PT Scenario Back Story: A tornado just passed through the neighborhood next to yours. You walk quickly to the neighborhood and begin helping a person move the debris to free their dog trapped beneath the rubble. You work for almost 30 minutes moving heavy lumber, roofing materials and furniture. You were successful in freeing the dog and the dog is not injured. However, you suffer from asthma and all of this exercise has caused an asthma attack. You begin to feel your lungs close up and start wheezing on exhale. You do not have an inhaler on you or at home a block away. Then you remember that just before the tornado hit you were going to go to the drug store to pick up your rescue inhaler prescription. That is out of the question now since roads are now closed and there is no electricity in town. You are standing on top of a pile of rubble, having difficulty breathing, you become dizzy and you fall and tumble down the pile of rubble to the hard ground.
When the caregiver walks up to you, be wheezing on exhale.
PT SAMPLE HX
- Signs and Symptoms: You are wheezing on exhale. You feel dizzy and thirsty.
- Allergies: Asthma
- Medications: Rescue Inhaler for Asthma
- Past Medical HX: Asthma
- Last In – Last Out
- Drink – This morning at 6 am. A sip of water with your Pop-Tart
- Food – Poptart at 6 AM
- Pee – You peed about an hour ago at it was dark yellow.
- Poop – This morning and it was normal
- Events Leading Up to the Crisis: You’ve been helping rescue a dog. You felt your lungs start to close up, you felt dizzy and you fell off a pile of rubble.
PT Exam
Primary Assessment:
- This is a Positive MOI scenario. Your caregiver should secure your spine – with an improvised SAM Splint c-collar or reminders on your neck and head.
- 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.
- You do not have any broken bones or pain anywhere.
Secondary Assessment.
- Asthma: The caregiver, realizing you do not have a rescue inhaler should attempt to treat asthma using pursed-lip breathing or giving you a caffeinated drink. If your caregiver treats you with one of these methods, you are 100% better and your breathing returns to normal.
- Dehydration and Possible Hypoglycemia: 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 Vital Signs: When the caregiver takes your vital signs, come out or character and read off the vital signs they would measure.
Complete Care
Asthma Treated – Food and drink provided
| Time: | 1 | 2 | 3 | 4 |
| LOC: | A+Ox3 | A+Ox3 | A+Ox3 | A+Ox3 |
| HR | 90 | 74 | 70 | 70 |
| RR | 20 | 14 | 12 | 12 |
| Skin | Pale – Cool – Moist | Pink – Warm – Dry | Pink – Warm – Dry | Pink – Warm -Dry |
Incomplete Care
Asthma Treated – Food and water NOT provided
| Time: | 1 | 2 | 3 | 4 |
| LOC: | A+Ox3 | A+Ox3 | A+Ox3 | A+Ox3 |
| HR | 90 | 80 | 80 | 80 |
| RR | 20 | 14 | 14 | 14 |
| Skin | Pale – Cool – Moist | Pale – Cool – Moist | Pale – Cool – Moist | Pale – Cool – Moist |
Incomplete Care
Asthma NOT Treated – Food and water NOT provided
| Time: | 1 | 2 | 3 | 4 |
| LOC: | A+Ox3 | A+Ox3 | A+Ox3 | A+Ox3 |
| HR | 90 | 94 | 100 | 110 |
| RR | 20 | 22 | 24 | 30 |
| Skin | Pale – Cool – Moist | Pale – Cool – Moist | Pale – Cool – Moist | Pale – Cool – Moist |
PT Outcome
Your caregiver should run the Spine Clearing Checklist and you successfully pass. Once your spine is cleared, they can sit you up and create a rescue plan for you.