Section V: Patient Data and Baseline (PATIENT #2) Scenario States, Modifiers and Triggers Patient State Patient Status Learner Actions, Modifiers & Triggers to Move to Next State 1. Preparation - Assigns to team members prior to patient arrival - Prepares equipment 2. Baseline State Unresponsive. Learner Actions Modifiers Rhythm: asystole - IV, O2, monitors Changes to patient condition based on learner action HR: 0 No gag with - ± Continue CPR - 2 minutes or attempt BP: 0 oral airway. - Cardiac POCUS to assess for thoractomy 2nd patient arrives RR: 14/min cardiac activity: reasonable to - Epi/CPR no ROSC (bagged) call code if none - Needle decompression air O2SAT: 75 % NRB - Level 1 transfuser - Finger thoracostomy air and T: 35oC - Call for pRBC (O+), transfuse blood back bilaterally 2 units rapidly - tube insertion 500cc on L - Bilateral finger thoracostomy and 600cc on R, O2 82% ± chest tube insertion - Intubation O2 84% - Check pelvic binder placement - Intubation Triggers - ± Epi 1mg IV q2-3 min For progression to next state - ± FAST exam - Team leader decides to end - ± TxA 1g IV over 10 mins resuscitation END CASE - Consider calling code
Scenario States, Modifiers and Triggers Patient State Patient Status Learner Actions, Modifiers & Triggers to Move to Next State 1. Preparation - Assigns to team members prior to patient arrival - Prepares equipment 2. Baseline State Rhythm: asystole HR: 0 BP: 0 RR: 14/min (bagged) O2SAT: 75 % NRB T: 35oC Unresponsive. No gag with oral airway. Learner Actions - IV, O2, monitors - ± Continue CPR - Cardiac POCUS to assess for cardiac activity: reasonable to call code if none - Level 1 transfuser - Call for pRBC (O+), transfuse 2 units rapidly - Bilateral finger thoracostomy ± chest tube insertion - Check pelvic binder placement - Intubation - ± Epi 1mg IV q2-3 min - ± FAST exam - ± TxA 1g IV over 10 mins - Consider calling code Modifiers Changes to patient condition based on learner action - 2 minutes or attempt thoractomy 2nd patient arrives - Epi/CPR no ROSC - Needle decompression air - Finger thoracostomy air and blood back bilaterally - tube insertion 500cc on L and 600cc on R, O2 82% - Intubation O2 84% Triggers For progression to next state - Team leader decides to end resuscitation END CASE Section V: Patient Data and Baseline (PATIENT #2)
multitrauma-cric-and-blunt-vsa-case.docx