Tandem D RLP Rozhodčí: D RZP Rozhodčí: Tandem D INT Judges: Time limit for task: max. 15 min. Lydie Fehérová, Olga Sedláčková RALLYE REJVÍZ <strong>2010</strong> Štefan Liptay, Dáša Majerová Tomáš Vaňatka, Jiří Mašek Story get to team at task start. • • • A B C D Story for team: Dispatch centre received emergency call: Fire brigade called to evacuate from flooded house pregnant women which has regular contractions. Your task is: assess scene, begin contact instructing of fire brigade by radio-communication examination, treatment and preparation of patients for transport Local situation: Nearest hospital is 20 km by ground transport with surgery, anaesthesia and General Intensive Care,internal medicine (neurologists on duty nonstop),gynecology and obstetric and biochemistry. Higher level hospital 42 km by ground transport, dept. as A + ED,ENT, CT, neurologic dept. with ICU, psychiatry, infectious diseases and pediatric dept. Specialized centre 55 km by ground. Depts. as B + traumacentre, burn unit, cardiocentre, stroke unit, NMR. Helicopter rescue available at 15 mins. Situation: During floods in lone flooded house fire brigade evacuate pregnant women in 37th week of pregnancy. At crews arrival fire brigade chief officer informs the crew about the situation. It is not possible to get to the patient because of technical reasons. On the other side of river with the patient are two firefighters, communication is possible only trough radio and provisional bridge will be ready in 5min. Driver can drive around the river over a bridge cca 15min away. Crew can take only the essential equipment because of safety measures (they have to prepare it before the driver leaves). Through the radio they get to know that birth has already started and that firefighters will have to deliver the child, even though they never did it before. Mother is nervous, it is necessary to calm her, provide correct positioning and retrieve patients history. Childs birth ends withouth complications. After the birth the provisional bridge is complete and the crew can cross the river. Situation on birth site - mother is feeling good, bleeds adequately. Child has a light blue skin color, breathes irregularly, weight cca 2800 g. In her pregnacy records or after examination the crew finds out it was preterm birth. Crew should divide, examine and treat the child and mother. Driver with ambulance car is already in the place and the crew has to prepare them for transport. Point of task: Check the ability to communicate in long distance, management trough radio, physical prowess, theoretical and practical knowledge of birth, possible complications, basic treatment of mother and child only with basic equipment,trainig drive . 1 Team scoring 1 2 3 Communication Orientation and management on site 2x20 Management trough radiocommunication, anamnesa 2x20 Securing of equipment bor childbirth (towels, wire, scissors) + washing hands(firefighters) 20+20 training drive 40 40 40 50 4 5 Max. Points 1 200 Correct decision + performance Orientation: fire brigade chief officer informs - on the other side of rives is pregnant women, which has contractions. cca in 5 mins there will be crossing ready for two crew members, driver has to go around (driving time around 15 min.). It´s possible to cross only with the most essential equipment. On the other side are 2 firefighters, contact possible by radiocommunication. 170 Management trough radio- communication: way of communication, diagnostics of preterm birth (her pregnancy records), simple patient history of mother (negative), preparation of things for birth - towels, wire, scissors ,enquire about a gloves,instructing firefighters to wash their hands. preparation of bag.Training drive. 2 Birth Birth instructed trough radiocommunication: calming, positioning, breathing, "pushing" (4x50) clamp of umbilical cord,checking of bleeding,uterine massage 3x20 Thermal comfort, checking of breathing on child (yelling) (2x25) Crossing of the river equipment of bag: orig.childbirth kit + Oxygen 2x20 410 birth management: mother is nervous,small part of child haed is between labias - instructing firefighters. Calming of mother, positioning, breathing and pushing (instructing firefighters). Birth continues also without help, after birth -clamp a umbilical cord - instructing firefighters. Child yells after birth - control via radiocommunication, thermal comfort of child. Control of mother - delivery without any problem,expulsion of placenta a minute after childbirth(judge inform a crew about it), checking of bleeding, stronger bleeding - instructing firefighlers -uterine massage to stimulate contractions ,bleeding - adequately. Crossing of river.Necessary equipment of bag:orig.childbirth kit + Oxygen 3 4 5 Mother (on site) 200 60 50 60 40 Examination: BP, HR,Sat,tonus of uterus,bleeding (5x10) Therapy :i.v.line, sanit.napkin (2x20) Dg: preterm birth preparation for transport, BP and HR, transport of placenta (3x10) 50 40 30 30 Examination: Therapy: suction Control: Transport:cover to saturation+skin+H +asist ventilation sat+skin+breathing baby+napkin+baby Dg.Susp.apnoic Child (on site) R+breathing (4x20) ambu-bag(O2) (2x50) +HR (4x20) ś cap+oximeter (4x20) pause 370 Players 80 100 80 80 30 Fire brigade chief officer Mother 20 80 150 100 Examination: BP 110/70, HR 100, Sat 98 %, GCS 4+5+6,tonus of uterus-adequately,bleeding - adequately. Therapy: i. v.line (according to former bleeding), sanitary napkin(mother Dg. Preterm childbirth. Preparation for transport: check BP 120/80, HR 90, transport of placenta - plastic sack(enquire about it firefighters) examination: sat 87 %, skin blue, HR 100 min., doesn´t yell (not possible to hear). Therapy: suction of a baby,ambu-bag asist ventilation - O2 reservoire(mouth to mouth breath or asist ventilation without O2- 1/2 points) - 5 x - after basic therapy control: pink, breathing normal, HR 120 Sat 99 %. Preparation for transport by bundling up the child (mother has prepared bag in case of childbirth - cover to baby,napkin baby,cap to baby) - prevention of heat loss,oximeter.Dg.Suspicion of a short apnoic pause. Subjective player evaluation of crew tenderness, empathy and sensitivity. Limits: 0 - 100 points.
START MUC. RR Rozhodčí: D RLP Rozhodčí: D RZP Rozhodčí: START D INT Judges: Časový limit pro splnění úkolu: max. 15 min. Miroslav Ptáček Miroslav Ptáček Kateřina Kozová, Kateřina Nováková Ilja Chocholouš Legendu posádka obdrží na startu úkolu. RALLYE REJVÍZ <strong>2010</strong> • • • Legenda pro posádku: KOS ZZS Vás vysílá na místo mimořádné události - nehoda autobusu na vlakovém přejezdu, po dojezdu vaši skupinu řídící lékař určil k provádění třídění. Vašim úkolem je: Vytřídění skupiny zraněných provedením prvotního třídění pomocí metody START - včetně označení a celkové evidence (červená = T1, žlutá = T2, zelená =T3, černá /bíláT4) Praktické provedení: pacienti jsou na třídící stanoviště dopravování postupně Údaje s typem postižení a a prima vista parametry mají figuranti na sobě.Ostatní potřebné klinické údaje zjistíte vlastním vyšetřením - údaj sdělí rozhodčí. Cíl úkolu: Prověřit znalost třídění dle START a schopnost rozhodování v zátěži Max. bodů Hodnocené kroky posádky 1 2 3 4 5 6 7 8 9 10 11 12 13 Správný postup 1 200 1 třídění správně 92 92 92 92 92 92 92 92 92 92 92 92 92 1 196 2 absence třídících karet -200 3 přehledný list evidence NE -96 Použití profi třídících karet evidenční list i improvizovaný 4 ČAS - doba potřebná k vytřídění , běží od pokynu co nejrychlejší možný čas