Scenario 1. Medical Technology Bandaging & Shock Positioning Lab
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- Godwin Wade
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1 Scenario 1 Arriving on campus at 7am for your Driver s Ed class, you see a custodian lying on the ground. He is lying prone in an area of wet pavement with the pressure sprayer near by. He is conscious and breathing, but bleeding on his head. His wound is located superior to his right eyebrow, lateral to his hairline and is approximately 4cm long. 1. As you assess the scene, what are your first steps? 2. What type of wound would you expect to see in this situation? Would you be able to clean this wound? If so, how? Would you need to seek medical attention? Explain. 3. What type of healing would you expect from this wound? Do you need to worry about infection and why? 4. Would you expect the person to shock, and if so, how would you position them and what would you need to decrease their likelihood of shocking? Follow the instructions below to bandage the head wound. Take measures to control the bleeding Proceed to bandaging using a cravat or triangular bandage
2 Scenario 2 After school, walking through the parking lot, a student carrying a skateboard approaches you. He has visible scrapes on both medial forearms and palms of his hands that are oozing blood. He informs you that he fell off his board and needs help. 1. As you assess the scene, what are your first steps? 2. What type of wound would you expect to see in this situation? Would you be able to clean this wound? If so, how? Would you need to seek medical attention? Explain. 3. What type of healing would you expect from this wound? Do you need to worry about infection and why? 4. Would you expect the person to shock, and if so, how would you position them and what would you need to decrease their likelihood of shocking? Following the instructions for bandaging hand and forearm. Hand: Using elastic wrap or roller bandage Take measures to control the bleeding. Proceed to bandaging using roller bandage or elastic wrap
3 Scenario 2, continued: For wrapping the forearm, there are several options. Don t forget to take measures to control bleed. Forearm: Using Cravat, Method 1 Forearm: Using roller bandage, Spiral Method 2
4 Scenario 3 On your way to school, you witness a pedestrian and auto collision on the corner of Day Road and Loma Vista Road. The student s posterior lower leg just proximal to the ankle was caught on the front bumper of the car during the collision and is visibly torn. The student also has a large scrape from the pavement on his medial knee. The student is lying on the ground next to the curb and is conscious and breathing, but is bleeding severely. 1. As you assess the scene, what are your first steps? 2. What type of wound would you expect to see in this situation? Would you be able to clean this wound? If so, how? Would you need to seek medical attention? Explain. 3. What type of healing would you expect from this wound? Do you need to worry about infection and why? 4. Would you expect the person to shock, and if so, how would you position them and what would you need to decrease their likelihood of shocking? For wrapping the knee, there are several options. Don t forget to take measures to control the bleeding. Knee: Using Cravat, Method 1 Bend the knee slightly, unless it causes pain. Then place the middle of your wide, long cravat at the underside of the knee joint (and over any dressing). Wrap the cloth, with opposite ends crossing, over the knee and the upper or lower leg (depending on the location of the wound). Tie ends into a knot
5 Scenario 3, continued: Knee: Using a roller bandage, Method 2 (Note** the same procedure would apply to elbows, with a difference in bandage size. Typically, a 3 roller bandage is used for the elbow while a 4 roller bandage is used for the knee.
6 Scenario 3, continued: Follow the instructions below for wrapping ankle, then continue to do spiral bandage from top of the ankle to just below the knee cap. (See spiral bandage instructions from scenario 2) Spiral Bandage to the top of ankle to just below the knee cap: Make a circular turn around the ankle. Begin the second bandage at the top of the ankle, securing the first bandage. Continue wrapping in spiral turns to just below the kneecap. Secure wrap.
7 Scenario 4 Visiting college night, you are waiting in line to talk to the representative from Harvard, when the students in front of you get into a heated debate about which school is better. The next thing you know, one student has stabbed the other in the lateral arm just proximal to the elbow with a mechanical pencil. While attempting to remove the pencil, you notice that a piece has remained embedded in the student s arm. 1. As you assess the scene, what are your first steps? 2. What type of wound would you expect to see in this situation? Would you be able to clean this wound? If so, how? Would you need to seek medical attention? Explain. 3. What type of healing would you expect from this wound? Do you need to worry about infection and why? 4. Would you expect the person to shock, and if so, how would you position them and what would you need to decrease their likelihood of shocking? Follow the instructions for making a ring pad. Fold the triangular bandage into a 3 fold cravat. Create a doughnut that will fit around the puncture wound with one end of the cravat by wrapping the bandage around your fingers several times. Weave the remainder of bandage around the loop. Follow the instructions for wrapping a doughnut pressure bandage. Place the bandage on ring pad and complete a circular wrap one and a half times. Wrap the bandage in a figure eight around the edges of the ring pad or doughnut (applying pressure to both sides of the doughnut, but not the middle) Finish with a circular turn above the doughnut and secure the bandage.
8 Scenario 5 At lunch you are walking in front of Spirito Hall when you notice a student sitting on the curb holding his foot. He was wearing flip-flops and had accidentally stepped on broken glass that had pierced his sandals. He is bleeding heavily from the bottom of his foot proximal to the toes. 1. As you assess the scene, what are your first steps? 2. What type of wound would you expect to see in this situation? Would you be able to clean this wound? If so, how? Would you need to seek medical attention? Explain. 3. What type of healing would you expect from this wound? Do you need to worry about infection and why? 4. Would you expect the person to shock, and if so, how would you position them and what would you need to decrease their likelihood of shocking? Follow the instructions from scenario 3 for wrapping a foot. Remember to control the bleeding, as necessary.
9 Scenario 6 After school you are walking across the quad when you notice the power lawn mower turned on with no one near it, but you hear moaning. As you approach the scene you notice a custodian on the ground holding his leg. He is missing his foot just distal to the ankle. 1. As you assess the scene, what are your first steps? 2. What type of wound would you expect to see in this situation? Would you be able to clean this wound? If so, how? Would you need to seek medical attention? Explain. 3. What type of healing would you expect from this wound? Do you need to worry about infection and why? 4. Would you expect the person to shock, and if so, how would you position them and what would you need to decrease their likelihood of shocking? Follow the instructions for applying a tourniquet. A tourniquet is used only when the amount of blood being lost endangers the casualty's life. You may need to make this decision quickly if the need for the tourniquet is obvious. You may also need to resort to this decision when all other methods of controlling the bleeding have failed and you have no other option. Since the tourniquet will stop blood circulation, the body tissues below (distal to) the tourniquet will not receive oxygen and nutrients. The tourniquet should be placed two to four inches above the edge of the wound Place padding around the limb where the tourniquet will be applied. Place the tourniquet band material around the limb. Tie the band with a half knot. Place the rigid object (such as ruler or stick) on top of the half knot. Tie a full knot over the rigid object. Twist the rigid object either clockwise or counterclockwise until the tourniquet is tight and the bright red bleeding has stopped. (Bright red blood is from a severed artery. Darker blood is from a vein. Dark blood may continue to ooze even after the tourniquet has been properly applied.) Secure the stick in place with another band distally from where the tourniquet was applied.
10 Bandaging/Shock Lab Response Sheet Scenario 1: Arriving on campus at 7am for your Driver s Ed class, you see a custodian lying on the ground. He is lying prone in an area of wet pavement with the pressure sprayer near by. He is conscious and breathing, but bleeding on his head. His wound is located superior to his right eyebrow, lateral to his hairline and is approximately 4cm long. First Steps: Type of Wound: Cleaning Wound: Medical Attention Necessary? Type of healing expected: Risk of Infection: Expectation of shock: Positioning: Any other equipment needed? Teacher Initials for correct completion of bandaging/positioning: head cravat
11 Scenario 2: After school, walking through the parking lot, a student carrying a skateboard approaches you. He has visible scrapes on both medial forearms and palms of his hands that are oozing blood. He informs you that he fell off his board and needs help. First Steps: Type of Wound: Cleaning Wound: Medical Attention Necessary? Type of healing expected: Risk of Infection: Expectation of shock: Positioning: Any other equipment needed? Teacher Initials for correct completion of bandaging/positioning: Palm forearm (cravat) forearm (roller bandage)
12 Scenario 3: On your way to school, you witness a pedestrian and auto collision on the corner of Day Road and Loma Vista Road. The student s posterior lower leg just proximal to the ankle was caught on the front bumper of the car during the collision and is visibly torn. The student also has a large scrape from the pavement on his medial knee. The student is lying on the ground next to the curb and is conscious and breathing, but is bleeding severely. First Steps: Type of Wound: Cleaning Wound: Medical Attention Necessary? Type of healing expected: Risk of Infection: Expectation of shock: Positioning: Any other equipment needed? Teacher Initials for correct completion of bandaging/positioning: knee (cravat) knee (roller bandage) ankle w/leg
13 Scenario 4: Visiting college night, you are waiting in line to talk to the representative from Harvard, when the students in front of you get into a heated debate about which school is better. The next thing you know, one student has stabbed the other in the lateral arm just proximal to the elbow with a mechanical pencil. While attempting to remove the pencil, you notice that a piece has remained embedded in the student s arm. First Steps: Type of Wound: Cleaning Wound: Medical Attention Necessary? Type of healing expected: Risk of Infection: Expectation of shock: Positioning: Any other equipment needed? Teacher Initials for correct completion of bandaging/positioning: donut donut w/bandage
14 Scenario 5: At lunch you are walking in front of Spirito Hall when you notice a student sitting on the curb holding his foot. He was wearing flip-flops and had accidentally stepped on broken glass that had pierced his sandals. He is bleeding heavily from the bottom of his foot proximal to the toes. First Steps: Type of Wound: Cleaning Wound: Medical Attention Necessary? Type of healing expected: Risk of Infection: Expectation of shock: Positioning: Any other equipment needed? Teacher Initials for correct completion of bandaging/positioning: foot
15 Scenario 6: After school you are walking across the quad when you notice the power lawn mower turned on with no one near it, but you hear moaning. As you approach the scene you notice a custodian on the ground holding his leg. He is missing his foot just distal to the ankle. First Steps: Type of Wound: Cleaning Wound: Medical Attention Necessary? Type of healing expected: Risk of Infection: Expectation of shock: Positioning: Any other equipment needed? Teacher Initials for correct completion of bandaging/positioning: tourniquet
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