Výsledková listina a přehled úkolů Rallye Rejvíz 2010

Pitbul N RLP Rozhodčí:
N RZP Rozhodčí:
Pitbull N INT Judges:
Time limit for task:
max. 12 min.
Andrej Billy, Libor Sobek,Jana Motyčková RALLYE REJVÍZ 2010
Petr Černohorský, Lukáš Ludwig, Jaroslav Liška
Berndt Schreiner (A), Lukáš Konečný, Monika Skalková
Story get to team at task start.
•
•
•
•
A
B
C
D
Story for team:
Dispatch centre received emergency call:
More persons have been bitten by dog in the appartement, caller is much excited. Police are on the way.
Your task:
to examine victims
to establish working diagnos
to provide primary exam on the site
to set up way of transport and direction to appropriate health care facility
Local situation:
The nearest hospital is 20 kms by ground:surgical, internal, gynecological + obstetric dept., laboratory, neurologist available 24 hrs.
Regional hospital: 42 kms by ground transport, as A + ED, ENT, CT, neurological dept. with ICU, psychiatric, infectious disease, pediatric dept.
University hospital: 55 kms by ground, as B + traumacentre, burn unit, cardiac centre, oncological dept., neurological dept. with ICU, NMR.
Helicopter rescue available at 15 mins.
Situation:
At arrival on the site behind the door is barking dog. Communication through the closed door. dog should be secured by Police. At the entrance hall large amount of blood on the floor, young excited and
crying woman present, hands and head with patches of blood. By one hand is keeping large bleeding wound on the forearm of standing older man. Site assessment: in th kitchen is sitting mother with bite
wounds on both hands. Call for other crew with PM. Necessary to keep the dog closed in the room. Calming victims. Daughter wish to sign refusal of examination and treatment. She have to be examined with
focus to neurological signs. When crew enter immediately into appartement - the task ends. They are bite by dog, another crew necessary in real situation.
The task ends also when policeman is NOT instructed explicitly about neccesity to keep the dog inside the room (team leader have to say to policeman what he needs). In real situation author experienced
room secured by 2 policemen and daughter excited and hysteric, try to enter the room to see her lovely litle dog. When the room will not be closed by police, daughter open the door and free the dog which
bite the crew members.
Physical exam:
Father: GCS 14, BP 140/80, HR 90, SpO2 97 %, glyc. 6,8, EKG norm., neurol. light ataxy, RR 14/min., abdomen and legs normal.
Mother: GCS 15, BP 120/80, HR 96, SpO2 98 %, EKG norm., neurol. norm., RR 16/min., abdomen, legs normal
Daughter: GCS 15, BP 110/70, HR 87, SpO2 97 %, EKG norm., neurol. norm., RR 18/min., abdomen, legs normal
Key issues:
Detailed examination and correct care and treatment. Correct evaluation of the situation, safety measures. Right patient history taking, thorough examination, correct treatment, treatment of pain, fear and
distress. Decision to leave the patient on the site with reverse signature, neurological exam recommended.
Features: scene safety (dog, drunked father and hysteric daughter), detail examination - glycemia and hidden serious chest injury at father .
Max. points
Team scoring 1 2 3 4
5 Correct decision and performance
1 200
Dog is eliminated
Security - ask from
ask for police dog
and closed to Police enter as first
1 Security measures behind the door
handler
110
room by owner
30 30 20 30
After arrival behind the door is barking dog.
Communication through close door. Owner should put
the dog securely into separate room.Entrance after
Police oficers - risk of continuing fathrer agresivity.
2
Situation assessment and
bleeding control
Whole
appartement Primary
assessment, assessment both
number of victims parents and
including person in bleeding control in
the room with the 2 min (50+50)
dog (15+15)
Order to police
guard the room
with dog
next Ambulance
calling
Primary survey of
both parents and
treatment after 2
min (25+25)
175
Situation assessment - whole appartment check.
Mother in the kitchen - control of bleeding, direct
pressure, press. Bandage.Order to Police guard the
room with dog. Other crew with PM necessary to call.
30 100 25 20 50
Father:
OA: DM on insulin;
Allerg: 0; PH: what
happened (fight,
child abuse, fall,
alcohol
(3 x 15)
Mother:
PH: CAD;
Allergies: 0; Event:
Daughter:
PH: hepatitis C;
Allergies:
3 Patients history
objective signs
AMPicilin; PH:
dog - vaccination
155
(3 x 15)
Father:
1. VIT.FF
2. complete
examination
(20+20)
event, alcohol?
(3 x 15)
Veterinary
documentation of
45 45 45 20
Mother: Daughter:
1. VIT.FF 1. VIT.FF
2. complete 2. complete
glycaemia of father
EKG of mother,
AIM anterosept.
4 Examination
examination examination
years ago
180
(20+20) (20+20)
40 40 40 30 30
1. IV line v. jugul.
ext. OR intraosseal
line cryst. 500 ml,
2. analg., 3.
bandage and
immobilisation
(3x20)
1. IV line, cryst.
500 ml, 2.
analgesia,
3.bandage and
immobilisation
(3x20)
1. head injury
superficialis cover ,
2. calming by
words, 3. sedation
Daughter:
neg. revers -
necessary
explanation of
Father:
IV line into v.
5 Treatment jugularis externa 260
by drug IM, head trauma
OR I.O. Access
diazepam consequences +
(3x20) neurological exam
History of incident: fathet hit the daughter, she fellt
down, make a wound, without uncosnciousness. Next
dog striked the father and mother.
Basic personal and allergic history.
Physical exam of 3 victims, glycemia at father as
reason for aggressive behaviour. ECG of mother with
older AIM.
Father: IV line jugularis externa (forearms veins
damaged) OR I.O., crystaloids, analgesia, bandage
and immobilisation, daughter refuse transport to
hospital - sign neg. revers
60 60 60 40 40
1. vulnera morsa
antebrachii bilat.,
manus bilat.,(bites
wounds of
forearms and
1. vulnera. morsa:
antebracii l.
dx.,(bites wounds
of right forearm) 2.
1. contusio. capitis
et vulnus lacerum
capitis reg.
occipitale, head
Father:
v. morsa thoracis
dx., ruptura m.
brachioradialis l.
6 Correct diagnose v. morsa. manus l. wound 2. ebrietas
dx. (bite wounds of 180
hands) 2. ebrietas
sin. (bites wounds etylica (intxication
chest, rupture of
etylica (alcohol
of left hand) by alcohol)
forearm muscle)
intoxication)
(20+20) (20+20)
(40+20)
(20+20)
7 Players
40 40 40 60
Father: PM crew to Mother: PM crew
A
to A
20 20
8 Figuranti
Father Mother Daughter
100
25 25 50
40
Complete examination with stress on father exam
(only small damage on the shirt but larger under),
forearm muscle is rupured completely
Subjective players evaluation acording rules
Points: 0 - 100.