RomeViking09

Scenario setting: Resident Overnight Scout Camp in the Blue Ridge Mountains in North GA

Time: 1156 Local Time

Call Info: Camper has been found near the lake he looks "loopy" and is being taken to the Health Lodge by an Adult Leader

at 1159 the camper and leader walk up to the heath lodge you pull the camper's heath form and see no Hx, the camper says he has not had anything to eat since 0845. Baseline Vitals are:

Camper Age 13

A+O x4

GCS 14/13 (problems with obey commands)

HR 56/Strong/Reg

RR 16/Reg/Unlabored

BP 125/65

STCM Pale/Cool/Dry

Pupils PERRL @ 5 mm

Temp 99.2ºF

Blood Sugar 75 mg/dL

You give the kid a Gatorade and some water and let him rest for a while and then send him to lunch. @ 1732 The Kid is found again disoriented near his camp site he is taken to the health lodge and you take his vitals:

A+O x3

GCS 13

HR 58/Strong/Reg

RR 20/Reg/Unlabored

BP 130/55

STCM Pale/Cool/Calmmy

Pupils PERRL @ 6 mm

Temp 102.6ºF

Blood Sugar 141 mg/dL

Kid says he has been drinking water all day but you get him to tell you that he dropped a pack of skittles into his water before drinking it and that he has been doing this all week (makes the water taste better).

ALS can be on scene in 1 hour and 45 min. The camp heath lodge is stocked with almost everything that would be on a BLS ambulance, you can only provided BLS Care and can provide non-emergency transport to a ER that is 45 min from camp.

Post how you would treat the PT and if you would send him home, to the ER, or allow him to stay in camp.

In SA EMT-B's can't transport IVed pt's

NREMT Scope EMT-Bs can't Transport IV you need EMT-Is or EMT-Ps to Transport with IVs

Helicopters are not going out to us for something unless the PT needs a Level 1 Trauma Center

local term for on camp medical emergency that requires ALS transport is Code

Per state law I would transport (all 911s get transport in GA) but I would call the Police and I have a gut feeling he would be brought up on charges for abuse of the 911 System

Scenario setting: Resident Overnight Scout Camp in the Blue Ridge Mountains in North GA

Time: 1322 Local Time

Call Info: A Scoutmaster with reaction to ant bites has stepped in a bed of red fire ants.

at 1325 medic (you) are on scene with a BTLS Jump Bag and you have pulled 2 EpiPens from the Drug Lock Up. You know from the health form review that the PT carries EpiPens for ant bites, once on scene you find that the PT has given himself two .3ml EpiPens in the last 5 min "he did not feel the first one working" Baseline Vitals:

A+O x4 (Destressed)

RR 23/Regular/Labored

HR 106/Regular/Bounding

BP 145/P

Pupils PERRL @6mm

STCM Red/Hot/Damp

Camp Ranger is Standing by to move the PT to the Camp Health Lodge.

ALS has been called and will be on scene in 1 hour and 45 min the camp heath lodge is stocked with almost everything that would be on a BLS ambulance with access the the following Drugs:

Acetaminophen

Ibuprofen

Naproxen

Diphenhydramine HCL

Pseudoephedrine HCL

Epinephrine 1:1000 (5x 0.3ml EpiPen, 5x 0.15ml EpiPen)

You team is yourself, The Camp Director (retired EMT-I/85), the Camp ranger (retired Fire Fighter/ EMT-P), 2nd Medic (in route to scene who is EMT-I/85) and Camp Health Officer (LPN with no Emergency Training works as a School Nurse and is not on Scene)

Post how you would treat the PT while waiting for the ALS truck (you do have access to On-Line Direction from the ER and radio comm to the truck in route to the camp)

Here is the info you asked for from my field notes from this summer:

Review of PTs Class 1 and Class 2 showed no past Hx and review of camp med log showed no past injuries while at camp

PTs Vitals upon getting to the health lodge where:

A+O x4 (destressed)

BP 120/80

HR 95/Strong/Regular

RR 32/Regular/Unlabored

(We do not have a pulse ox at camp) no O2 Stats Taken

Pupils PERRL @7mm

The Ranger, Medic (me/ you in the Scenario), and Camp Director Log Rolled the PT to a long board and moved him into the Health Lodge Trauma Bay (Note; C-Spine was applied while PT was still Prone before moving him)

Upon getting the PT into the health lodge all clothing was removed to allow for a full Exam. The Ranger set up radio contact to ALS and the ER for On-line direction per local camp protocal.

PT was give 02 by Nasal Cannula (camp did not have Non-Rebreather, only BVM, and NC) @ 4LPM per Online Direction

Exam showed injury (visual bruising and swelling) to the spine between T-10 and T-11 (Scoutmaster says he thinks the PT fell on a rock) Good CSM x3, no feeling in Right Leg slow refill in Right big toe.

PT was covered and Vitals taken every 5 min until ALS was on scene

(Note: All Meds are covered under Off-line direction before camp starts based on the level of training of all medics on camp. Camp was staffed by myself (Wilderness First Responder at the Time now and EMT-I Student), an LPN with no Emergency Training, 1 EMT-I, and the Camp Director and Camp Ranger all Staff are trained in BLS/CPR/AED in staff week, all medical staff must take 5 hours in wilderness protocols related to the region the camp is in, the night of this event the EMT-I was working for the local Fire Dept and the LPN was on her night off)

PT was transported to a Level 2 Trauma Center, ER doc was able to breakup a hemotoma in the T10 T11 Region and the PT returned to camp the next day

On Scene ALS did gain IV Access and give Morphine per Online Direction

Camp staff did not give any meds per online director due to a possible unstable condition.

(I have two more Codes from this Summer I will Post)

Scenario setting: Resident Overnight Scout Camp in the Blue Ridge Mountains in North GA

Time: 2000 Local Time

Call Info: Scoutmaster reports one of his scout was running in camp and fell, the scout master is on his way to the health lodge with the scout.

at 2015 the Scoutmaster pulls up in a 15 Passenger Van with a 12 y/o male in a prone position across the middle bench seat of the van with pain in the T10 Region and no feeling or movement in the Right Leg. ALS has been called and will be on scene in 1 hour and 45 min the camp heath lodge is stocked with everything that would be on a BLS ambulance with access the the following Drugs:

Acetaminophen

Ibuprofen

Naproxen

Diphenhydramine HCL

Pseudoephedrine HCL

Epinephrine 1:1000 (5x 0.3ml EpiPen, 5x 0.15ml EpiPen)

You team is yourself, The Camp Director (retired EMT-I/85), the Camp ranger (retired Fire Fighter/ EMT-P), and the Scoutmaster (no real medical training beyond CPR).

Post how you would treat the PT while waiting for the ALS truck?