You arrive on scene and see police and crowds of people everywhere. 2 Police officers call you to the front garden of the property where you see a male in his 20’s, semi-conscious, covered in blood. The two Police officers are placing pressure on a stab wound on his front thigh. You note a significant pool of blood surrounding the patient, his breathing is very poor and noisy, and he looks very pale and clammy. What is your first priority

You note the catastrophic haemorrhage and can see blood still spurting from the thigh wound despite the Police officers’ pressure. What action should you do first for a limb catastrophic haemorrhage

You apply a tourniquet above the wound a tighten it until you can’t any more. The patient starts to grimace and moan, putting his hand to the tourniquet. Despite the tourniquet being applied, blood continues to flow from the wound. What next step should you take

The second tourniquet is applied and the haemorrhage has now stopped. The Police officers move away, but you note that blood is continuing to pool around the patient. For a full assessment of the trauma patient, what should you do to help identify injuries 

You remove all clothing while maintaining patient dignity and warmth. You see an additional stab wound in the patients’ right flank. Blood is flowing from the wound. What first action can you apply to manage the injury

You dress and bandage the wound with pressure, and this stops the external bleeding. You quickly further assess for injuries but there are no more. Next you move onto the airway. The patient has slow breaths and snores with each inspiration. A quick look into the airway shows no obvious signs of obstruction. Basic airway maneuvers fail so you move to an OPA. Your colleague grabs the patients’ side and asks you to help put them in a recovery position to help protect the airway. Is this advisable within the scenario

You explain the possibility of disrupting formed blood clots on moving the patient and keep them in the supine position. Applying the OPA helps manage the snoring but the patient is still only breathing at a rate of 4 per minute. You grab a BVM and start ventilating. In oxygenation and ventilating a patient, what should be applied to all major trauma patients 

You begin ventilating the patient with 100% oxygen and continue to monitor their airway. Your colleague continues with a FLAPS TWELVE breathing assessment. As part of the breathing assessment, why is it important to also assess the patients’ back 

Searching the back shows no further injury and your colleague states there are no further deficits on the FLAPS TWELVE assessment. They continue with their examination feeling for pulses and checking haemorrhage management. The patient has very thready radial pulses at a rate of 130, and all haemorhage control measures are managing. The saying blood on the floor plus 4 is a useful tool to help identify external and internal haemorrhage. What make up the ‘plus four’ elements 

Following assessment, you suspect the patient has potential internal abdominal haemorrhage. A second ambulance arrives on scene and a Paramedic crew approaches you with further equipment. What do you include in your handover