Advanced Trauma Life Support ATLS Student Course Manual 2018

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APPENDIX F n Triage Scenarios
Triage Scenario IV
Cold Injury
SCENARIO
While in your hospital, you receive a call that five members of a doctor’s family were snowmobiling on a lake
when the ice broke. Four family members fell into the lake water. The doctor was able to stop his snowmobile
in time and left to seek help. The response time of basic and advanced life support assistance was 15 minutes.
By the time prehospital care providers arrived, one individual had crawled out of the lake and removed another
victim from the water. Two individuals remained submerged; they were found by rescue divers and removed
from the lake. Rescuers from the scene provided the following information:
PATIENT A—The doctor’s 10-year-old grandson was removed from the lake by rescuers. His ECG monitor
shows asystole.
PATIENT B—The doctor’s 65-year-old wife was removed from the lake by rescuers. Her ECG monitor
shows asystole.
PATIENT C—The doctor’s 35-year-old daughter, who was removed from the water by her sister-in-law,
has bruises to her anterior chest wall. Her blood pressure is 90 mm Hg systolic.
PATIENT D—The doctor’s 35-year-old daughter-in-law, who had been submerged and crawled out of the
lake, has no obvious signs of trauma. Her blood pressure is 110 mm Hg systolic.
PATIENT E—The 76-year-old retired doctor, who never went into the water, reports only cold hands and feet.
1. Establish the priorities for transport from the scene to your emergency department, and explain your
rationale.
TRANSPORT
PRIORITY PATIENT RATIONALE
1
2
3
4
5
2. In the emergency department, all patients should have their core temperature measured. Core temperatures
for these patients are as follows:
PATIENT A: 29°C (84.2°F)
PATIENT B: 34°C (93.2°F)
PATIENT C: 33°C (91.4°F)
PATIENT D: 35°C (95°F)
PATIENT E: 36°C (96.8°F)
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