Bioterrorism Drill Case 3 Dirty Bomb: Patient Roles

1. Bioterrorism Drill Case 3Dirty Bomb: Patient Roles

2. You are a student on a rotation at a local hospital. While stopping by the cafeteria for a mid-morning coffee break, you hear a huge explosion and are knocked off your feet. You do not recall losing consciousness. As you climb out from under debris, you notice a fine dust floating in the air and covering everything. You help several other people out from under debris, and make your way towards the outside through a blown out window. Much of the hospital is demolished and it appears as though a small truck drove into the lobby and blew up. You want to help, but you don’t feel well so you make your way two blocks to another hospital’s Emergency Department (ED). You present to the ED with: Nausea / Vomiting SLIGHT cough but NO breathing difficulty Headache, Tinnitus Fatigue Bruises, scratches and scrapes all over your body If asked about vital signs, please show the opposite side of this card. 3Y You are a student on a rotation at a local hospital. While stopping by the cafeteria for a mid-morning coffee break, you hear a huge explosion and are knocked off your feet. You do not recall losing consciousness. As you climb out from under debris, you notice a fine dust floating in the air and covering everything. You help several other people out from under debris, and make your way towards the outside through a blown out window. Much of the hospital is demolished and it appears as though a small truck drove into the lobby and blew up. You want to help, but you think you may be injured, so you make your way two blocks to another hospital’s Emergency Department (ED). You present to the ED with: Bilateral arm fractures Severe pain in distal leg on walking SLIGHT cough without breathing difficulty Headache, Tinnitus Bruises, scratches and scrapes all over your body If asked about vital signs, please show the opposite side of this card. 3y

3. General impression: Patient is vomiting and complaining of “not feeling well.” Vital Signs: Pulse: 100 Respirations: 20 BP: 130/80 Temp: 98ºF, PO Pupils: PERRLA General impression: Patient appears to be in pain from multiple bruises and possible fractures. Vital Signs: Pulse: 11070 Respirations: 24 BP: 104/72 Temp: 98ºF, PO Pupils: PERRLA

4. You are a student on a rotation at a local hospital. While stopping by the cafeteria for a mid-morning coffee break, you hear a huge explosion and are knocked off your feet. You do not recall losing consciousness. As you climb out from under debris, you notice a fine dust floating in the air and covering everything. You help several other people out from under debris, and make your way towards the outside through a blown out window. Much of the hospital is demolished and it appears as though a small truck drove into the lobby and blew up. You want to help, but you don’t feel well so you make your way two blocks to another hospital’s Emergency Department (ED). You present to the ED with: Nausea / Vomiting / Diarrhea Cough with some shortness of breath Headache, Tinnitus Fatigue Bruises, scratches and scrapes all over your body If asked about vital signs, please show the opposite side of this card. 3R You are a student on a rotation at a local hospital. While stopping by the cafeteria for a mid-morning coffee break, you hear a huge explosion and are knocked off your feet. You do not recall losing consciousness. As you climb out from under debris, you notice a fine dust floating in the air and covering everything. You help several other people out from under debris, and make your way towards the outside through a blown out window. Much of the hospital is demolished and it appears as though a small truck drove into the lobby and blew up. You want to help, but you don’t feel well and you think you may be injured pretty severely, so you make your way two blocks to another hospital’s Emergency Department (ED). You present to the ED with: Significant confusion Severe bleeding Shrapnel wounds on abdomen and extremities Headache, Tinnitus Bruises, scratches and scrapes all over your body If asked about vital signs, please show the opposite side of this card. 3r

5. General impression: Patient is vomiting, incontinent of stool, and seems acutely ill. Vital Signs: Pulse: 110 Respirations: 20 BP: 100/70 Temp: 98ºF, PO Pupils: PERRLA, sluggish General impression: Patient is severely confused and appears to be losing a large volume of blood. Vital Signs: Pulse: 130 Respirations: 36 BP: 60/40 Temp: 96ºF, PO Pupils: Dilated, sluggish response, equal bilaterally

6. You are a student on a rotation at a local hospital. While stopping by the cafeteria for a mid-morning coffee break, you hear a huge explosion and are knocked off your feet. You do not recall losing consciousness. As you climb out from under debris, you notice a fine dust floating in the air and covering everything. You help several other people out from under debris, and make your way towards the outside through a blown out window. Much of the hospital is demolished and it appears as though a small truck drove into the lobby and blew up. You started to help look for survivors, but then began feeling ill, so you make your way two blocks to another hospital’s Emergency Department (ED). You present to the ED with: Severe Nausea / Vomiting / Diarrhea Significant confusion Headache, Tinnitus Fatigue Bruises, scratches and scrapes all over your body While waiting to be decontaminated or triaged, please be towards the back of the group. After 2 or 3 minutes, you have a seizure and will remain unresponsive for the rest of the drill. If asked about vital signs, please show the opposite side of this card.3B You are a student on a rotation at a local hospital. While stopping by the cafeteria for a mid-morning coffee break, you hear a huge explosion and are knocked off your feet. You do not recall losing consciousness. As you climb out from under debris, you notice a fine dust floating in the air and covering everything. You help several other people out from under debris, and make your way towards the outside through a blown out window. Much of the hospital is demolished and it appears as though a small truck drove into the lobby and blew up. You are semi-conscious, and are dragged two blocks to another hospital’s Emergency Department (ED). You present to the ED with: Semi-consciousness An open head injury Shrapnel wounds on abdomen and extremities Bruises, scratches and scrapes all over your body While waiting to be decontaminated or triaged, please be towards the back of the group. After 2 or 3 minutes, you have a seizure and will remain unresponsive for the rest of the drill. If asked about vital signs, please show the opposite side of this card.3b

7. General impression: Patient is unresponsive. Vital Signs: Pulse: 200 Respirations: 40 BP: 40/P Temp: 96ºF, PO Pupils: Unresponsive General impression: Patient is unresponsive. Vital Signs: Pulse: 200 Respirations: 40, then 0, then 0, then 0 BP: 40/P Temp: 96ºF, PO Pupils: Unresponsive and dilated

8. You are a parent who dropped your 14 year old daughter off at the pediatrics clinic for an appointment while you ran some errands on the other side of town. You were going to pick her up in the lobby of the hospital, but when you arrived, the police told you that there had been an explosion at the hospital and would not let you in. You have come to the Emergency Department at the nearest other hospital in search of her, and you are very worried. You need to find whoever is in charge and find out from them where your daughter is. You present to the ED with: Hysteria – you need to find your daughter! If asked about vital signs, please show the opposite side of this card. 3G You are a patient who was scheduled to see the podiatrist at the hospital tomorrow for your bunions (they’re very painful, you know). You heard on the radio there had been an explosion at the hospital, and you now wanted to know if your appointment was going to be cancelled. When you called, nobody answered the telephone, so decided you’d better go in person to find out. As you approached the hospital, the police directed you away. You knew there was another hospital just a few blocks away, so decided to go there to see if they knew if your appointment had been canceled. After arriving at the other hospital, you got in line behind the other patients waiting to go into the hospital so you could go to the information desk and ask them about your podiatry appointment. You present to the ED with: Bunions, but your podiatrist was supposed to look at them tomorrow. Now you just want to know if your podiatry appointment at the other hospital be canceled. If asked about vital signs, please show the opposite side of this card. 3g

9. General impression: No apparent distress, but extremely worried. Vital Signs: Pulse: 110 Respirations: 20 BP: 142/86 Temp: 99ºF, PO Pupils: PERRLA General impression: No apparent distress, but the patient is concerned their podiatry appointment for tomorrow will be canceled. Vital Signs: Pulse: 90 Respirations: 18 BP: 138/86 Temp: 98ºF, PO Pupils: PERRLA