Scenario: The Bank Job Part One

[Guest guest]

You receive a call for urgent medical assistance from control. Shots have

been exchanged between a police armed response unit* and a team of

criminals trying to evade arrest after a bank robbery. Police notify you, via

control, that the scene is now safe to approach.

As usual you are first on scene and have a ten to fifteen minute advantage

over the ambulance.

Patients (rapid info for triage only)

[One] Police officer.

Airway appears patent.

Breathing is very rapid (44pm), shallow and guarded

Radial pulse is present though weak and rapid

Severe bleeding from right thigh

He is shielding his chest with one hand and his leg with the other

[Two] Police officer.

No response

Breaths absent

Pulse Absent

Penetrating injuries (three in chest), pool of blood on pavement

[Three] Criminal

Moaning

Rapid breaths (c24)

Radial pulse present (c100)

Single penetrating wound to centre of chest

[Four] Criminal

Unresponsive

Gargling blood

Breaths, rapid and shallow

Radial pulse present (c80)

Single penetrating wound to centre of throat

[Five] Bystander

Screaming

Breaths (c40)

Carotid pulse present (c132)

Large penetrating injury to lower left quadrant of abdomen

[six] Bank clerk, behind bullet resistant glass

Screaming

Breaths and pulse unattainable do to security lock down

Multiple punctures and lacerations to face

[seven] Bank clerk, behind bullet resistant screen

Responsive

Breaths, rapid and deep (visibly)

The other two criminal have escaped the scene.

As always you have the contents of the rapid response vehicle and

your own skills to bring into play. There are also a first-aider (bank staff)

and a member of the armed response unit who is a trained trauma tech.

Initial triage, diagnoses and team priorities.

Good Luck

*The scenario has been set in the UK, were armed officers are limited to

specialist teams.