MCI REPORT – CASE NOTES
You are tasked to a motor vehicle crash on Montague Street, Southbank, where a bus has driven under a low bridge. There are people trapped in the bus. You are the first responding ambulance to the scene. The scene is secure when you arrive (fire service in attendance) and traffic has been managed.
Location
Part1
Provide a SITREP you would give after you have been on scene for a couple of minutes and have a headcount. The list of patients is below.
Patient list
Patients
Triage Sieve score
Triage Sort score
Patient 1
Female 83
Chest pain; # ribs
Not walking
RR 32
Pulse 96
Systolic 120
GCS 14
Patient 2
Female 96
Unconscious
Not walking
RR 7
Pulse 62
Systolic not recordable
GCS 3
Patient 3
Male 78
Fractured arm; facial contusions
Able to walk
RR 22
Pulse 110
Systolic 175
GCS 15
Patient 4
Female 88
Scalp laceration
Not walking
RR 4
Pulse 45
Systolic 180
GCS 6
Patient 5
Male 79
Neck pain
Walks with assistance
RR 24
Pulse 64
Systolic 155
GCS 14
Patient 6
Male 80
# hip & pain lower legs
Not walking
RR 32
Pulse 114
Systolic 110
GCS 13
Patient 7
Female 68
Abdominal pain
Walking
RR 28
Pulse 112
Systolic 105
GCS 15
Patient 8
Male 58
Facial bruising and orbit fracture
Not walking
RR 12
Pulse 45
Systolic 165
GCS 6
Patient 9
Female 84
Chest pain, SOB
Walking
RR 34
Pulse 140
Systolic 90
GCS 13
Patient 10
Female 73
Dislocated shoulder & neck pain
Walking
RR 16
Pulse 72
Systolic130
GCS15
Patient 11
Female 58
Neck pain, paralysis arms & legs
Not walking
RR 28
Pulse 45
Systolic 85
GCS 15
Patient 12
Male 45
Penetrating trauma; impaled by piece of metal through abdomen
Not walking
RR 24
Pulse 130
Systolic 60
GCS 12
Patient 13
Male 52
# humerus & shoulder pain
Walking
RR 20
Pulse 96
Systolic 150
GCS 15
Patient 14
Male 32
Scalp haematoma & semi-conscious
Not walking
RR 16
Pulse 58
Systolic 145
GCS 12
Patient 15
Male 19
# femur
Not walking
RR 26
Pulse 130
Systolic 90
GCS 15
Part 2: Triage
For each patient, provide a:
a) triage sieve score
b) triage sort score
Part 3: Roles
Patient 7: Passenger who was sitting on the 7th row of the bus. During the crash, she sustained a sharp blow to the R) lateral side of the thorax/abdomen, at the level of the 9th rib. Once freed from the bus, she was able to walk.
Briefly explain the actions taken by the primary triage, secondary triage and casualty clearance officers in managing this patient.
After some time the casualty clearance officer notices that patient 7 appears pale and distressed. Her observations are now:
Abdominal pain; increasing severity
not walking
RR 28
Pulse 124
Systolic BP 85
GCS 14
Explain the actions the casualty clearance officer would take now.
Briefly explain the roles of the transport officer and the attending paramedic during the trip to hospital and at hospital handover.
No referencing required.