DOC

Patient Pepper Spray

By Amanda Henderson,2014-01-10 23:38
9 views 0
Patient Pepper Spray

1

    First Scenario Exterior Instructor Card

    (you may also play dispatcher)

    While outside, answer questions, pair „em up, &tell them:

    --“learn to identify major problems, you don‟t need to

    know what caused them—that‟s diagnosis.”

    --“you will see injuries that you might not know how to treat. Your job is to do no harm, practice within your

    limits, and get more help if needed.” --“It‟s 60 degrees and sunny” --form students into buddy pairs, tell them to always

    know where their buddy is.

    --run them around a bit to get their adrenaline up

    -give them a cell phone number to use as “911”

    Testing for improvisation

    Right when the first group is about to be chased inside,

    take gloves away from one of the medic pairs. They will

    have to improvise.

First Scenario Interior Instructor Card

    count how many cards you hand out, write it down, and be sure you

    get them all back before repeating the scenario second round….

    Ask who feels tired, who feels energetic. Give them the

    unresponsive and the seizure cards respectively. Ask for

    2-3 people who don‟t mind getting bloody. Tell them it‟s

    60 degrees and sunny.

    Make up: Give superficial wound above eyebrow of

    “bloody scalp wound” and a more subtle forehead wound

    to “closed head injury”, and battle signs and racoon eyes.

    Give this pt. the whiskey shirt or booze bottle.

    During scenario: Part way through, announce that the

    temperature has dropped to 40 degrees and it‟s raining.

    Testing for scene survey:

    When all patients seem close to being resolved, tell one

    medic pair that “a line of riot police is approaching. They‟re two blocks away, and are clearing the streets.

    They will be here in 5 minutes.” See what they do with

    this information. If they do nothing, “pepper spray” and

    “arrest” some of them. After this, they will be freshly

    reindoctrinated on the importance of continually doing

    scene survey, looking for dangers.

2

    First Scenario Injury/Patient Cards

Patient/Distraction/Consent: Bloody Scalp Wound

    You were running and bumped into a street sign and tore

    some skin off your eyebrow. Heads bleed a lot and that‟s normal and not life threatening.

    What your medic should do. Ask for consent. Do not give consent to the medic. Tell the medic to leave you

    alone. If you get left alone, continue to move around and

    see if you attract attention of other medics. Don‟t be a jerk, just be visible, to see if you elicit a response.

    scenario 1

    Patient: The hidden patient. In this scenario, most of the other patients will be lying

    down, spread out and visible on the floor. You role is to

    find a place in the room where you will not be too

    noticeable. Don‟t hide completely, but the students

    playing the medic role shouldn‟t find you immediately.

    If and when they do find you, they will try to see if you

    are responsive. Do not respond. Don‟t smile or open your

    eyes. Don‟t respond!

    What your medic should do. Call 911. Send for help from more highly trained medics. Build a wall of people

    around you to provide privacy and safety. Be nice.

    scenario 1

Patient/Distraction/Consent: Bloody Scalp Wound

    You were running and bumped into a street sign and tore

    some skin off your eyebrow. Heads bleed a lot and that‟s

    normal and not life threatening.

    What your medic should do. Ask for consent. Do not give consent to the medic. Tell the medic to leave you

    alone. If you get left alone, continue to move around and

    see if you attract attention of other medics. Don‟t be a

    jerk, just be visible, to see if you elicit a response.

    scenario 1

3

    Patient: Possible Head/Neck/Back Injury

    Sorry! You may have a broken neck.

    Signs and Symptoms: Lie on your back. You are conscious but dazed. You were climbing up a street

    signpost to get a better view and slipped and fell six feet.

    You don‟t remember how you landed. You don‟t feel any

    pain in your neck. You think you‟re probably okay. In

    fact, now you‟re not feeling dazed anymore. You want to

    get up, walk away, and go find the action.

    What your medic should do. Get consent (and you

    should give it). Ask what happened. Upon learning of the

    fall, the medic should stabilize your head and get more

    help, at least from a better-trained medic. The medic

    should strongly encourage you to not move. Ask “why?”

    The medic should tell you why you shouldn‟t move your

    head around or stand up.

    scenario 1

    Patient: Not Responsive We‟re not sure how this happened to you, but you are

    unconscious (breathing, and with a pulse). Your job is to

    remain unresponsive. Lie face down, eyes closed, and do

    not respond in any way to the medics.

    What the medics should do. Since they don‟t know how

    you got there, they shouldn‟t move you, and should

    activate EMS. Though we may not have taught it yet,

    they should keep close watch to be sure you are still

    breathing and have a pulse.

    scenario 1

    Distraction: Friend of patient You are best friends with the unresponsive patient. You

    brought her to the protest today. You lied to her parents

    telling them you were doing something else. Her parents

    are going to be very angry and punish her. Yes your

    friend isn‟t conscious but you want to get her back to her

    car so you can drive her home. Get in the way of the

    medics. Try to get into your friend‟s pockets to get the

    car keys out. You are frantic, and difficult to deal with.

    scenario 1

4

    Distraction: The helpful protestor

You want to help the medics who are treating injured

    people. No, you don‟t have any first aid training. Get right down by the patient where you‟re certain to be in

    the way. If the medic asks you to stand back or to

    perform a task, do it. Don‟t be weird, or a jerk in any way.

    We‟ve assigned that role to someone else. If no one gives

    you anything to do, move from medic pair to medic pair

    and offer to help.

    scenario 1

    Patient: Closed Head Injury Sorry, but you were hit on the head by a police club. As

    swelling forms around the injury site, pressure inside

    your skull increases, and your brain starts doing weird

    things. Over the course of the scenario, you will move

    from stage one to stage two symptoms. You do not have

    to present all these symptoms. Feel free to peek at the

    card to refresh your memory if needed.

    Signs and symptoms. Stage One: Slight disorientation, dizziness, some nausea, slightly “drunken” slurring and

    movement, headache, sleepiness. This progresses to

    Stage Two: Irritable/combative, more disoriented, really

    “drunk,” bad vomiting (if you wanna fake this, we can

    help you do so).

    What your medic should do. Get you to an emergency

    room as soon as possible and/or activate EMS.

    Variation: You stink of liquor or are clutching a beer

    bottle. This tends to make medics think you‟re drunk

    because the symptoms are almost identical.

    What your medic should do. Get you to an emergency

    room as soon as possible.

    scenario 1

5

    Patient: Seizure Sorry. You are having a seizure. Find a place on the

    ground where it will be safe for you to flop around a bit.

    Signs and symptoms. Your body tenses all its muscles

    and relaxes in quick waves. After a couple minutes you

    relax and lie there. Then gradually “wake up.” You will

    be disoriented. You are an epileptic so this isn‟t your first

    seizure. You missed taking your medicine last night and

    this morning in the excitement of preparing for the day.

    What the medic should do. Make sure you don‟t hit

    your head or hurt yourself. Nothing else. After the

    seizure, the medic should ask if you have had seizures

    before and if this seemed like a typical episode. Since

    you‟ve probably peed on yourself, the medic should

    arrange privacy and offer to help you change.

    scenario 1

    911 Dispatch script Your job is to demand that callers give you clear, calm,

    and concise information that is clearly prioritized. In other

    words, your job is to frustrate the medics. Don‟t let them

    get away with anythingthey are likely to be stymied by

    a real dispatcher, who will stonewall them until they

    deliver information properly. You are the gatekeeper. We

    recommend that you take notes, as you will get many calls

    and it will get hard to keep track of them. Including the

    time the scenario starts and the time of each call is useful

    feedback also. Here is a script you can work from

    improvise as needed, according to the call and the mood

    of the class:

    “911. Police, fire, or medical? From what phone number

    are you calling? What is your location? [must be exact

    address] What happened? How many patients are there? Is

    anyone with the patient? What are they doing? The police

    haven‟t declared that area secure yet, so we don‟t know

    when an ambulance will be able to reach you. Are you

    able to move your patient?”

    scenario 1

6

    Scenario 2 Exterior Instructor Card

    --Tell the medics that it‟s 98 degrees outside today and

    getting hotter.

    --Give a volunteer the Police Liaison card.

    --Be sure there aren‟t enough medics. send people inside

    if need be. Or give 1 or 2 medics the Medic Heat

    Exhaustion card.

    During Scenario: Potential police charge

    Have instructors form a line at the edge of the room. Pick

    one instructor to be the “scene commander.” Walk over to a medic pair and in the role of helpful bystander, tell

    them that it looks like the police are preparing to charge.

    Scenario 2 Interior Instructor Card

    count how many cards you hand out, write it down, and be sure you

    get them all back before repeating the scenario second round….

    Scene commander card: Make sure an instructor gets

    the scene commander card.Make sure another instructor

    gets the 911 Dispatcher script.

    Make up: Closed Head Injury gets wound on forehead, and NO battle signs/racoon eyes, since they aren‟t always present….

    --Internal Bleeding gets bruise on left side, over spleen

    --Pooling Blood needs a big piece of plastic sheeting

    taped flat on groundyou could have a big extra bit

    where Hidden Bleeding can share it. (without tape,

    people will trip and get blood everywhere). pour a half

    liter of fake blood in a pool in middle of plastic. have

    patient wear ruinable clothes and lie face down with

    abdomen in blood.

    --Dehydration/Hidden Bleeding must be positioned over

    plastic sheeting, and gets a ruinable shirt to wear. Fill a

    small ziploc bag with “blood,” and duct tape it to their

    back. Sit pt. somewhere against wall, where back isn‟t

    easy to see. Just before medics enter, snip a small hole in

    bag so it slowly but surely drips blood.

7

    Scenario 2, round 2, Instructor info. re: triage

    Have them try out the triage coordinator role in the

    second round of this scenario (or first round if you feel

    they‟re up for it). One instructor should shadow the triage

    coordinators and help them out. The coordinators will

    have a tendency to try to run around really fast and then

    they lose their ability to think straight. You can help them

    by having them walk around, calmly talk with each

    buddy pair, write stuff down, and then make decisions

    about who gets what. Make them walk, make them

    breathe, and try to teach them to block out all the

    distractions that are being thrown at them.

    Scenario 2 Injury/Role Cards

Triage Coordinator (round 2)

    Your job is to make sure every patient (if possible) gets

    at least a quick initial assessment (inc. ABCs), find out

    what‟s up with each patient without getting caught up in

    the care of a particular patient, and then prioritize

    personnel so that the most endangered patients get the

    most care. Other medics in the scenario have to trust their

    triage coordinators and perhaps leave their patients to go

    treat more seriously injured patients if so told. Triage

    coordinators have to trust that the medics at hand have

    done satisfactory assessments. Many assume that the

    triage coordinator role should go to the most experienced

    or most highly trained medics. This is not necessarily

    true. You may want to have someone with adequate skills

    who can see the big picture doing triage while the more

    highly trained are performing critical patient care.

    Scenario

    2

    Police Liaison Your job is to talk to the police. Ask to speak with the

    scene commander. Tell him/her 1) what you need, 2) why

    you need it 3) when you need it (now). Putting on

    attitude will not get you what you need. Your patient‟s

    needs are much more important than your ego. Scenario 2

8

    Patient: Pooling Blood

    Sorry, you are bleeding very badly from a wound in your

    abdomen. You are breathing, but unconscious. If the

    bleeding isn‟t stopped, you will be dead in about five

    minutes. You are also lying on your stomach, making

    access to your wound more difficult.

    What your medic should do. Get help, roll you over and apply direct pressure. Scenario 2

    Patient: Closed Head Injury Sorry, but you were hit on the head by a police club. As

    swelling forms around the injury site, pressure inside

    your skull increases, and your brain starts doing weird

    things. Over the course of the scenario, you will move

    from stage one to stage two symptoms. You do not have

    to present all these symptoms. Feel free to peek at the

    card to refresh your memory if needed.

    Signs and symptoms. Stage One: Slight disorientation, dizziness, some nausea, slightly “drunken” slurring and

    movement, headache, sleepiness. This progresses to

    Stage Two: Irritable/combative, more disoriented, really

    “drunk,” bad vomiting (if you wanna fake this, we can

    help you do so).

    What your medic should do. Get you to an emergency room as soon as possible and/or activate EMS.

    Variation: You stink of liquor or are clutching a beer

    bottle. This tends to make medics think you‟re drunk

    because the symptoms are almost identical.

    Scenario 2

9

    Patient: Internal Bleeding/Hypovolemic Shock

    Sorry! Yesterday, you were hit up under the ribs with a

    billy club on the first day of the protest. You don‟t know it, but your spleen is ruptured and you‟re slowly bleeding

    into your abdomen.. Yesterday you felt dizzy and thirsty.

    Signs and symptoms. Now, a day later, you are very irritable. You feel drowsy so go sit down someplace.

    Your breathing is shallow and rapid. When the medic

    takes your pulse, tell her it‟s very fast but weak. Your

    skin is pale.

    What your medic should do. The medic probably won‟t know what‟s wrong with you, but should know enough to

    recognize these red flags, call 911, and get help.

    Scenario 2

Patient: Dehydration/Hidden Bleeding/Hypovolemic

    Shock

    Sorry, you‟re dehydrated and you‟re slowly bleeding to

    death. You were standing with your back to a store when

    someone broke the window, showering you with glass. A

    big chunk slashed your back. Go sit down quietly on the

    floor someplace.

    Signs and symptoms. You are very thirsty. You haven‟t had anything to drink since last night. Tell the medics

    that you‟re very thirsty. We want the medics to focus on

    your thirst. You are exhausted and a bit irritable. Your

    breathing is shallow and rapid. When the medic takes

    your pulse, tell her it‟s very fast but weak. Your skin is

    pale.

    What your medic should do. The medic probably won‟t know specifically what‟s wrong with you but should

    know enough to recognize these red flags, call 911, and

    get help. You will not improve after drinking water.

    Hopefully, the medic will do a blood check and find the

    wound, applying direct pressure.

    Scenario 2

10

    Patient: Hypovolemic Shock Caused by Dehydration

    Sorry, this is what happens when you don‟t drink enough

    fluids. It‟s very hot, you‟ve been sweating, and you

    haven‟t had anything to drink since last night, when you

    had “a few cocktails.” Signs and symptoms. You are drowsy and very irritable. Your breathing is shallow and rapid. When the medic

    takes your pulse, tell her that it is very fast but weak.

    Your skin is pale.

    What your medic should do. The medic probably won‟t

    know specifically what‟s wrong with you but should

    know enough to recognize these red flags, call 911, and

    get help. She could also encourage you to drink water.

    Scenario 2

Patient: Heat Exhaustion Turning to Heat Stroke

    You have been running around in the streets in this heat

    for three days now, not drinking enough water, sweating

    a lot, and the squat you‟re sleeping in is overheated, even

    at night. Your body can‟t cool itself off.

    Signs and symptoms: As the scenario begins, you‟re sitting on the ground because you just fainted. You‟re

    awake again but dizzy and tired. If they check your pulse,

    it‟s very fast. You‟re very thirsty, your skin is damp, and

    you‟re irritable.

    What your medic should do. The medic probably won‟t

    know specifically what‟s wrong with you but should

    know enough to recognize these red flags, call 911, and

    get help. She should also get you out of the sun and

    encourage you to drink water. Early treatment is

    important. If your condition progresses to heat stroke,

    you only have a %50 chance of survival in the E.R.

    Scenario 2

Report this document

For any questions or suggestions please email
cust-service@docsford.com