EMT Lesson Plans

6.13

Situation: 22-year-old shot in chest during drive-by

Sucking Chest Wound

Scene Size-up: Safety:

Scene is safe

BSI:

Gloves

Patients: 1 Mechanism/Nature: MOI – gunshot Resources: ALS

Sucking chest wound with blood bubbling

Primary Assessment: General Impression: Young man on ground supine not moving Mental Status: Responsive only to pain Airway: Patent Breathing: 44 per minute, shallow, diminished sounds Circulation:

Rapid thready radial, pale sweaty skin, no bleeding

Desired Response:

Primary then Rapid assessment, transport, vitals / full body scan enroute

Rapid Scan: Head:

Full Body Scan: Head:

Unremarkable

Unremarkable

Neck:

Neck:

JVD, Trachea deviated

JVD, Trachea deviated

to right side

to right side

Chest :

Chest :

Sucking chest wound with blood bubbling

Sucking chest wound with blood bubbling

Abdomen:

Abdomen:

Unremarkable

Unremarkable

Pelvis:

Pelvis:

Unremarkable

Unremarkable

Extremities: Unremarkable Posterior : No exit wound

Extremities: Unremarkable Posterior : Unremarkable

Vitals: 1

2

3

OPQRST: O:

SAMPLE: S:

Pulse: 122

128

132

N/A N/A N/A N/A N/A N/A

Unobtainable Unobtainable Unobtainable Unobtainable Unobtainable Unobtainable

P: Q: R: S: T:

A: M:

BP:

102/70

94/64

78/50

Resp:

44

46

50

P: L: E:

SPO2: 92

88 82 (improve SPO2 if patient is bagged)

OTHER: If they seal the wound with a three-sided dressing, during transport tell them that the bag is becoming difficulty to squeeze. If they reassess the dressing, tell the students the dressing has become bloodied and is sticking to the area and no longer providing a 1-way valve effect