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IMPOSSIBLE SCENARIOS


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You think you're good at scenarios? At Sac Metro they test us on seemingly impossible scenarios that have actually happened in real life, just to see how we'd fare. I thought I'd share a few with you because I'm bored and want to see how you do.

Scenario 1:

You are an EMT-B assigned to an ALS unit. You pull up on a structure fire. There are about 7 people with severe burns lying around in front of the building, and you are the first unit to respond to the location. The building is fully engulfed on all floors, people have been jumping from the upper stories to save themselves (hint: this part is important!)

You exit your ambulance, check scene safety, put on BSI and are about to get to work. You hear a responding fire unit coming to your location. However, it has been raining lately and the streets are slick. The fire engine loses control, barrels into your EMT-P partner, and crashes into the building lengthwise. Your partner is thrown about ten feet and lies motionless. The fire engine is becoming engulfed in the flames, and no one is exiting the vehicle.

What do you do?

That's scenario 1, more to come. Keep in mind, these scenarios HAPPENED.

also: post your own!

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Contact dispatch, make sure more ALS units are enroute, advise them to respond a supervisor.

Initiate triage, with the eight patients that are not in a burning fire truck. I am not a fire fighter, and will not put myself in danger to try to rescue someone.

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Well, from how I see it now...I think the NIMS system needs to be executed. Sounds like it has become not only an EMS situation, but now you have a fire, and further rescue situation. SO....first we need an Incident Commander and then below him, we need a fire officer, someone in command of safety, someone in charge of triage, and possibly another branch. Then, below them, we need to place the medics and firefighters. Call for more ALS units and back up fire help, means for extrication, etc.

How bout we start there, Frankenstein, so the scene is not chaotic and things are getting done....??

:wink:

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Notify dispatch and advise them of the new incident. Making sure that dispatch sends adequate EMS, Fire/rescue, and L/E.

Say a quick prayer for the burn vic's and for the firefighters hoping GOD will handle them until backup arrives. And now focus all of my attention on my partner. I would hate to have to face my partner spouse and explain there death with out giving every thing I could.

That is just me!!!!! You want my license now or after you find a replacement for me?? :twisted:

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First and foremost....notify dispatch. Have them send more ALS rigs along with more fire rigs to help with the extrication and the structure fire along with battlion Chief and Medical Director, or supervisor. Once all parties havebeen notified, focus all attention on your partner. With the first in ALS rig to arrive on scene, have them take your partner to the ER stat rollin code. When the first fire rig pulls up grab the first FF or Medic to hop of the rig and then start workin the patients. (All FF are EMTs so they can help with boarding and treating the burns. Looks like this situation is manily BLS with treatent of burns. Seeing that some had jumped out of windows, I would board all of them and then weed out who didnt jump. Treat the burns accordingly....saline, dressings, etc. Then transport priority. Worst burns to mild burns.

Hopefully, everyone pulls out ok.

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So you get 8 more ambulances and 47 more fire trucks (hey it's a fire, you need at LEAST 47). Because of the aforementioned poor road conditions they all approach the scene and ALSO crash into each other and various surrounding buildings. Everything is on fire, everyone is burning alive and looking at YOU to save them.

As you stand there adequately practicing BSI and scene safety... 4x4 and epipen in hand, a bus looses control and smashes into the scene as well. You get the feeling this isn't any normal bus.... :shock:

With his last gasping breath, the bus driver says "This.....*gasp*....this bus is FULL OF BABIES!!!!!!....." Then he dies. Shortly thereafter the bus explodes sending like oh say 40 babies everywhere.

Keep in mind you still have those 4x4's, plenty of NRB's that you are dying to give oxygen at 15L/min with, and of course a fist full of epi-pens...

NOW WHAT DO YOU DO?

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So you get 8 more ambulances and 47 more fire trucks (hey it's a fire, you need at LEAST 47). Because of the aforementioned poor road conditions they all approach the scene and ALSO crash into each other and various surrounding buildings. Everything is on fire, everyone is burning alive and looking at YOU to save them.

As you stand there adequately practicing BSI and scene safety... 4x4 and epipen in hand, a bus looses control and smashes into the scene as well. You get the feeling this isn't any normal bus.... :shock:

With his last gasping breath, the bus driver says "This.....*gasp*....this bus is FULL OF BABIES!!!!!!....." Then he dies. Shortly thereafter the bus explodes sending like oh say 40 babies everywhere.

Keep in mind you still have those 4x4's, plenty of NRB's that you are dying to give oxygen at 15L/min with, and of course a fist full of epi-pens...

NOW WHAT DO YOU DO?

Your an angry, angry man.

:P

Regarding the scenario, triage, for the love of god triage.

Step back, assess all patients, determine priority, request resources, send patients off. Go home, climb in bed, forget day ever happened...

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You can't tend to the burn victims because more are jumping out of the window making it unsafe. You can't help the firemen because the damn truck is on fire making it unsafe. Your partner is probably the only that is in a safe zone. Now the other rigs and the bus O babies all crash and the B O B explodes. The area is still unsafe since I am sure the news crews and the milk man will soon crash too.

I can only hope your partner is in a safe area. If not, then the scene is not safe and you still must wait for LEOs and FF to arrive SAFELY and get the situation under control.

Radio dispatch and inform them of the road conditions to hopefully prevent any further accidents and explosions and baby bowling...............

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