EMT Lesson Plans

9.02

Situation: 20-year old shot in chest during drive-by

FINAL TRAUMA 2

Scene Size-up: Safety:

Scene is safe

BSI:

Gloves

Patients: 1 Mechanism/Nature: MOI – gunshot Resources: ALS

Sucking chest wound with blood bubbling

Primary Assessment: General Impression: Young man on ground supine not moving Mental Status: Responsive only to pain Airway: Patent Breathing: 42 per minute, shallow, diminished sounds Circulation:

Rapid thready radial, pale sweaty skin, no bleeding

Desired Response: Primary then Rapid scan, transport, vitals / full body scan enroute

Rapid Scan: Head:

Full Body Scan: Head:

Unremarkable

Unremarkable

Neck:

JVD, Trachea deviated

Neck:

JVD, Trachea deviated

to right side

to right side

Chest :

Sucking chest wound with blood bubbling

Chest :

Sucking chest wound with blood bubbling

Abdomen:

Unremarkable

Abdomen:

Unremarkable

Pelvis:

Unremarkable

Pelvis:

Unremarkable

Extremities:

Unremarkable

Extremities:

Unremarkable

Posterior :

No exit wound

Posterior :

Unremarkable

Vitals: 1

2

3

OPQRST: O:

SAMPLE: S:

Pulse: 112

118

122

N/A N/A N/A N/A N/A N/A

Unobtainable Unobtainable Unobtainable Unobtainable Unobtainable Unobtainable

P: Q: R:

BP:

106/70

98/64

84/50

A:

M:

Resp:

42

44

48

P: L: E:

S: T:

SPO2: 92

89 86 (improve SPO2 if patient is bagged)

OTHER: If they seal the wound with a three-sided dressing, during transport tell them that the bag is becoming difficulty to squeeze. If they reassess the dressing, tell the students the dressing has become bloodied and is sticking to the area and no longer providing a 1-way valve effect