You are working as a solo responder on the 09-1700 shift. Your day so far has been uneventful with a few routine calls. You’re well into the second half of your shift when your radio goes off. You look at the MDT screen and see a call for a traumatic injury at a building site not too far away. Details aren’t fully clear, but there seems to be an arm injury involved with a lot of bleeding. You respond to the site, where a builder greets you at the entrance. In a full panic, he instructs you to follow the other builders up ahead who are frantically waving.
You pull around a corner by a porta-cabin and see a load of workers frantically running around a man on the floor covered in blood. There is a large excavator nearby with blood on its side and what looks like an arm on the floor.
0 of 9 Questions completed
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading…
You must sign in or sign up to start the quiz.
You must first complete the following:
0 of 9 Questions answered correctly
Time has elapsed
You have reached 0 of 0 point(s), (0)
Earned Point(s): 0 of 0, (0)
0 Essay(s) Pending (Possible Point(s): 0)
Well done on completing the quiz. You need to score 70% or more in order to get a certificate. When you pass your quiz remember to download your certificate as proof of completing this quiz. Try and score as high as possible to show your knowledge on this subject.
A quick view around the scene seems safe. The builders come up to you frantically and try to explain that he has somehow got his arm wedged between the machine. The driver wasn’t aware and pulled away, which then pulled his arm off.
Standing next to the patient, he is lying supine on the floor, looks very pale, there is significant blood loss. His left arm has been amputated around mid humerus and there is a heavy flow of blood coming from the limb. What is your first action
You’ve applied the cat tourniquet and the bleeding has slowed to a slow flow. Is it safe to move on to airway assessment now
What can you further do in the limb catastrophic haemorrhage management to stop the bleeding
You apply the second cat tourniquet above the first and the bleeding has now stopped. Are you now able to move onto airway assessment
You move onto airway, the patient is lying supine with their mouth open as they are in a state of terror and shock. You see no obvious obstruction or airway trauma. The builders say the patient didn’t get thrown and there was no trauma to his back. Given that he is supine you are ok with the C-spine for the moment.
You assess breathing and his respiratory rate is around 30 per minute. Is O2 advised for all patients with critical trauma
You finish your breathing assessment and move on to circulation. What should you check in relation to the treatment you have already given
You check the amputation and see that blood has slowly begun to flow from the site again. What can you further do
The gauze and pressure bandage seemed to have worked. You continue to check other areas where bleeding may be possible but are happy that the main trauma is to the arm. You gain IV access to the other arm, and get some basic observations done. BP 79/38, O2 saturations 94%, Heart rate 135, Respiratory rate 29. What drugs might you consider giving if no contra-indications are present
You administer TXA and some fluids aiming at 90 mmHg systolic. You give IV paracetamol as morphine is contra-indicated due to his BP being 67/32.
Back up is just arriving as you finish your treatments and begin to re-evaluate. What further consideration priority should you look to manage with the patient