This is a prehospital scenario with two patients at the scene of a high speed motor vehicle accident which is secondary to the elderly driver having a cardiac event due to a complication of atrial fibrillation with rapid ventricular response. One patient is a middle aged male who is ambulatory without significant injuries. The second is an elderly male, who will be conscious but with an altered mental status lying next to the car with right sided pneumothorax and irregularly tachycardic. If the pneumothorax is identified within the first 5 minutes of the case and learners complete needle decompression, the patient will stabilize. If learners fail to recognize it the patient will clinically deteriorate eventually to cardiac arrest.

Learning Objectives

– Perform primary airway assessment
– Perform needle decompression to alleviate pneumothorax
– Call and give a report over handheld radio
– ID clinical deterioration and calls for help