Last Tuesday’s training at a cold Clearbrook was based around the Penmacra challenging scenarios (trauma). The attendees were split into 4 groups and each took a turn to attempt each scenario with points given for their attempt and bonus points given for background knowledge. Congratulations to the winning team.
All four scenarios plus a couple more are in the briefing attached and as you can see they are detailed and aimed at Casualty Carers and HCPs so are difficult. On Tuesday we did four scenarios.
1. Traumatic Cardiac arrest – Key points are that the UK Resuscitation Council recommends that traumatic arrests the reversible causes of the areas are treated before the CPR is commenced using the “HOT” principle.
2. Femur and pelvic injury
3. C spine injury
4. Entrapment injury
Key points are that the UK Resuscitation Council recommends that traumatic arrests the reversible causes of the areas are treated before the CPR is commenced using the “HOT” principle. This is because for example if someone is bleeding out of wound CPR will do nothing except increase blood loss and with the same principle with lack of oxygen.
1. Hot –
- Hypovolemia (blood loss) in our case stop any external or internal bleeding (ie dressings or pelvic splints etc)
- Oxygenate – Give oxygen correct hypoxia
- Tension Pneumothorax – Needle decompression (HCP only)
In reality, though at MREW team level we can only do so much due to skill level and equipment, so early CPR would take place. This is just to make you aware what is taught to Paramedics and so if they tell you to stop CPR you will know why.
2. In arrests asking for back up immediately is paramount so the ambulance is on the way. A more detailed ATMIST can follow later. The longer you don’t ask for back up the longer you will be doing CPR
3. All did well in the entrapment scenario, placing a tourniquet above the entrapment area will stop all the toxin build-up being released potentially causing organ failure and potentially cardiac arrest.