnaturally fast but slowing down	Yes - more calm
Respirations:	32	24	18
Pulse:	120	110	82
Oxygen Sats:	99%	99%	97%
Pain Score:	0	0	0
Blood Pressure:	136/74	130/70	120/70
Temperature:	37.0°c	37.0°c	37.0°c
Blood Glucose:	4.7	4.7	4.7

Tips for the patient actors:

You are suffering from hyperventilation. Read through the signs and symptoms (this is how you will need to look/act/feel) as well as all additional information such allergies/meds/past med history and event history . Be helpful and answer all questions. If you feel the first aider/clinician you can start to visually calm down as time progresses. Bystander actor notes: if you are asked question you will state you haven't known her long but when you walk over to get some more fencing you noticed she was struggling to breath and that when you called it in.

Scenario: Case 2: Secondary Survey