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View Full Version : Scenario based training....brings it all together



justanothergunnut
07-27-2014, 07:09 PM
Today I did a scenario based training exercise that involved a few different skill sets. Land navigation, Comms, tracking and medical.

The scenario: You are a SAR team tasked with finding two hikers who reported via cell phone that they were suffering serious medical conditions, ie vomiting and diarrhea. The signal was very weak and the female reported that they were going to try to walk out. The cell signal gave you a basic area to start in.

The exercise starts with the last known location(I should add GPS units not allowed) you must plot the last known location of the lost hikers on your topo then move there. They of course aren't there so you then have to use your tracking skills. You eventually find where they made camp and the male is unconscious when you arrive. You must do a trauma assessment and try to get as much info from the girlfriend as possible(she of course is emotionally in shock and it is difficult to get info from here) After the initial assessment and from the info given by the girlfriend i discovered that they were short on water and the boyfriend had been drinking from the creek. He had been suffering extreme diarrhea with stomach cramps for two days and had been refusing to take liquids on board for the last 12 hours. I diagnose either infection from Cryptosporidium or Giardia. I start a IV and have my counterpart head to higher ground to radio for evac..

synopsis:
I did well in every aspect EXCEPT starting the IV.. I was not aware at the beginning of the scenario that I would be required to start a IV.. (go figure, things happen you don't expect) I have trained with a certain brand of Catheter and always in clean classroom environments. This scenario my patient was laying on a woobie under a tarp in a canyon next to a creek. The Catheter was a 14ga of a style I have not used.. Bottom line.. I FAILED!!!! I could not get the catheter to advance on the needle, I got it into the vein and I got flash but I couldn't manipulate the catheter forward. I was pissed, this should be simple but the stress of unknown gear in a environment I had not done this task in before caused me to choke..

Conclusion:
I thought since I felt comfortable starting IV's in the classroom that I was good to go. HAHAHA that's funny, out there , in the field where it matters I was nervous. I had not trained on various styles of catheters and I felt nervous about maintaining a sterile environment. It was a great learning experience. Failure has a value those who cant face it don't understand. I wasn't perfect, in fact my patient may have died but the learning experience I got from it was AWESOME.....

Lowdown3
07-27-2014, 09:07 PM
Don't kick yourself too much.

There is some new SOF-T tourniquet out that isn't quite as stupid as the original one. It has some hook and latch closure.

I'm used to the stupid original SOF-T and I found myself threading the new one while it should have just been snapped together.

I carry CAT tourniquets and are more familiar with them.

Stuff is gonna happen, i.e, go wrong in stressful situations. This is why we train. Even when you feel confident with something, conditions change, the rust needs to be knocked off the blade, etc.

Thanks for sharing it. Should be a wake up to folks.

My personal not so favorite is the stupid safety type catheters that retract....

justanothergunnut
07-27-2014, 09:59 PM
aahh the auto catheter.. LOL gotta love it. im not really kicking myself, I feel more humble and yet I feel soo much better for the experience.. SUPER valuable.. I actually feel ok that I choked.. Now I know that I need to train harder in that area... You know LD3, if we want to train seriously our ego is one of the first things that must go.. IT WAS A GREAT DAY!!

SwampYankee
07-28-2014, 10:51 AM
Sounds like you did really good given the situation you encountered. You're right, experience is the best teacher and understanding what happens in training both good and bad is where the real lessons are learned. From the outside looking in you did well. What makes you say that you "choked"?

justanothergunnut
07-28-2014, 11:49 AM
Finding the "lost hikers" was only part of the test. The patient was severely dehydrated and on the verge of shock. In failing to get a IV started the final exam was not passed. I did salvage some of it by changing the scenario to fit my needs ie cover up my failure. I stated the patient was too dehydrated and the veins too collapsed to start a iv and that I would insert the tube rectally. The "patient" wasn't too excited to hear that. ;-). The bottom line is though that had I performed flawlessly it would have been a fun day in the field but through failure training value was added. Next time it will be different

Patriotic Sheepdog
07-28-2014, 04:47 PM
Sounds like you did okay. Not anyone can get an IV all the time. If you like a particular brand/type of IV catheter, why not get a couple and carry with you if possible?


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