Pedestrian Struck

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Scenario Professional Responder FR EMR

Trauma 1.10

Multi-System Trauma – Pedestrian struck

CALL DETAILS: You are dispatched to a pedestrian who was hit by a car while crossing at a crosswalk and thrown approximately 30 feet. Police are on scene as you arrive, and you notice a patient lying supine motionless on the street. There are a couple of bystanders beside the patient. Emergency service units are arriving along with you. It's a warm, sunny day.

ROLE PLAYER INSTRUCTIONS: Patient Role-Player Instructions: Occasionally moan when your legs are touched. You have a severe head injury and multiple injuries to your left side: humorous/bi-lateral femur fractures. Don’t respond when the responder asks a question. Instead, mumble random, unrelated words in a very drowsy-like state. Do so randomly, not when asked. Then stop after primary assessment.

NOTE(S):

SCENE ASSESSMENT FINDINGS/OBSERVATIONS

Environment

Daylight; sunny; warm; busy city street

Hazards

Patient is lying in the street; bystanders; traffic

MOI/Chief Complaint Struck by car; multiple injuries; unresponsiveness # of Patients 1 Resources

Police on scene; fire unit and ambulance responding

PPE Gloves; eye protection PRIMARY ASSESSMENT FINDINGS/OBSERVATIONS

Introduction

Responder IDs self and agency

Patient Appearance

Unresponsive; multi-system trauma; obvious head injury

LOR

P/9 (makes occasional moans when legs touched)

SMR

Manual stabilization (MOI)

Airway

Open; clear

Breathing

Present; slightly elevated

Circulation

Present; elevated; weak radial Professional Responder | Scenario | 1 of 2 Copyright © 2018 The Canadian Red Cross Society

PRIMARY ASSESSMENT CONT’D FINDINGS/OBSERVATIONS

Skin

Pale; cold; clammy (diaphoretic)

SpO2

88% (RA)

Rapid Body Survey

Head injury; large contusion/hematoma on right side of head; very slow response to pain stimuli applied on uninjured arm; moans; abrasions; left side bi-lateral closed femur fractures; left humorous (open) fracture; moderate bleeding

Transport Decision

Rapid transport (RTC)

Patient Positioning

Lying supine in the street

SECONDARY ASSESSMENT INTERVIEW

FINDINGS/OBSERVATIONS

PAIN

FINDINGS/OBSERVATIONS

Signs/ Symptoms

Head injury; multiple system injuries; decreased LOR

Onset

Rapid – on impact

Allergies

NKA

Pain

Some withdrawal on palpation

Medications

NKM

Quality

Unknown

Past Medical Unknown History

Radiate Unknown

Last Oral Intake

Unknown

Severity Unknown

Events Prior

Hit by a car travelling approximately 70km/h while trying to cross the road

Time

VITAL SIGNS

10 minutes ago

HEAD-TO-TOE PHYSICAL EXAMINATION SET 1

SET 2

FINDINGS/OBSERVATIONS

Pulse

120 rapid; weak; carotid

100 weak; carotid

Head/Face

Contusion/hematoma on right side of head; abrasions

Respiration

28 shallow

20 irregular; shallow

Neck

Deformity noted on palpation

Blood Pressure

140/70

150/70

Chest

Multiple abrasions/contusions (found when exposed); unequal expansion

Pupils

PEARL

Unequal; sluggish to react

Abdomen/ Pelvis

Rigidity noted on palp RUQ; pelvis unstable

Skin

Pale; cold; clammy

Pale; cold; wet

Back

No obvious deformities

LOR/GCS

P/9

U/6

Upper Extremities

Open left humorous fracture

SpO2

88% (RA)

94% (RA)

Lower Extremities

Bi-lateral femur fractures (open)

Body Temp.

36

No change

Neurological U/6 (unable to fully assess CNS on extremities and

BGL

6.9 mmol/L

No change

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