karantzalis
Forum Ride Along
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Found this on reddit and thought it was a good scenario to post here.
Scenario: Active shooting with at least 12 victims. Youngest injured victim is 15 years old, rest are all above age 20. Nearest peds trauma center is 20 miles away. Nearest level I trauma center is 30 miles in the other direction. No landing zones nearby for hems. ALS is 20 minutes away. Only 2 BLS rigs available for transport.
Victims are brought to staging area with the following stats:
4 out of 12 were triaged expectant/DEO.
5 of them tagged as immediate.
1 tagged as delayed.
2 tagged as minimal.
Patient 1:
Red-tagged/immediate
15 yom with GSW x2 to the chest
Unresponsive.
BP 74/45, RR 10 after repositioning airway
Patient 2:
Red-tagged/immediate
21 yof with GSW x3 to abdomen RUQ, right shoulder, right arm
Heavy bleeding on scene, cold/clammy skin.
Tourniquet applied to right arm.
BP 90/60, HR 120, RR 40, CAOx4.
Patient 3:
Red-tagged/immediate.
40 yom with GSW to pelvis.
Talking but confused
BP 150/85, HR 190, RR 32, CAOx2.
Patient 4:
Red-tagged/immediate.
56 yof with GSW to right ankle.
Tourniquet applied to right leg.
BP 132/74, HR 100, RR 35, CAOx4
Patient 5:
Red-tagged/immediate
45 yom with GSW x2 to head and neck
Heavy bleeding on scene, cold/clammy skin
Unresponsive
BP 60/30, HR 122, RR 10
Patient 6:
Yellow-tagged/delayed
34 yof with GSW to left calf
Bleeding is a slow ooze
Tourniquet applied to left leg
BP 150/85, HR 118, RR 20, CAOx4
Do you re-triage these patients once they’re brought into the staging area? If so, do any of the patients’ tag color change?
Who do you take first? To which hospital?
What interventions do you take when another patient is being transported?
Scenario: Active shooting with at least 12 victims. Youngest injured victim is 15 years old, rest are all above age 20. Nearest peds trauma center is 20 miles away. Nearest level I trauma center is 30 miles in the other direction. No landing zones nearby for hems. ALS is 20 minutes away. Only 2 BLS rigs available for transport.
Victims are brought to staging area with the following stats:
4 out of 12 were triaged expectant/DEO.
5 of them tagged as immediate.
1 tagged as delayed.
2 tagged as minimal.
Patient 1:
Red-tagged/immediate
15 yom with GSW x2 to the chest
Unresponsive.
BP 74/45, RR 10 after repositioning airway
Patient 2:
Red-tagged/immediate
21 yof with GSW x3 to abdomen RUQ, right shoulder, right arm
Heavy bleeding on scene, cold/clammy skin.
Tourniquet applied to right arm.
BP 90/60, HR 120, RR 40, CAOx4.
Patient 3:
Red-tagged/immediate.
40 yom with GSW to pelvis.
Talking but confused
BP 150/85, HR 190, RR 32, CAOx2.
Patient 4:
Red-tagged/immediate.
56 yof with GSW to right ankle.
Tourniquet applied to right leg.
BP 132/74, HR 100, RR 35, CAOx4
Patient 5:
Red-tagged/immediate
45 yom with GSW x2 to head and neck
Heavy bleeding on scene, cold/clammy skin
Unresponsive
BP 60/30, HR 122, RR 10
Patient 6:
Yellow-tagged/delayed
34 yof with GSW to left calf
Bleeding is a slow ooze
Tourniquet applied to left leg
BP 150/85, HR 118, RR 20, CAOx4
Do you re-triage these patients once they’re brought into the staging area? If so, do any of the patients’ tag color change?
Who do you take first? To which hospital?
What interventions do you take when another patient is being transported?