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You and your dad are rummaging around the attic looking for old memorabilia from your childhood glory days, when all of a sudden you hear your dad yell for help as he falls down the attic stairs. You climb down the stairs and immediately notice what appears to be a fairly deep laceration to his left leg. You also notice that his right shoulder is now much lower than his left shoulder and you must assume it was dislocated from the fall. How would you handle this scene from start to finish?
edit- spelling
Appreciate the help! :)
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Assess for response- Conscious or not conscious?
Airway, breathing circulation?
Far more interested in spinal trauma than the shoulder ?fracture/dislocation
If conscious and maintaining own airway- direct pressure, elevation, indirect pressure, dressings, haemostatic agent as required for the laceration, otherwise keep in position found, make as comfortable as possible without moving, request ambulance and maintain spinal immobilisation until they arrive.
Not conscious?- jaw thrust for airway, check for breathing, deal with the bleeding as above, call 999, maintain spinal immobilisation with jaw thrust until ambulance arrives.
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Not conscious?- jaw thrust for airway
As jaw thrust is not taught EFAW or FAW it would have to be head tilt/chin lift. Plus, if person was on back unconscious then recovery position if you had to leave him to call for help.
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Originally Posted by: bjacks77  Not conscious?- jaw thrust for airway
As jaw thrust is not taught EFAW or FAW it would have to be head tilt/chin lift. Plus, if person was on back unconscious then recovery position if you had to leave him to call for help. that would be true if I were EFAW or FAW trained...but I'm not.
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Originally Posted by: stud01 You and your dad are rummaging around the attic looking for old memorabilia from your childhood glory days, when all of a sudden you hear your dad yell for help as he falls down the attic stairs. You climb down the stairs and immediately notice what appears to be a fairly deep laceration to his left leg. You also notice that his right shoulder is now much lower than his left shoulder and you must assume it was dislocated from the fall. How would you handle this scene from start to finish?
edit- spelling
Appreciate the help! :)
FAW - Firstly always start with DRsCAB...
- Dangers, is it safe for you to approach, approach casualty site safely. minimising any movement of the casualty (Mech of Injury), only move casualty if its not safe to leave them there. Ensure you have protective gloves on! 'BSI for my buddy and I' (Body Substance Isolation)
- Responses - where is the casualty on the A.V.P.U scale? Ask q's, give commands, pinch for a pain response 'DO NOT SHAKE'
Shout for Help - is there anyone else in the house that can assist send for help, use your mobile the list goes on...
Catastrophic Bleeding - stop it ASAP with traditional methods
Airway - does the casualty have an airway? if talking, then obviously yes, consider C Spine Control leaving casualty in position found...
If no airway give airway via level of training provided... FAW = Head Tilt Chin Lift
Yes there will be the obvious issue of spinal injury but if no airway thats the least of the casualties issues.
Breathing - is the casualty breathing? Yes look to start secondary first aid procedures. If No then Start CPR once you have dialed 999 for an ambulance and defib..
Once you have completed your primary survey you can then move in to the secondary survey, History taking and treatment.
Work through Priorities of treatment ABBBBB as you commence a Head to Toe examination recording all observations taken.
Airway - is it secure and clear? protecting the C Spine at this stage if possible due to hight of fall...
Breathing - how is the casualty breathing Rate, Rhythm, Depth, equal both sides?
Bleeding - stop any Bleeding (Direct / Indirect pressure) any signs of internal?
Breaks - imobilise limb
- Burns - Cool and Dress
Body temp - what is the casualties ambient body temp in line with the environmental temp? keep them warm..
Hopefully by then the Ambulance is on scene and you are then able to hand over to them all the observation, History details and actions taken during this incident.
- Hope thats sufficient for you, if you need more always happy to help
- Jon
- c/o Tarian Training
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" pinch for a pain response "
Pinch and you will get a punch !!!
Can someone explain to me what right have I got, as a FA, to cause pain to a casualty .
More importantly, what difference is it really going to make to the rest of my P survey ?
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Can someone explain to me what right have I got, as a FA, to cause pain to a casualty
Fred, it's not about rights, it's about trying to find out the level of consciousness of your patient in relation to AVPU. If you don't want to pinch them, try tapping on their collarbone instead.
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Some lovely text book responses.
However, back to the scenario as described.
Your dad fell down the stairs.
Unlikely to be much danger to you as the rescuer so I would feel OK about approaching him.
It's my Dad so I don't think I would be too concerned about gloves.
he shouted for help so I can assume he was conscious then. I assume he is still responsive as the OP didn't say differently,
Assuming he is responsive I would apply direct pressure to the gash on his leg. There's nothing I can do about his dislocated shoulder so we'll leave that.
I would monitor his level of consciousness by speaking to him and reassuring him continuously, reminding him to keep still
If someone else in the house I get them to phone for an ambulance if not use my mobile. I would then get them to support his head or apply pressure to his leg whilst I supported his head.
Carry on pressing, supporting and reassuring until the ambulance gets there, if anything changes react appropriately
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I think it largely depends on what the rummaging around the attic revealed.....
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