We did our second simulation yesday; I was a primary responder this time. My patient had an ankle injury he couldn't walk on and a small branch through his hand. Unfortunately, he was also this simulation's Mr. Obnoxious; his entire job consisted of hobbling away from me at every turn, trying to bandage himself with random stuff from my bag, and deafening me by yelling to his friends, other responders, and anyone within earshot (and some who were outside of earshot) to find out what was going on and if everyone else was alright. (Overall, the simulation involved a cookstove explosion, some hypothermia, toxic berries, and a few falls and impaled objects.) After a few minutes of being happily bandaged, he went into an acute asthma attack which quickly advanced to respiratory failure.
It was a high-stress day. One of the benefits of these simulations is that they do a pretty good job of getting your adrenaline levels going. Going through the simulation as a primary responder after half a week of high-intensity days is mentally and emotionally exhausting, and I think that's exactly the point. I hate to admit it, but I got in the car to go home after class last night and basically bawled like a child. (Thank goodness Joe was driving.) I just kept going over what I did wrong, what I should have done differently, and what I missed that might have triggered the asthma attack that ultimately led to us evacuating my previously-stable patient on a stretcher. Luckily for me, it was just a two-hour simulation, and now that I'm looking back on it, I actually ended up with the perfect patient for myself. I tend to be Way Too Nice, and dealing with an unruly patient who tried to take advantage of that was the best learning experience I could have asked for. At this point, I can only imagine how stressful a real-life first response situation will be like.
On the bright side, I get to be a patient for our final simulation on Friday. After the last two, I can't wait to see what they've got in store for us.
We also learned yesterday how to wrap hypothermia patients and to make improvised litters out of almost anything we have lying around: paddles and life jackets, climbing rope, tent poles, you name it. (And you guessed it- a couple of them included duct tape.)
UPDATE: I talked with Jeff before class began this morning, and I feel much better about yesterday's simulation. It turns out that my Mr. Obnoxious thought he had an internal bleed that they never actually gave him. Because of that, he showed symptoms of a problem for which there were no physical signs. (Turns out there was a little ad-libbing in there, too. *grin*) So even though I didn't do everything quite right, I ended up not doing too bad.
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