You are working as a double Paramedic crew on an Ambulance. A call comes in for a disturbance at a residential property, there has been reports of a stabbing. Police have already been dispatched.
On arrival of the property there are numerous Police cars and staff on scene, they explain the assailant has been arrested and is now on their way to the cells. They show you into the property explaining a woman has been stabbed a number of times.
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You enter the kitchen where there is a significant amount of blood on the floor and across the cabinets. A woman is slumped on a chair looking very pale with a reduced GCS. She is pressing her hands against a section of her abdomen where you can see blood dripping through. Multiple police officers are attempting to help the woman by holding her on the chair and pressing on what wounds they can see.
What is your first priority?
You manage to get most of her clothing out of the way to expose where any obvious haemorrhages are stemming from. Your initial focus is directed to a deep laceration/penetration to the lower left quadrant of her abdomen which she is putting her hands on. What actions can you do to stop the bleeding
You apply the dressing and get one of the officers to place pressure on the site. Very quickly you see the flow of blood saturate the dressing and the bleeding continues. You apply a further dressing and pressure but the haemorrhage continues. What further action can you take to stem the bleeding
The packing of the wound with pressure from the dressing manages to control the haemorrhage from the abdomen. While you completed this, your colleague has been trying to control another haemorrhage from the lower right thigh. They have also packed and dressed the wound with pressure but blood continues to flow form the site. What actions can you to further stop the haemorrhage
The tourniquet stops the haemorrhage from the limb. There are other wounds across the patients’ arms and sides, you do a quick assessment of them but they are more superficial, not haemorrhaging. At this point, the patient seems to be losing consciousness and she is gently lowered to the floor by the police. On the floor, you assess and feel a weak carotid pulse and rapid breaths. You feel you have managed any initial Catastrophic Haemorrhages, what is your next assessment
You quickly look into the airway and see it is clear. You consider and are aware of potential C-spine issues due to the trauma sustained. A police officer is supporting her head and neck for this. In a major trauma situation when looking at Airway and Breathing, what should you administer for further support
You place the O2 on the patient and continue with your assessment moving onto breathing. The patient has a number of small wounds to her chest. What assessment pneumonic can be used to quickly and thoroughly assess Breathing
As you work through FLAPS TWELVE, on searching the back and sides you note a penetrating stab wound under her right armpit. You note that when the patient breathes, there is an almost ‘sucking’ action of the wound. What type of wound is this and what treatment do you give
You apply the dressing to the wound and are happy with the rest of the Breathing assessment. Your colleague is busy getting bilateral IV access while you continue with your Circulation assessment. Whilst assessing circulation, what should you reassess
You recheck all Haemorrhage sites and confirm any haemorrhage is still being controlled. Your colleague has gained IV access. What other drug may you consider to help with haemorrhage control process
Your colleague manages the TXA while you are made aware that another Ambulance has arrived. You ask the officer to relay a message that you need a scoop and extrication brought in. You move onto Disability and Exposure. You note the patient is P on AVPU and feels cold with a temperature of 35.1 ⁰c. What should you do for the patient
You place a space blanket with other blankets on the patient to keep them warm. What triad is hypothermia a part of
Your colleagues come in with a scoop and stretcher ready to extricate the patient. On lifting the patient from the floor, what movement do you want to avoid for the unnecessary disruption of clots