Question
Directions: Write a one page response for numbers 1 through 4. Write a two page response for number 5.
1. Suppose you are the First Responder on scene. You find the patient has an altered mental status and appears to be injured. Apparently, he fell 12 feet from a tree he was trimming. His family will not allow you to assess or provide care to him, and they are re insisting they need to move him into the main house. You call medical direction for assistance in convincing them not to move the patient until the paramedics arrive on scene. What information will the physician need before he/she can help you?

2. You and your partner have been called to the scene of “two elderly women down.” When you arrive, a policeman who found the women meets you. As he walks you to the patients, he assures you that the scene is safe to enter. What step in your initial assessment should you perform first? Your partner takes responsibility for the unconscious patient. He finds her unresponsive. What should he/she do to assess her airway and breathing?

3. Regarding the scenario in #2, you take responsibility for the conscious patient, who you find confused and unable to follow directions. What should you do to move her? Be specific and give examples.

4. You are called to the scene of an unresponsive man in his backyard. As you begin scene size-up, you see the patient lying on the dirt just outside of his tool shed. It looks as if he was working on an old, freshly stripped door, which is flat on top of two sawhorses. On the ground beside the patient is a power sander, not running. You and the patient’s wife are at the patient’s side. Your initial assessment found him to be unresponsive, with adequate respirations, a rapid weak pulse, and skin that is very dry and somewhat flushed. There are no signs of injury. While you wait for the EMTs to arrive with an ambulance, you follow local protocol and administer oxygen to the patient. What else should you do? Gather the patient’s history from his wife or conduct a thorough physical exam? Explain your answer.

5. You are called to an accident at a new home construction site. Scaffolding collapsed and sent two workers to the ground. One person on the ground was struck by falling pieces of scaffolding. What hazards should you expect to be present? What resources and additional assistance should you request from dispatch? What factors would you consider when evaluating the mechanism of injury? Write a report of this event.

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