CYCLE # TEAM # 5001 5002 5003 5004 5005 5006 5007 Did the team ASK for SITUATION HISTORY? 5008 Did the team DETERMINE the NUMBER OF CASUALTIES? 2 5009 Did the team ID SELF and OBTAIN CONSENT? 5010 5011 Did the team ASSESS LEVEL OF CONSCIOUSNESS? Fully Conscious 5012 Did the team ASSESS AIRWAY? Open 5013 Did the team ASSESS BREATHING? 28 shallow & irreg. crying 5014 Did the team ASSESS SKIN CONDITION (Circulation) Pale, cool & clammy 5015 Did the team PERFORM A RAPID BODY SURVEY? Major R arm injuries 5016 5017 5018 5019 SCENE/PRIMARY SURVEY Did the team TAKE CHARGE of the situation? Did the team wear protective GLOVES? Did the team ASSESS for HAZARDS? Did the team use Wheel Chock to prevent further movement of truck? Did the team verbalize to turn off the truck? Did the team CALL OUT FOR HELP? Did the team WARN THE CASUALTY NOT TO MOVE? Did the team lightly cover all 3 open bone ends to prevent further infection? Did the team IMMEDIATELY COVER WITH A BLANKET for shock and warmth? Did the team ACTIVATE EMS/AMBULANCE? Did the team ACTIVATE POLICE? (Workplace Injury) JUDGES NOTE: This section is active for the first 3 minutes of the scenario only! During these first 3 minutes, the competitor may perform the actions that are both listed here and in the Secondary Survey. After the 3 minutes, the competitor is eligible to receive marks only in the Secondary Survey and no marks may be awarded in this Primary Survey. Actions in this section may be done in any order. Score Sheet for Patient #1 - "Crushed Arm" Page 1 of 8
SECONDARY SURVEY Actions in this section may be performed by the competitor in the first 3 minutes of the scenario as well as the Primary Survey. After the 3 first minutes, this is the only section that points shall be awarded to. Actions in this section may be done in any order. HISTORY OF THE PATIENT 5020 Did the team ask about SYMPTOMS Severe pain R arm 5021 Did the team ask about ALLERGIES? None 5022 Did the team ask about MEDICATIONS? None 5023 Did the team ask about MEDICAL HISTORY? Previously healthy 5024 Did the team ask about LAST ORAL INTAKE? Ate meal as normal 5025 Did the team determine INCIDENT HISTORY? Truck check, rolled over arm 1st Set of VITAL SIGNS 5026 Did the team check LEVEL OF CONSCIOUSNESS? Fully Conscious 5027 Did the team check RESPIRATIONS? 28 shallow & irreg (crying) 5028 Did the team check PULSE? 130 bounding & rapid 5029 Did the team check SKIN CONDITION/TEMP? Pale, Cool & Clammy 5030 Did the team check PUPILS? Equal/Reactive HEAD TO TOE EXAMINATION 5031 Check SCALP/HEAD? No Findings 5032 Check both EYES? No Findings 5033 Check NOSE? No Findings 5034 Check CHEEKBONES? No Findings 5035 Check MOUTH? No Findings 5036 Check JAW? No Findings 5037 Check both EARS? No Findings 5038 Check NECK? No Findings 5039 Check both COLLARBONES? No Findings 5040 Check both SHOULDERS? No Findings 5041 Check RIGHT ARM? Open Fx R Upper, Open Fx R 2x Lower, Crushed hand, tire marks across arm 5042 Check LEFT ARM? No Findings 5043 Check CHEST? No findings 5044 Check ABDOMEN? No Findings 5045 Check BACK? No Findings 5046 Check PELVIS? No Findings 5047 Check RIGHT LEG? No Findings 5048 Check LEFT LEG? No Findings Score Sheet for Patient #1 - "Crushed Arm" Page 2 of 8
FIRST AID / TREATMENT Actions in this section may be performed by the competitor at any point in the scenario. Care for Right UPPER ARM - Open Fracture with 1 protruding bone 5049 Did the team CHECK CIRCULATION BEFORE BANDAGING 5050 Did the team APPROPRIATELY DRESS Bone end with padding? 5051 Did the team ELEVATE the arm using a STANDARD ARM SLING? 5052 Did the team SECURE the ARM to the CHEST using 2 WIDE BANDAGES? 5053 Did the team RE-CHECK CIRCULATION AFTER BANDAGING Care for Right LOWER ARM - Open Fracture with 2 protruding bones 5054 Did the team CHECK CIRCULATION BEFORE BANDAGING? 5055 Did the team APPROPRIATELY DRESS Bone end with padding? 5056 Did the team SECURE with 1 ABOVE & 1 BELOW to an APPROPRIATE size SPLINT? 5057 Did the team ELEVATE the arm using a STANDARD ARM SLING? 5058 Did the Splint used extend beyond the end of elbow to beyond end of fingers? 5059 Did the team RE-CHECK CIRCULATION AFTER BANDAGING Care for CRUSH INJURY to Right HAND 5060 Did the team CHECK CIRCULATION BEFORE BANDAGING 5061 Did the team PLACE DRESSING BETWEEN EACH FINGER? 5062 Did the team WRAP/BANDAGE all DRESSINGS APPROPRIATELY? 5063 Did the team SECURE HAND to an APPROPRIATE size SPLINT? 5064 Did the team ELEVATE the arm using a STANDARD ARM SLING? 5065 Did the team RE-CHECK CIRCULATION AFTER BANDAGING SHOCK & GENERAL CARE 5066 Did the team REASSURE the patient about their OWN CARE? 5067 Did the team RE-check LEVEL OF CONSCIOUSNESS? Fully Conscious 5068 Did the team RE-check RESPIRATIONS? 24 Shallow & irreg. crying 5069 Did the team RE-check PULSE? 118 Bounding & Rapid 5070 Did the team RE-check SKIN CONDITION/TEMP? Pale, Cool & Clammy 5071 Did the team RE-check PUPILS? Equal/Reactive 5072 Were GLOVES EFFECTIVE THROUGHOUT? (Torn gloves MUST be replaced!) Score Sheet for Patient #1 - "Crushed Arm" Page 3 of 8
RECORDING for Patient #1 - Crushed Arm 5073 Was ALL of the patients PERSONAL INFORMATION recorded? 5074 5075 5076 5077 5078 5079 5080 5081 5082 5083 Was the CRUSH INJURY to the Right HAND recorded? Vital Signs MUST be the CORRECTED #s & HAVE the TIME recorded, to be awarded points!!! 5084 5085 5086 5087 5088 5089 5090 5091 5092 5093 5094 5095 5096 5097 5098 5099 5100 5101 5102 Was the INCIDENT TIME AND DATE recorded? Was the INCIDENT LOCATION recorded? Was the INCIDENT HISTORY (Accurately) recorded? Was the patients ALLERGIES (None) recorded? Was the patients MEDICATIONS (None) recorded? Was the patients MEDICAL HISTORY (Previously Healthy) recorded? Was the LAST ORAL INTAKE (Ate last normal meal time) recorded? Was the OPEN FRACTURE to UPPER Right arm recorded? Was the OPEN FRACTURE to LOWER Right arm recorded? Was 1st set of vital signs - LEVEL OF CONSCIOUSNESS recorded? Was 1st set of vital signs - RESPIRATIONS recorded? Was 1st set of vital signs - PULSE recorded? Was 1st set of vital signs - SKIN CONDITION recorded? Was 1st set of vital signs - PUPILS recorded? Was 2nd set of vital signs - LEVEL OF CONSCIOUSNESS recorded? Was 2nd set of vital signs - RESPIRATIONS recorded? Was 2nd set of vital signs - PULSE recorded? Was 2nd set of vital signs - SKIN CONDITION recorded? Was 2nd set of vital signs - PUPILS recorded? Was the PRE-BANDAGING CIRCULATION of the RIGHT ARM recorded? Was the POST-BANDAGING CIRCULATION of the RIGHT ARM recorded? Was the BANDAGING of the UPPER ARM OPEN FRACTURE accurately recorded? Was the BANDAGING of the LOWER ARM OPEN FRACTURE accurately recorded? Was the BANDAGING of the CRUSHED RIGHT HAND accurately recorded? Was the Application of a BLANKET recorded? Was the NOTIFICATION OF POLICE WITH TIME recorded? Was the NOTIFICATION OF EMS WITH TIME recorded? Was the Name(s) of the first aid team LEGIBLY recorded? Score Sheet for Patient #1 - "Crushed Arm" Page 4 of 8
CYCLE # TEAM # 5103 5104 5105 5106 5107 5108 5109 5110 Did the team DETERMINE the NUMBER OF CASUALTIES? 2 5111 5112 5113 SCENE/PRIMARY SURVEY Did the team TAKE CHARGE of the situation? Did the team wear protective GLOVES? Did the team ASSESS for HAZARDS? Did the team use Wheel Chock to prevent further movement of truck? Did the team verbalize to turn off the truck? Did the team CALL OUT FOR HELP? Did the team ASK for SITUATION HISTORY? Did the team ID SELF and OBTAIN CONSENT? Did the team WARN THE CASUALTY NOT TO MOVE? Did the team IMMEDIATELY provide C-SPINE SUPPORT? 5114 Did the team ASSESS LEVEL OF CONSCIOUSNESS? Fully Conscious 5115 Did the team ASSESS AIRWAY? Open 5116 Did the team ASSESS BREATHING? 30 Shallow & rapid 5117 Did the team ASSESS SKIN CONDITION (Circulation) Pale, warm and dry 5118 Did the team PERFORM A RAPID BODY SURVEY? LAC to head, LEFT leg injuries 5119 Did the team Place an absorbant Gauze on the LAC to the head? 5120 Did the team IMMEDIATELY COVER WITH A BLANKET for shock and warmth? 5121 Did the team ACTIVATE EMS/AMBULANCE? 5122 Did the team ACTIVATE POLICE? (Workplace Injury) JUDGES NOTE: This section is active for the first 3 minutes of the scenario only! During these first 3 minutes, the competitor may perform the actions that are both listed here and in the Secondary Survey. After the 3 minutes, the competitor is eligible to receive marks only in the Secondary Survey and no marks may be awarded in this Primary Survey. Actions in this section may be done in any order. Score Sheet for Patient #2 - "Crushed Leg" Page 5 of 8
SECONDARY SURVEY Actions in this section may be performed by the competitor in the first 3 minutes of the scenario as well as the Primary Survey. After the 3 first minutes, this is the only section that points shall be awarded to. Actions in this section may be done in any order. HISTORY OF THE PATIENT 5123 Did the team ask about SYMPTOMS Dizziness, headache & Leg pain 5124 Did the team ask about ALLERGIES? None 5125 Did the team ask about MEDICATIONS? None 5126 Did the team ask about MEDICAL HISTORY? Previiously Healthy 5127 Did the team ask about LAST ORAL INTAKE? Ate (breakfast/lunch) as normal 5128 Did the team determine INCIDENT HISTORY? Trying to help worker, truck rolled on foot 1st Set of VITAL SIGNS 5129 Did the team check LEVEL OF CONSCIOUSNESS? Fully Conscious 5130 Did the team check RESPIRATIONS? 30 Shallow & Rapid 5131 Did the team check PULSE? 132 Boundings & Rapid 5132 Did the team check SKIN CONDITION/TEMP? Pale, warm & Dry 5133 Did the team check PUPILS? Equal & Reactive HEAD TO TOE EXAMINATION 5134 Check SCALP/HEAD? 2" LAC to back of head with moderate bleed 5135 Check both EYES? No Findings 5136 Check NOSE? No Findings 5137 Check CHEEKBONES? No Findings 5138 Check MOUTH? No Findings 5139 Check JAW? No Findings 5140 Check both EARS? No Findings 5141 Check NECK? No Findings 5142 Check both COLLARBONES? No Findings 5143 Check both SHOULDERS? No Findings 5144 Check RIGHT ARM? No Findings 5145 Check LEFT ARM? No Findings 5146 Check CHEST? No Findings 5147 Check ABDOMEN? No Findings 5148 Check BACK? No Findings 5149 Check PELVIS? No Findings 5150 Check RIGHT LEG? No Findings 5151 Check LEFT LEG? CLOSED Fx Tib/Fib & Crushed L Foot Score Sheet for Patient #2 - "Crushed Leg" Page 6 of 8
FIRST AID / TREATMENT Actions in this section may be performed by the competitor at any point in the scenario. Care for BLUNT FORCE HEAD INJURY 5152 Did the team SECURE DRESSING appropriately to head? 5153 Did the team MAINTAIN C-SPINE SUPPORT throughout Scneario (until fully immobilized?) 5154 Did the team REMAIN in CONSTANT Monitor of the IMMOBILZED patient? 5155 Care for Left LOWER LEG- Closed Fracture Did the team CHECK CIRCULATION BEFORE BANDAGING? 5156 Did the team Use 5 WIDE BANDAGES to IMMOBILIZE the Leg 5157 Did the team SECURE with 1 ABOVE & 1 BELOW to an APPROPRIATE size SPLINT? 5158 Did the team APPLY PADDING BETWEEN FRACTURE & SPLINT? 5159 Did the team RE-CHECK CIRCULATION AFTER BANDAGING 5160 Did the team APPLY AN COLD PACK with a barrier (not directly on the skin)? 5161 Did the team ELEVATE the Leg (6-12")? 5162 Care for CRUSH INJURY to Left FOOT Did the team CAREFULLY REMOVE CRUSHED SHOE/ FULLY EXPOSE the injury? 5163 Did the team CHECK CIRCULATION BEFORE BANDAGING 5164 Did the team PLACE DRESSING BETWEEN EACH TOE? 5165 Did the team WRAP/BANDAGE all DRESSINGS APPROPRIATELY? 5166 Did the team SECURE HAND to an APPROPRIATE PILLOW/BLANKET like SPLINT? 5167 Did the team ELEVATE the foot? 5168 Did the team RE-CHECK CIRCULATION AFTER BANDAGING SHOCK & GENERAL CARE 5169 Did the team REASSURE the patient about their OWN CARE? 5170 Did the team RE-check LEVEL OF CONSCIOUSNESS? Slow to Respond, but conscious 5171 Did the team RE-check RESPIRATIONS? 24 Shallow & regular 5172 Did the team RE-check PULSE? Rapid & Strong 5173 Did the team RE-CHECK Skin Condition/Temperature? Pale, cool & Dry 5174 Did the team RE-check PUPILS? Slow to Respond, equal but reactive 5175 Were GLOVES EFFECTIVE THROUGHOUT? (Torn gloves MUST be replaced!) Score Sheet for Patient #2 - "Crushed Leg" Page 7 of 8
RECORDING for Patient #2 - Crushed Leg 5176 Was ALL of the patients PERSONAL INFORMATION recorded? 5177 Was the INCIDENT TIME AND DATE recorded? 5178 Was the INCIDENT LOCATION recorded? 5179 Was the INCIDENT HISTORY (Accurately) recorded? 5180 Was the patients ALLERGIES (None) recorded? 5181 Was the patients MEDICATIONS (None) recorded? 5182 Was the patients MEDICAL HISTORY (Previously Healthy) recorded? 5183 Was the LAST ORAL INTAKE (Ate last normal meal time) recorded? 5184 Was the 2" LAC to BACK OF HEAD & BLUNT FORCE HEAD INJURY recorded? 5185 Was the CLOSED FRACTURE Left Leg Recorded? 5186 Was the CRUSH INJURY to the LEFT LEG recorded? Vital Signs MUST be the CORRECTED #s & HAVE the TIME recorded, to be awarded points!!! 5187 Was 1st set of vital signs - LEVEL OF CONSCIOUSNESS recorded? 5188 Was 1st set of vital signs - RESPIRATIONS recorded? 5189 Was 1st set of vital signs - PULSE recorded? 5190 Was 1st set of vital signs - SKIN CONDITION recorded? 5191 Was 1st set of vital signs - PUPILS recorded? 5192 Was 2nd set of vital signs - LEVEL OF CONSCIOUSNESS recorded? 5193 Was 2nd set of vital signs - RESPIRATIONS recorded? 5194 Was 2nd set of vital signs - PULSE recorded? 5195 Was 2nd set of vital signs - SKIN CONDITION recorded? 5196 Was 2nd set of vital signs - PUPILS recorded? 5197 Was the PRE-BANDAGING CIRCULATION of the Left LEG recorded? 5198 Was the POST-BANDAGING CIRCULATION of the Left LEG recorded? 5199 Was the BANDAGING of the LOWER LEG CLOSED FRACTURE accurately recorded? 5200 Was the BANDAGING of the CRUSHED LEFT FOOT accurately recorded? 5201 Was the C-Spine Support recorded? 5202 Was the Application of a BLANKET recorded? 5203 Was the NOTIFICATION OF POLICE WITH TIME recorded? 5204 Was the NOTIFICATION OF EMS WITH TIME recorded? 5205 Was the Name(s) of the first aid team LEGIBLY recorded? Score Sheet for Patient #2 - "Crushed Leg" Page 8 of 8