Question

Scenario 1: You see a skateboarder going down a hill and suddenly lose control, crashing into the gravel on the side of the bike path. The skateboarder was wearing a helmet and did not hit their head on the ground when they fell. You walk over to the skateboarder to see if you can help them and notice them struggling to sit up and moaning in pain. You notice blood on the pavement and look to find a large deep gash on the skateboarder’s thigh that is spurting blood. You are first aid certified and want to help. (1) What are the initial steps you should take when responding to this emergency? (2) How would you determine what your plan of care would be, and how would you care for the victim? Describe in detail.

Scenario Continued: You have been applying pressure to the thigh with gauze pads, but the bleeding still continues and is still spurting. (1) With this new information how would you change your care? Describe in detail.

Scenario 2: You are playing a pickup game of basketball with your friends. During the game, one of the players trips over an untied shoelace and falls forward. As they are falling, they put their hands out in front of them to break their fall. They fall to the ground then yell in pain. You look over at them and they are sitting on the ground holding their arm close to their body. When you look at the arm you can see that their elbow is pointed at a weird angle and there is an obvious bump on the back of it. The athlete says that they felt a pop and they are unwilling to move their arm. (1) Describe in detail the initial steps you would take in this situation. (2) Explain how you would determine what your plan of care for the athlete should be.

Scenario Continued: You have determined that the athlete has dislocated their elbow and they need more medical attention. (1) Explain what steps you would take when giving care for the athlete. (2) When would you stop providing care for the athlete?

Answer 1

Answer

Scenario 1:

(1) As we can see the patient is in bleeding and pain, the first step in first aid is to elevate the wound above heart and stop bleeding by applying direct pressure on the wound or cut using a clean piece of cloth, tissue or gauze. Also, comfort the patient verbally during the procedure.The second step is to clean the wound area with warm water, if available.The third step is to protect the wound and apply antibiotic cream,if available and cover with sterile bandage. Advise him to get a tetanus shot to avoid sepsis and infection.

(2)The selection of plan of care depends on the condition of the patient, severity of wound, blood loss etc.In this case, the patient is presented with a deep injury on thigh with no head injury.Thus, the best care plan is to stop bleeding with the help of a clean cloth by applying direct pressure on the wound area.Cleaning the wound with warm water and applying an antibiotic cream would be better. Cover the wound with a sterile bandage,if available.As the wound is deep,helping him to consult a nearby nursing home would be recommended for completing the care needed.

Scenario continued:

(1) As you can still find spurting of blood from the wound, which may be caused by bleeding from artery, and, may not clot and stop fastly, call out someone for help or directly call 102 youself and take the patient to a nearby hospital for better care.Meanwhile, use more pieces of clean cloth without disturbing or removing the pad or cloth soaked in blood, as it may disturb any blood clots that have already formed.Continue applying direct pressure and stay with the patient elevating the wound, until medical help arrives.

Scenario 2:

(1) As they are in severe pain unable to move their arm and we find the elbow in a wierd angle with a bump on the back of it, it may be due to dislocation of elbow due to fall. So, the main point is to leave the joint without moving it as it can damage blood vessels,ligaments, muscles etc. Application of ice, if available can reduce swelling and ease pain to a great extent.Call 102 yourself or ask someone to help.

(2) Here, the plan of care should be determined according to the severity of injury and condition of the athlete.First of all, the elbow should not be moved. Application of ice and pain killers can reduce the pain.Consulting the orthopedician for specific care is recommended.

Scenario continued:

(1) An elbow dislocation occurs when the forearm,i.e. radius and ulna move out of palce compared to humerus bone of upper arm. As elbow is the joint combining all these bones, this dislocates it. It requires a medical care when you have severe pain, inability to move the joint, lose feeling in hand or absence of pulse.Powerful analgesics will be given prior to relocating of joint by the doctor. Then, X-ray will be taken and examined and a splint will be put to keep the elbow bent and to prevent the movement of arm.Usually,the armwill be placed in a sling to keep intact.

(2) After the above mentioned medical care is provided to the athlete, he is ready to be sent home.Advise the patient to wear splint and avoid moving elbow and apply ice to reduce swelling.