PT Scenario Back Story: You were riding your horse on a trail. The horse saw something on the trail that scared it and you were thrown from the horse and you landed on your head. You are laying on the ground on your back with your face pointing straight up at the sky. You are responsive only to pain. You have the signs and symptoms of a traumatic brain injury.
PT Exam. Watch the caregiver while they perform the Primary and Secondary Assessment. When the caregiver rolls you (the manikin) on the side and palpates the spine – moan when (or if) the caregiver touches the cervical spine – the back of the neck. If the caregiver does not palpate the cervical spine (neck) – don’t moan. During the Secondary Assessment – watch the caregiver and if the caregiver looks behind the ears of the manikin or the caregiver verbalizes “I am looking behind the ears” – come out of character and say “You see bruising behind the ears” and then go back into character. The goal of this scenario is for the caregiver to perform a complete Primary and Secondary Assessment.
Vital Signs
When the caregiver attempts to take vital signs (or verbalizes “I am taking vital signs) – come out of character and provide the caregiver the vital signs from the table below.
| Time: | 1 | 2 | 3 | 4 |
| LOC: | P | P | P | P |
| HR | 70 | 60 | 50 | 40 |
| RR | 14 | 10 | 8 | 6 |
| Skin | Pale – Cool | Pale – Cool | Pale – Cool | Pale – Cool |
Debrief. Your caregiver should perform a complete Primary and Secondary Assessment. When the caregiver has completed the Primary and Secondary Assessment provide you caregiver feedback. What steps did they miss? Did they look to find the bruising behind the ears? Did they recognize that something may be seriously wrong with the patient based on the vital sign trends?