Pre-Hospital RSI Part I

In the next couple of steps we will bring together our learning so far using an RSI scenario video. In this first part we will see initial patient assessment and airway management by the first on scene paramedics, the arrival of the HEMS team and the RSI kit dump set up.

(Not all aspects of scene management and patient care are portrayed and a relatively simple scenario has been selected to emphasis the key learning points.)

Post-Video Exercise:

Watch the video first and then consider the following scenario reflections and challenges.

Reflections:

• How did the HEMS team and first on-scene paramedics communicate with each other?
• How was concurrent activity and time-efficiency achieved?
• Would you have approached the scenario differently – if so how?

Scenario Challenges:

How would you manage this scene differently if:

• It was night time and/or raining?
• The driver of the vehicle was drunk and aggressive to the clinical team?
• The vehicle was unstable or leaking fuel?
• The patient was trapped in or under the vehicle?
• There were multiple critically injured casualties?

How would you manage this patient differently if:

• They were GCS 10, combative and agitated?
• They had multiple limb injuries and suspected pelvic fracture?
• They were cardiovascularly unstable and urgently needed blood product resuscitation?