Scenario: The Gym Part One

[Guest guest]

Any of you familiar with ECOnline may have seen the weekly scenarios.

This is the first one we are doing on Remote Medics and hope they will

continue for some time.

+++ START +++

You have been called to an incident at a local gym. Ambulance is less than

5 mins from incident. As usual you have the response car, onboard

equipment and your own skills to bring into play.

Jerry is a forty five year old born again fitness fanatic. He has been bench

pressing heavy weights (340 lbs) and his spotter momentarily left for

a call of nature. On return, the weight bar was across his chest and Jerry

was unresponsive. With the help of the centre's lifeguard the weight

has been lifted off and away from him.

Jerry, is breathing fast, at present c32 per minute. He has a faint rapid

pulse

and BP has been roughly attained at 90/55. His face is bright red and both

eyes are blood shot. Both pupils are equal and responsive to light. He is

alert to speech, although gasping and unable to engage in conversation.

On exposure there is a visible red line across the chest about centre of the

sternum.

The instructor informs you that the gym does not tolerate any misuse of

drugs

and that Jerry has a determination to stay 'natural' in his training. His

kit bag

contains no medications apart from a bottle of Lucozade, a bottle of still

mineral water and a medic-alert bracelet stating he is intolerant to

aspirin.

+++ FINISH +++

Good luck

Ross Boardman

editor@...

[Guest guest]

Poor Jerry - he has nearly " traumatic(aly) asphyxia(ated) " himself.

Barring pump failure as a percursor to dropping the weight give him lots of

O2 and check that his trachea is central and he has good bilateral air entry

; then post him off! Could have been a candidate for a hypoxic cardiac

aresst.

Davy Gunn

<snip>

[Guest guest]

In a message dated 17/04/00 17:46:19 GMT Daylight Time, emonline@...

writes:

> You have been called to an incident at a local gym. Ambulance is less than

> 5 mins from incident. As usual you have the response car, onboard

> equipment and your own skills to bring into play.

OK, Arrive onscene, inform control -

> Jerry is a forty five year old born again fitness fanatic. He has been

bench

> pressing heavy weights (340 lbs) and his spotter momentarily left for

> a call of nature. On return, the weight bar was across his chest and Jerry

> was unresponsive. With the help of the centre's lifeguard the weight

> has been lifted off and away from him.

How long was the spotter away, I assume somebody has moved the weights?

> Jerry, is breathing fast, at present c32 per minute. He has a faint rapid

> pulse

ABC's 100% O2 via hudson trauma mask.

Reassess breathing.

Call control, inform need transport vehicle ASAP due to breathing diffs

conect monitor, assess rythmns, attach SPO2 What sats are we getting?

While waiting full chest exam, breath sounds? expansion ? paradoxical

movement ?

> and BP has been roughly attained at 90/55. His face is bright red and both

> eyes are blood shot. Both pupils are equal and responsive to light. He is

> alert to speech, although gasping and unable to engage in conversation.

> On exposure there is a visible red line across the chest about centre of

the

> sternum.

Obvious upper, chest injury, starting now to think, about pneumo thorax's,

punctured lungs etc

> The instructor informs you that the gym does not tolerate any misuse of

> drugs

> and that Jerry has a determination to stay 'natural' in his training. His

> kit bag

> contains no medications apart from a bottle of Lucozade, a bottle of still

> mineral water and a medic-alert bracelet stating he is intolerant to

> aspirin.

Ok from this we can assume he is fairly clean, however should bear it in mind

in case its not the case. he is sensitive to aspirin, why ? is he asthmatic

in anyway?

Thats seems like enough for the assessment - give a few answers Ross and I'll

start to think about the treatment

Best wishes

Ian S

**********************************************************

Ian Sharpe

Medic / Dive Medic

Ian@...

IanSharpe@...

ICQ 26318188