Interview Scenario

[hoosieremt88]

I was given this scenario at an interview so I wanted to see what people thought. Had an unresponsive male in a warehouse. U/A I find a male mid 20's, laying supine on the floor. I have a by stander to help me so i have them hold cspine while I get v/s. I get a rapid pulse=144, no breath sounds, cool clammy skin. I insert airway adjunct, and bag with O2 at 15lpm. I listen for breath sounds again, nothing. So i get ready to insert a combitube, give the incoming medic a report, then help the medic intubate. And that was the end of my scenario. Any advice or suggestions on what else I could have done differently or not change anything? Thanks

 

[TripsTer]

I just want to clarify, when you say breath sounds do you mean breath sounds as in putting your steth to the PT's chest and listening to their lungs or breath sounds as in you don't hear any breathing?

I was always taught to check breathing by listening after doing a head-tilt, chin lift or jaw thrust, not by using your steth but I guess that could work.

Either way, can't think of anything else you could do from a BLS perspective. Sounds about right.

Oh, what kind of warehouse? Any Hazardous materials present?

 

[MedicMeJJB]

BLS perspective, you did well. I don't think you should have done anything differently. You took care of A and B.. Good.. Now.. as further assessment, what would you have done? If you had completed your ABC's ...

 

[hoosieremt88]

Yea I did a head tilt chin lift and no breath sounds with my steth... and no haz mat.

 

[FLEMTP]

Yea I did a head tilt chin lift and no breath sounds with my steth... and no haz mat.

If you did a head tilt chin lift in a suspected trauma patient (which, in this case, unknown trauma) then thats BAD ...

jaw thrust = good

 

[hoosieremt88]

Thanks... I knew I messed up right after that, but nothing I could do to change it at that point.

 

[MedicMeJJB]

Did you mention.. "No! I wouldn't do that, I'm sorry, I would have done a jaw-thrust" ??

 

[boingo]

Did you consider the possibility of foreign body? If you attempted to ventilate the patient and had no chest rise, inserted an adjunct, and again had no chest rise (or breath sounds) airway obstruction might be on the top of your list of differentials.