PT Scenario Back Story: You are performing trail maintenance. You started early at 6 AM because you wanted to be back home this afternoon. You were in a hurry this morning so you ate no breakfast and you forgot your water.  You were walking with an ax in your hand – you are feeling very dizzy – you stumbled and tumbled down a hill. During the tumble, you break your right leg and you cut the hand on your left arm with the ax.  The cut requires a pressure dressing to stop the bleeding. When the caregiver finds you, you are laying on your back.

When the caregiver starts talking to you say “Look, my left hand is bleeding. I cut the palm of my hand!”

PT SAMPLE HX

1. Signs and Symptoms: You feel dizzy, thirsty, and hungry. Your arm hurts and you fear you may have broken your right leg.
2. Allergies: None
3. Medications: None
4. Past Medical HX: None. 
5. Last In – Last Out
   1. Drink – Diet Coke. Last evening at around 7 PM.
   2. Food – A salad and slice of bread. Last evening at around 7 PM
   3. Pee – You peed about an hour ago at it was dark yellow and smelled bad
   4. Poop – You have not pooped today.  The last time you pooped was yesterday morning and it was normal for you.
6. Events Leading Up to the Crisis: You’ve been performing trail maintenance this morning, you were carrying an ax, you were feeling dizzy, you stumbled and fell down a hill.

PT Exam

Primary Assessment: 

• This is a Positive MOI scenario. Your caregiver should secure your spine – with reminders on your neck and head, perform a Primary Assessment – stop at “C” – Circulating Out – and apply a pressure dressing to your bleeding hand. 
• If your caregiver does not secure your spine, sometime during the Primary Assessment start moving your head and scream out to your caregiver that you are paralyzed.  If the caregiver realizes their mistake and secures your spine, you are no longer paralyzed.

Secondary Assessment. 

• Broken Leg: The pain level for your broken right leg is a 10 out of 10 when your caregiver palpates it. Once your caregiver splints your leg the pain goes down to a 4 out of 10.
• Bleeding: If your caregiver has not applied a pressure dressing, feel free to lose consciousness and lay limp.
• Dizziness: Your caregiver can and should provide you with imaginary food and water by mixing sugar with water and pouring sips of water into your mouth while you are on your back.  If they do this, your dizziness goes away.

PT Outcome

Your caregiver should run the Spine Clearing Checklist and you successfully pass.  Once your spine is cleared, they can set you up and create a rescue plan.

Scenario: Day 2 Morning

PT Vital Signs:  When the caregiver takes your vital signs, come out of character and read off the vital signs they would measure.

Complete Care

Pressure Dressing was applied.  Food and water provided

Time:	1	2	3	4
LOC:	A+Ox3	A+Ox3	A+Ox3	A+Ox3
HR	80	74	70	70
RR	18	14	12	12
Skin	Pale –  Cool	Pale –  Cool	Pink – Warm	Pink – Warm

Incomplete Care

No pressure dressing or no food and drink

Time:	1	2	3	4
LOC:	A+Ox3	A+Ox3	A+Ox3	A+Ox3
HR	80	84	86	88
RR	18	20	22	24
Skin	Pale –  Cool	Pale –  Cool	Pale –  Cool	Pale –  Cool

Debrief with your caregiver after your spine is cleared and the leg splint is completed.