Patient is a wounded soldier in a desert area suffering from multiple traumatic injuries. Patient had been passenger in a humvee when an IED was triggered and rolled the humvee, throwing the patient and causing serious injury. Participant starts case next to patient, who is confused and is in severe pain. A relatively unharmed soldier from the unit is standing nearby and can give further history. On exam, the patient is found to be tachycardic, but with otherwise stable vital signs, with a GCS E3V4M6, diffuse abdominal tenderness to palpation, LUQ most, and an obvious right tibial mid-shaft fracture with intact distal pulse and sensation. The participant must then use their portable ultrasound to conduct an EFAST exam, identifying fluid in the LUQ and behind the bladder, use their unit information to identify that the NPC soldier is a viable donor, and begin treatment. The participant must secure IV access to the patient and give pain medication, then they must collect one pint of blood from the donor and then have the donor administer that blood to the patient via syringe push. The participant must then re-constitute and administer 1 unit of freeze dried plasma and a single dose of TXA. Once blood and medications have been given, the participant must dress the leg wound, apply a splint to the leg, and give antibiotics. Finally, the participant must radio for evacuation instead of just waiting for the nearest Forward Surgical Team to arrive.
Emergency medicine, Prehospital, Trauma
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