Scenario: Major trauma

Facilitator:
Time: 15 mins; 1650-1705
Actual time:
Learning Objectives:
Materials: Make-up, wild cards, (see "Patients"); visuals cues to define scene: car, planter, half a summer sausage, dog.

Tell everyone

You're at an action camp a few miles away from a planned tar sands mining site near Moab, Utah. It's a family-friendly event attended by several different crowds: local environmentalists, a group of interfaith clergy members, Rising Tide people with a lot of action experience, some snowboarder-types, and people from Occupy groups that had caravans.

A group of young men in trucks showed up earlier in the day, very upset about the camp. They made threats to the camp organizers, who met them on the road. Rumors spread through the camp all morning. At lunch, a small group of protesters said not to worry; they'd brought firearms to camp.

Right before the scenario starts, add:

That evening the guys in trucks showed back up, and drove by the camp fast, yelling drunken threats. Some shots were fired, and one truck careened into the camping area, clipping a few tents before coming to a stop. The other trucks left quickly.

Tell truck guys:

You are the sons of business owners in the area. None of you fired the shots. After your friend hits those people, you sober up real quick and take off. When you stop and realize what happened, you go back (when directed by trainers) and offer to take people to the hospital.

Tell medics and patients:

If medics need information about the status of the person they are treating, medics can ask them. For example, when assessing breathing, medics can say, "I am looking, listening, and feeling for breathing. What do I find?" and the patient can answer.

Tell patients

The guy who drove his truck into the tents was dragged from his truck and beaten severely by a snowboarder and some Occupy people. The rest of the crowd is reacting with various kinds of critical incident stress to witnessing or almost witnessing the kid get hit. Be serious; make it real. Other truck drivers return, ashamed of what their buddy did and offer to evacuate the injured. After an opportunity to see how their return goes over, this ends the scenario.)

PATIENTS

Add "wild cards" (emotional/social situations) and be specific with patients about the forensics: what part of the truck struck their body where at what speed, did they roll up on the hood, etc.

Aging costumed protester was hit by one corner of the truck at 20 mph as it entered the crowd; it spun her around and she fell. Has femur fracture, scalp lacerations, MOI for c-spine (whiplash), potentially broken wrist (landed on it). Costume hides bruising. Person is sitting on ground, screaming about blood from scalp laceration. Doesn't realize her leg is broken until she can't get up. After about 10 mins she decompensates and gets shocky (because of big internal bleed into the thigh related to femur fracture): rapid shallow breathing, LOR decreasing slowly but progressively because of internal blood loss, may eventually vomit.
8-year-old child hit full-on at about 15 mph, goes under truck (chassis is high so not run over by any wheels). Head injury and C-spine MOI from head hitting concrete pad; bruising and scrapes. Unresponsive.
Elderly clergy person whose foot was crushed by vehicle. Then begins having chest pain, not for first time. Knows and has known he might die as soon as chest pain hits, not calling out to medics, might ask someone to call an ambulance for him, wants to see his doctor.
Protester fell off a picnic table in the stampede to get away from the truck, landed on pile of protest signs twisted foot inward and can't bear weight.
Protester has been choking on summer sausage since he was startled by seeing the truck hit the tents. Coughing at first, turning red in face, then goes silent. 3-5 abdominal thrusts should get it out, then coughing again. Otherwise LOR goes down fast (4 mins til only verbal or pain responsive).
10-year-old child got minor injuries in stampede to get away from car. Separated from parents. Has asthma attack (has inhaler in pocket).
Occupy protester tangled in tent, struck by corner of truck at low speed. Bruising, possible broken rib. Really scared because trapped in collapsed tent. Acts drunk but is having diabetic emergency (low blood sugar); realizes this only after calmed down and talked to (or SAMPLE taken).
Driver of truck -- was pulled out of truck, kicked, stomped, and beaten with object. Unresponsive. Ears leaking blood. Facial fractures and rib fractures, as well as internal bleeding in abdomen.
Snowboarder who started the beating of the driver after seeing the kid get hit. Bite injury on knuckles (from punching the driver in the face before dragging him out of the car); scratches on arms from broken glass and fingernails; fingernail gouges on face. Declines treatment at first and attempts to interfere with any effort to treat the driver, if that is attempted. Exits scene ASAP when other trucks return.
(Lots of fight, flight, freeze): If we have lots of extras, they are mostly people who are reacting to the trauma of what just happened. Any additional injuries are due to this stress or its effects (jostling, elbowing, falling, etc). Even if injured, most may be helpful if given something to do.

OTHER ACTORS

Volunteer park ranger who is on the phone with the sheriffs. Late on scene, trying to figure out what happened, not a bad guy, wants to take charge but definitely out of his depth; doesn't see beaten driver.
Livestreamer who wants to interview someone who saw the kid get hit and get footage of beaten driver's face.