Two casualty scenario

Scenario:

Choose a convenient grid reference for your team to navigate to. Ideally choose a grid reference on uneven terrain where a casualty can be out of sight to add to the challenge.

You are a team of medics working with the Edale MRT. An injured hiker has been found by a member of the public, disorientated, and confused at grid reference X. You may use any of the kit you have with you. Please take a few minutes to establish roles and a plan if you wish.

Casualty 1: Casualty is in visible spot, in the sun.

D: nil

R: casualty is confused and disorientated, unsure where they are or what happened. If asked explicitly if they were walking with someone, explain that they had a hiking partner ‘X’ who got injured yesterday, has been walking lost since trying to find help.

A: talking to medics.

B: RR is 15, chest expansion equal and symmetrical, O2 sats are 98%.

C: HR is 95 bpm, BP is 105/75mmHg, cap refill is >2 sec, heart sounds normal.

D: temperature is 38.9C, blood glucose is 3.6, skin is dry, pupils equal and reactive to light.

E: secondary survey is normal, no injuries of note.

Priorities: patient dehydrated, hypoglycemic and mildly hyperthermic, establish the presence and whereabouts of a second casualty early on. Appropriate division of resources and skills, including kit. Leadership and communication.

Casualty 2: Casualty 2 is in an inconvenient location, wedged between rocks/trees/dip in ground, hidden from sight. Casualty explains that they had a fall whilst out walking, their friend left them with the remaining food and water and went to find help.

D: nil

R: talking, not confused. Patient complains of pain.

A: talking to medics, airway patent.

B: RR is 18, chest expansion symmetrical, auscultation normal breath sounds. O2 sats 98%. 

C: HR is 89 bpm, BP is 121/83mmHg, cap refill is <2 sec, heart sounds normal.

D: temperature is 37.1C, blood glucose is 4.7, pupils equal and reactive to light.

E: fractured ankle, patient complaining of being in pain.

Priorities: provide analgesia and splinting, communication regarding evacuation and who is priority for evacuation.