Question

Scenario:

Your AMTRAK train has just derailed while crossing the Northern Plains of the U.S. during wintertime. Fortunately, you and your traveling companion (both trained in first aid) have escaped with minimal injury, but many passengers are injured in the rail cars that overturned. Emergency crews are limited in this remote rural area, and the severity of the weather is a major concern. As you arrive on the scene of the overturned cars you see that many injured passengers are being dragged from the wreckage. After a quick assessment of the injured and the available resources, you and your partner select a 10 year old child with obvious musculoskeletal injuries. Other bystanders are not available to help, since they are either involved with other victims or they have themselves sought out shelter.   This area does not have 9-1-1 service. Emergency services are being called in, but response times will obviously be more than 30 minutes, mainly due to location and number of victims involved. Decide what your assessment steps will be when approaching the scene and victim, how you will budget out the supplies you have at hand and what you will do with your victim until advanced help is available.

Your available resources include:

A single broken snow ski (one 3 ft. board)

A single short piece of debris (one 1 ft. board)

A blanket

Strips of cloth torn from clothing (triangular bandages)

Magazines

A pillow

Paper towels

One roll of gauze (luckily found in your travel gear)

You discover the following signs/symptoms:

• Closed fracture of the upper arm on the victim’s right side (arm presented bent) (no open wound)
• 4 in. laceration of the right upper leg (1/2 in. deep)
• Moderate to severe bleeding of the lower right leg at the sight of a protruding bone (leg presented straight)
• Small avulsion with bleeding on temple (just above ear) on the right side
• Large scrape with minimal bleeding (superficial) covering the majority of the left forearm
• Potential for Hypothermia due to weather conditions

1. What will your assessment steps be upon arrival? (The things you do and check upon recognizing that an emergency exists until you begin bandaging and splinting. Think back to the first four chapters of the NSC text.)

2. How will you use items from your resources to address the victim’s injuries? Describe what materials you will use for each injury and briefly describe how you will treat the injury/illness.

3. What will you do with your victim after you have completed first aid treatments? (Are you moving them or staying put and any additional steps you should take.)

Answer 1

. What will your assessment steps be upon arrival? (The things you do and check upon recognizing that an emergency exists until you begin bandaging and splinting. Think back to the first four chapters of the NSC text.)

- Check whether the person is conscious

-check for airway breathing and circulation

-check for the injuries

-stabilise the neck

- apply pressure bandage on the site of bleeding

-apply a sprint at the site of bone frature

- give the child some warmth to prevent hypothermia

- keep NPO

2. How will you use items from your resources to address the victim’s injuries? Describe what materials you will use for each injury and briefly describe how you will treat the injury/illness.

materials	injury
Blanket	hypothermia
single piece of snow ski, single piece of debris	- stabilise fracture -stabilize neck
triangular bandages	- temple injury

treat them

- elevate the leg

- cover the leg with gauze

- apply gauze with pressure on the laceration

- maintain patent airway

- watch for shock

- immediately shift to hospital

3. What will you do with your victim after you have completed first aid treatments? (Are you moving them or staying put and any additional steps you should take.)

-be there side and try to shift to hospital as early as posssible.