FAQ - Guide for Emergency Room: Disaster Strikes

Emergency Room: Disaster Strikes FAQ
Version .81B
Copyright of Paul Pike [[email protected]]
Emergency Room: Disaster Strikes is copyright of Legacy Interactice
(www.legacyinteractive.com)

Ok everyone listen up! I want everyone to know that this is my work and I don't
want anybody ripping this FAQ off for themselves. (where have we heard this
before?)

What is Emergency Room: Disaster Strikes?
=========================================
This game is quite the sequel to ER 2 with a whole lot more variety of cases
and for once, has a story. Los Angeles just got hit by a 7.9 earthquake, winter
storms and a mudslide, and doctors are in such short supply. Care to help out?

The Med-o-matic
===============

It's still your best friend with the same functions. Here they are:

S.O.A.P. (Subjective, Objective, Assessment, Plan)
Notes (Used to review which tests and treatments you've done)
Comm (Used to talk to either Dr. Snyder [taking the place of Dr. D Boss] or
Nurse Irene Adams)
Glossary (Used to look up those medical terms and definitions of body parts)

S.O.A.P.: Answering the questions of the S.O.A.P. allows you to get more points
and make good with Dr. Snyder [if you ask me, he's a lot nicer than D Boss].
The S.O.A.P. quesations here are done in respective order from top to bottom
(ex. S: 2nd and 1st choices. That means on the Subjective Part, click on the
2nd circle, go down, then click the 1st circle.)

Notes: You can look at the notes to see what the results were of the test you
did.

Comm.: Besides talking to Dr. Snyder, you can use this to ask for help from
Irene (IMHO, I don't think she's a real blond)

Glossary: Do I need to say anything more?

Tools of the trade
==================

Examination Room
----------------

EKG: Used on the heart to record the electric impulses in the heart
Sphygmomanometer [say that 3X fast ;)]: Used on the upper arm to measure blood
pressure
Thermometer: Used in the mouth to measure the body temperature
Respirometer: Used to measure the patient's respiration rate
Magnifying Glass: Used to examine a part of the body
Glove: Used to get palpation info on a body part
Pulsometer: Used on a finger to measure the pulse rate
Stethoscope: Used on the heart to hear heart sounds, on the lungs to hear
respiration sounds, and on the abdomen to hear bowel sounds
Penlight: Used on the eye to check pupil response
Nasoscope: Used on the nose to examine the nasal mucosa
Othalmoscope: Used on the eye to inspect the inside of the eye
Tongue depressor: Used in the mouth to examine the mouth and throat
Othoscope: Used on the ear to view inside the ear
Eye dye: Used on the eye to detect abnormalities in the cornea

Imaging room
------------

X-ray: Used to take a photograph of the inside of the body
Ultrasound: Used for diagnostic or therapeutic purposes
CAT Scan: Used to get tomography info

Laboratory
----------

Blood test: Used to measure hemoglobin/hematocrit (H/H), type and cross,
complete blood count (CBC), amylase, glucose, liver enzyme, kidney panel,
cardiac enzyme, monospot, gall bladder panel, poison screen, blood alcohol,
theophylline level and toxic screen
Urine test: Used to measure dipstick, microbiology/chemistry/cytology
Swab culture: Used to measure throat/quick
Blood gas test: Used to measure O2/CO2 and carboxyhemoglobin
Stool test: Used to measure bacteria, ova/parasites and hemoccult

Treatment
---------

Nasal Prongs: Inserted into the nostrils to administer oxygen as treatment
protocol
Ear, Eye and Nose Drops: Medication administered into the ear, eye or nose
Sponge: Used to cleanse a wound skin area
Ambu Bag: Squeezable air reservoir used over the mouth to provide ventilation
Cervical Collar: Used to immobilize the neck
Silver Nitrate/Hot Cautery Tip: Used to stop a wound from bleeding or to
release a subungal hematoma
Wrap: Used to apply compression on an extremity
ET (Endo-tracheal) Tube: Placed in the trachea through the mouth for
ventilation
Tongue Guard: Used in the mouth for seizure protection
Irrigation Syringe: Used to irrigate a wound
Medication Syringe: Used to inject medication in the upper arm or locally at
the wound site
Forceps: Used to explore and debride wounds, and to remove foreign bodies
Oxygen Mask: Placed over the mouth and nose to improve oxygen
PO Meds (Per Oral Medications): Medications taken by mouth
Compress: Used to apply a warm or cool compress to an area
Topical Medication: Medications placed topically on the skin
Aerosolized Medications: Medications inhaled through the mouth into the airways
IV Medications: Medication infused through the IV system (usually in the
forearm)
NG (Nasal-gastric) Tube: Inserted into the nose to pump the stomach  of its
contents or to decompress air in the GI tract
Gauze: Used to pack wounds
Splint Material: Used to immobilize an extremity
Nasal Splint: Used to immobilize the nose
Bandage: Used to dress a wound
Gel: Anesthetic applied to certain wounds
IV: Inserted into a vein (usually the forearm) to established an IV route,
increase fluid volume, or infuse blood
Needle: Used to suture wounds. The curved shape facilitates accurate stitching

NOTE!: Sometimes, the questions on the S.O.A.P. contradict what the notes say.
Either the programmers didn't have enough coffee or they weren't paying
attention

Here come the patients
======================

Earthquake Scenario
------------------------

Patient 200
Case: Knocked down by falling rubble, hurt thigh

S.O.A.P. Questions

S: 3rd and 3rd choices
O: 4th and 1st choices
A: 2nd choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on left thigh
-Glove on left hip, left knee and pelvis

Treatment
-Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on left thigh
-Med syringe on upper arm (5th)
-Discharge

Patient 201
Case: Burned leg

S.O.A.P. Questions

S: 2nd and 4th choices
O: 3rd and 1st choices
A: 2nd choice
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on right leg

Treatment
-Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on right leg
-Discharge

Patient 202
Case: Knocked down by wall, hurt thigh

S.O.A.P. Questions

S: 3rd and 3rd choices
O: 2nd and 2nd choices
A: 3rd choice
P: 2nd and 3rd choices

Examination room
-Magnifying glass and glove on right thigh

Imaging
-X-ray right thigh

Laboratory
-Blood test CBC and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Compress on right thigh (1st)
-IV (2nd) and IV med (3rd) on forearm
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Elevate
	-Immobilize
	-Advise patient to take nothing by mouth (NPO)
	-Continue neuro-vascular checks

Patient 203
Case: Fell down stairs, hurt arm

S.O.A.P. Questions

S: 1st and 4th choices
O: 2nd and 1st choices
A: 4th choice
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on right forearm
-Glove on right elbow and right wrist

Treatment
-Spomge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on right
forearm
-Med syringe on upper arm (5th)
-Discharge

Patient 204
Case: Trapped by falling rubble, hurt thigh

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 1st and 3rd choices
A: 4th choice
P: 2nd and 3rd choices

Examination room
-Magnifying glass and glove on right thigh
-Glove on right knee
-Sphygmomanometer on upper arm
-Stethoscope and EKG on heart

Imaging room
-X-ray right thigh

Laboratory
-Blood test CBC and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-IV on forearm (1st)
-Nasal prongs in nose (2nd)
-EKG on chest (3rd)
-Compress on right thigh (4th)
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Elevate
	-Immobilize
	-Advise patient to take nothing by mouth (NPO)
	-Continue neuro-vascular checks

Patient 205
Case: Falling rubble cut thigh

S.O.A.P. Questions

S: 3rd and 2nd choices
O: 2nd and 3rd choices
A: 1st choice
P: 2nd and 3rd choices

Examination room
-Sphygmomanometer on upper arm
-Stethoscope on heart
-Magnifying glass and glove on right thigh

Imaging room
-X-ray right thigh

Laboratory
-Blood test CBC and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-IV (1st) and IV med (2nd) on forearm
-Med syringe on upper arm (3rd)
-Call in vascular surgeon to continue care and admit
-Hospital orders
	-Apply pressure at pressure point

Patient 206
Case: Fell, hurt shoulder

S.O.A.P. Questions

S: 1st and 4th choices
O: 4th and 2nd choices
A: 4th choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on right shoulder

Imaging
-X-ray right shoulder

Treatment
-Compress (1st) and splint (2nd) on right shoulder
-Discharge
-Hospital orders
	-Immobilize

Patient 207
Case: Fell in earthquake, hurt knee

S.O.A.P. Questions

S: 3rd and 4th choices
O: 2nd and 4th choices
A: 1st choice
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on left knee

Imaging room
-X-ray left knee

Treatment
-Compress (1st) and splint (2nd) on left knee
-Discharge
-Hospital orders
	-Immobilize
	-Elevate area
	-Reduction by traction, reposition, recheck
	-Crutches

Patient 208
Case: Burned leg in fire

S.O.A.P. Questions

S: 4th and 4th choices
O: 4th and 4th choices
A: 1st choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on right leg

Treatment
-Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on right leg
-Med syringe on upper arm (5th)
-Discharge

Patient 209
Case: Stepped on something

S.O.A.P. Questions

S: 1st and 3rd choices
O: 3rd and 4th choices
A: 3rd choice
P: 2nd and 1st choices

Examination room
-Magnifying glass and glove on left foot
-Thermometer in mouth

Imaging room
-X-ray left foot

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), magnetized instrument (4th),
irrigation syringe (5th), gauze (6th), topical med (7th) and bandage (8th) on
left foot
-Discharge

Patient 210
Case: Rubble fell on foot

S.O.A.P. Questions

S: 1st and 1st choices
O: 3rd and 3rd choices
A: 2nd choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on right foot

Imaging room
-X-ray right foot

Treatment
-Compress (1st) and splint (2nd) on right foot
-Discharge
-Hospital orders
	-Immobilize
	-Elevate
	-Crutches

Patient 211
Case: Wheezing

S.O.A.P. Questions

S: 2nd and 1st choices
O: 3rd and 3rd choices
A: 1st choice
P: 4th and 1st choices

Examination room
-Stethoscope on chest heart
-Sphygmomanometer on upper arm
-Respirometer in mouth
-Magnifying glass on chest
-EKG on heart

Imaging room
-X-ray chest

Laboratory
-Blood gas test O2/CO2 on wrist

Treatment
-Aero med in mouth (1st)
-Med syringe on upper arm (2nd)
-Discharge
-Hospital orders
	-Ecourage fluids
	-Recheck patient
	-Constant monitoring

Patient 212
Case: Stepped on sharp object, cut foot

S.O.A.P. Questions

S: 1st and 3rd choices
O: 2nd and 1st choice
A: 2nd choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on left foot

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
needle (5th), topical med (6th) and bandage (7th) on left foot
-Discharge

Patient 213
Case: In appartment fire, respiratory problems

S.O.A.P. Problems

S: 4th and 4th choices
O: 1st and 2nd choices
A: 3rd choices
P: 1st and 3rd choices

Examination room
-Sphygmomanometer on upper arm
-Stethoscope and EKG on heart
-Stethoscope on chest
-Respirometer and tongue depressor in mouth
-Magnifying glass on nose
-Magnifying glass on both eyes

Imaging room
-X-ray chest

Laboratory
-Blood gas test carboxyhemoglobin and O2/CO2 on wrist

Treatment
-ET tube (1st) and ambu bag (2nd) in mouth
-IV on forearm (3rd)
-EKG on chest (4th)
-Aero med in mouth (5th)
-Call in pulmonologist to continue care and admit

Patient 214
Case: Can't breathe

S.O.A.P. Questions

S: 1st and 2nd choices
O: 4th and 4th choices
A: 2nd choice
P: 4th and 3rd choices

Examination room
-Stethoscope on chest and heart
-EKG on heart
-Sphygmomanometer on upper arm
-Respirometer and tongue depressor in mouth
-Magnifying glass on nose and chest

Imaging room
-X-ray chest

Laboratory
-Blood gas test carboxyhemoglobin and O2/CO2 on wrist
-Blood test theophylline level on elbow

Treatment
-ET tube (1st) and ambu bag (2nd) in mouth
-IV on forearm (3rd)
-Aero med in mouth (4th)
-Call in pulmonologist to continue care and admit

Patient 215
Case: Burned thigh

S.O.A.P. Questions

S: 1st and 3rd choices
O: 4th and 3rd choices
A: 3rd choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on right thigh

Treatment
-Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on right
thigh
-Discharge

Patient 216
Case: Dropped bricks on foot

S.O.A.P. Questions

S: 1st and 3rd choices
O: 3rd and 3rd choices
A: 3rd choice
P: 3rd and 3rd choices

Examination room
-Magnifying glass and glove on right foot

Imaging room
-X-ray right foot

Laboratory
-Blood test CBC, H/H and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Sponge (1st), bandage (2nd) and compress (3rd) on right foot
-IV (4th) and IV med (5th) on forearm
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Immobilize
	-Elevate area
	-Take nothing by mouth (NPO)
	-Continue neurovascularity checks

Patient 217
Case: Dry nose, spontaneous nose bleeding

S.O.A.P. Questions:

S: 4th and 1st choices
O: 3rd and 2nd choices
A: 2nd choice
P: 4th and 1st choices

Examination room
-Magnifying glass, glove and nasoscope on nose
-Glove on both cheeks
-Tongue depressor in mouth

Treatment
-Irrigiation syringe (1st), nasal spray (2nd), compress (3rd) and cautery (4th)
on nose
-Discharge
-Hospital orders
	-Pinch nose closed
	-Recheck for bleeding after 15 minutes

Patient 218
Case: Trapped in appartment fire

S.O.A.P. Questions:

S: 4th and 4th choices
O: 1st and 2nd choices
A: 3rd choice
P: 3rd and 3rd choices

Examination room
-Stethoscope on chest and heart
-EKG on heart
-Sphygmomanometer on upper arm
-Respirometer and tongue depressor in mouth
-Magnifying glass on nose and both eyes

Imaging room
-X-ray chest

Laboratory
-Blood gas test O2/CO2 and carboxyhemoglobin on wrist
-Blood test glucose on elbow

Treatment
-ET tube (1st) and ambu bag (2nd) on mouth
-IV (3rd) and IV med (4th) on forearm
-EKG on chest (5th)
-Aero med in mouth (6th)
-Call in pulmonologist to continue care and admit

Patient 219
Case: Fell, hurt elbow

S.O.A.P. Questions:

S: 3rd and 2nd choices
O: 3rd and 2nd choices
A: 1st choice
P: 3rd and 3rd choices

Examination room
-Magnifying glass and glove on left elbow
-Glove on left wrist

Imaging room
-X-ray left elbow

Laboratory
-Blood test CBC, H/H and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Sponge (1st), bandage (2nd) and compress (3rd) on left elbow
-IV (4th) and IV med (5th) on forearm
-Call in orthopedic surgeons to continue care and admit
-Hospital orders
	-Immobilize
	-Elevate
	-Take nothing by mouth (NPO)
	-Continue neurovascularity checks

Patient 220
Case: Beam fell on thigh

S.O.A.P. Questions:

S: 1st and 3rd choices
O: 2nd and 3rd choices
A: 3rd choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on right thigh
-Sphygmomanometer on upper arm
-Stethoscope on heart
-Tongue depressor in mouth

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
needle (5th), topical med (6th) and bandage (7th) on right thigh
-Discharge
-Hospital orders
	-Observation

Patient 221
Case: Sinus pain, yellow discharge

S.O.A.P. Questions:

S: 4th and 1st choices
O: 3rd and 2nd choices
A: 4th choice
P: 1st and 1st choices

Examination room
-Thermometer and tongue depressor in mouth
-Magnifying glass and nasoscope in nose
-Glove on right cheek
-Othoscope on one ear (doesn't matter which)

Imaging room
-X-ray skull

Laboratory
-Swab culture throat/quick in mouth

Treatment
-PO meds in mouth (1st)
-Nasal spray in nose (2nd)
-Discharge

Patient 222
Case: Spider bit forearm

S.O.A.P. Questions:

S: 3rd and 1st choices
O: 4th and 3rd choices
A: 1st choice
P: 1st and 3rd choices

Examination room
-Stethoscope on chest
-Magnifying glass and glove on right forearm
-Glove on right upper arm and chin/neck

Laboratory
-Blood test CBC and glucose on elbow

Treatment
-IV (1st) and IV med (2nd) on forearm
-Call in plastic surgeon to continue care and admit
-Hospital orders
	-Elevate

Patient 223
Case: Stomach pain, nausea

S.O.A.P. Questions

S: 3rd and 2nd choices
O: 3rd and 3rd choices
A: 1st choice
P: 1st and 3rd choices

Examination room
-Magnifying glass, glove and stethoscope on abdomen
-Thermometer in mouth

Imaging room
-X-ray abdomen

Laboratory
-Blood test CBC and H/H on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Call in family physician to continue care and admit
-Hospital orders
	-Take nothing by mouth except medications (NPO
	-Observation

Patient 224
Case: Hand crushed by falling rubble

S.O.A.P. Questions

S: 3rd and 1st choices
O: 3rd and 4th choices
A: 4th choices
P: 2nd and 3rd choices

Examination room
-Stethoscope on heart
-Sphygmomanometer on upper arm
-Respirometer in mouth
-Magnifying glass and glove on right hand

Imaging room
-X-ray right hand

Laboratory tests
-Blood test CBC, H/H and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Sponge (1st), bandage (2nd) and compress (3rd) on right hand
-IV (4th) and IV med (5th) on forearm
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Immobilize
	-Elevate
	-Continue neurovascularity checks
	-Take nothing by mouth (NPO)

Patient 224
Case: Hurt finger clearing rubble

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 3rd and 3rd choices
A: 2nd choice
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on left hand
-Glove on left cheek

Imaging room
-X-ray left hand

Treatment
-Compress (1st) and splint (2nd) on left hand
-Discharge
-Hospital orders
	-Elvate
	-Immobilized

Patient 226
Case: Scratched eye, vision normal

S.O.A.P. Questions

S: 3rd and 2nd choices
O: 3rd and 3rd choices
A: 4th choices
P: 4th and 1st choices

Examination room
-Penlight, othalmoscope, magnifying glass and eye dye on right eye

Treatment
-Irrigation syringe (1st) and drops (2nd) on right eye
-Discharge

Patient 227
Case: Fell, hurt chest

S.O.A.P. Questions

S: 2nd and 1st choices
O: 2nd and 4th choices
A: 3rd choices
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on chest
-Stethoscope on chest and heart

Imaging room
-X-ray chest

Treatment
-Compress (1st) and splint (2nd) on chest
-Discharge
-Hospital orders
	-Rest

Patiant 228
Case: In appartment fire

S.O.A.P. Questions

S: 3rd and 4th choices
O: 3rd and 2nd choices
A: 3rd choice
P: 2nd and 1st choices

Examination room
-Stethoscope on chest and heart
-Sphygmomanometer on upper arm
-Respirometer in mouth
-EKG on heart
-Magnifying glass on nose and both eyes

Laboratory
-Blood gas test O2/CO2 on wrist

Treatment
-O2 mask on mouth (1st)
-EKG on chest (2nd)
-Discharge
-Hospital orders
	-Recheck patient

Patient 229
Case: Headache, weak on left side

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 2nd and 1st choices
A: 3rd choice
P: 1st and 3rd choices

Examination room
-Magnifying glass on mouth
-Glove on forehead
-Penlight and othalmoscope on both eyes

Imaging room
-CAT Scan skull

Laboratory
-Blood test CBC, H/H, type/cross and glucose on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-IV (1st) and IV med (2nd) on forearm
-Tongue guard in mouth (3rd)
-Call in neurologist to continue care and admit

Patient 230
Case: Chest pain

S.O.A.P. Questions

S: 2nd and 1st choices
O: 1st and 3rd choices
A: 3rd choice
P: 3rd and 3rd choices

Examination room
-Stethoscope on heart
-Sphygmomanometer on upper arm
-EKG on heart

Laboratory
-Blood test CBC, H/H, bleeding times and cardiac enzyme on upper arm

Treatment
-O2 mask in mouth (1st)
-IV on forearm (2nd)
-EKG on chest (3rd)
-IV med on forearm (4th)
-Med syringe on upper arm (5th)
-PO meds in mouth (6th)
-Call in cardiologist to continue care and admit

Patient 231
Case: Chemical burn on face, glass in arm

S.O.A.P. Questions

S: 3rd and 4th choices
O: 2nd and 1st choices
A: 3rd choice
P: 2nd and 1st choices

Examination room
-Magnifying glass and glove on left cheek
-Magnifying glass, penlight, eye dye and othalmoscope on left eye
-Magnifying glass and glove on left forearm

Treatment (2 parts)
Face
-Irrigation syringe on left eye (1st)
-Sponge (2nd) and topical med (3rd) on left cheek

Forearm
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
gauze (5th), topical med (6th) and bandage (7th) on left forearm
-Discharge
-Hospital orders
	-Lift glass slivers with tape

Patient 232
Case: Severe vaginal pain

S.O.A.P.

S: 2nd and 2nd choices
O: 1st and 4th choices
A: 3rd choice
P: 1st and 3rd choices

Examination room
-Glove on abdomen and chest
-Magnifying glass on chest
-Stethoscope on heart
-Magnifying glass and glove on pelvis

Imaging room
-Ultrasound on pelvis

Laboratory
-Urine test pregnacy on pelvis
-Blood test CBC, H/H and type/cross on elbow

Treatment
-IV (1st) and IV med (2nd) on forearm
-Call in obstetrician to continue care and admit
-Hospital orders
	-Inform of non-viable pregnancy

Patient 233
Case: Gunshot injury to upper arm

S.O.A.P. Questions

S: 3rd and 1st choices
O: 2nd and 1st choices
A: 2nd choice
P: 3rd and 3rd choices

Examination room
-Magnifying glass and glove on left upper arm

Imaging room
-X-ray left shoulder

Laboratory
-Blood test CBC, H/H and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Sponge (1st) and bandage (2nd) on left upper arm
-IV (3rd) and IV med (4th) on forearm
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Elevate
	-Immobilize
	-Continue neurovascularity checks
	-Take nothing by mouth (NPO

--end of scenario--

Winter Storm Scenario
---------------------

Patient 234
Case: Stepped on something, streaking visible

S.O.A.P. Questions

S: 2nd and 2nd choices
O: 2nd and 3rd choices
A: 1st choice
P: 2nd and 3rd choices

Examination room
-Magnifying glass and glove on left foot
-Thermometer in mouth
-Glove on pelvis
-Magnifying glass on left leg

Laboratory
-Blood test CBC and glucose on forearm

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
gauze (5th), topical med (6th) and bandage (7th) on left foot
-IV med in forearm (8th)
-Call in family doctor to continue care and admit

Patient 235
Case: Hurt finger clearing debris

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 2nd and 3rd choices
A: 4th choice
P: 2nd and 2nd choices

Examination room
-Magnifying glass and glove on left hand

Imaging room
-X-ray left hand

Laboratory
-Blood test CBC, H/H and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Compress on left hand
-Call in orthopedist to continue care and treatment
-Hospital orders
	-Immobilize
	-Elevate
	-Continue neurovascularity checks
	-Take nothing by mouth (NPO)

Patient 236
Case: Wire piece in finger

S.O.A.P. Questions

S: 2nd and 1st choices
O: 3rd and 2nd choices
A: 2nd choice
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on right hand

Imaging room
-X-ray right hand

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
magnetized instrument (5th), topical med (6th) and bandage (7th) on right hand
-Discharge

Patient 237
Case: Tripped on stairs, hurt arm

S.O.A.P. Questions

S: 2nd and 2nd choices
O: 2nd and 1st choices
A: 3rd choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on right forearm
-Glove on right wrist and right elbow

Treatment
-Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on right
forearm
-Discharge

Patient 238
Case: Hit by flying debris, cut leg

S.O.A.P. Questions

S: 2nd and 2nd choices
O: 2nd and 2nd choices
A: 4th choice
P: 2nd and 1st choices

Examination room
-Magnifying glass and glove on left leg

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
cautery (5th), needle (6th), topical med (7th) and bandage (8th) on left leg
-Discharge

Patient 239
Case: Hit on side

S.O.A.P. Questions

S: 2nd and 2nd choices
O: 1st and 4th choices
A: 2nd choice
P: 3rd and 3rd choices

Examination room
-Stethoscope on heart
-Sphygmomanometer on upper arm
-Magnifying glass and glove on left flank
-Glove on abdomen and chest

Imaging room
-X-ray abdomen

Laboratory
-Urine test dipstick on pelvis
-Blood test CBC and type/cross on elbow

Treatment
-IV on forearm
-Call in urologist to continue care and admit
-Hospital orders
	-Advise patient to take no food or drink by mouth (NPO)

Patient 240
Case: Water heater exploded, cut thigh

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 1st and 3rd choices
A: 4th choice
P: 2nd and 3rd choices

Examination room
-Magnifying glass and glove on left thigh
-Stethoscope on heart
-Sphygmomanometer on upper arm
-Glove on left knee and left foot

Imaging room
-X-ray left thigh

Laboratory
-Blood test CBC, H/H and type/cross on elbow
-Urine microbiology/chemistry/cytology on pelvis

Treatment
-IV on forearm (1st)
-Nasal prongs in nose (2nd)
-EKG on chest (3rd)
-IV med on forearm (4th)
-Call in vascular surgeon to continue care and admit
-Hospital orders
	-Apply pressure at pressure point
	-Immobilize
	-Continue neurovascularity checks

Patient 241
Case: Struck on thigh by blown debris

S.O.A.P. Questions

S: 3rd and 3rd choices
O: 1st and 1st choices
A: 4th choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on right thigh

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
needle (5th), topical med (6th) and bandage (7th) on right thigh
-Discharge

Patient 242
Case: Something in eye, hurts to look at light

S.O.A.P. Questions

S: 2nd and 1st choices
O: 1st and 2nd choices
A: 3rd choice
P: 3rd and 1st choices

Examination room
-Magnifying glass, penlight, othalmoscope and eye dye on left eye

Treatment
-Drops (1st), magnetized instrument (2nd) and irrigation syringe (3rd) on left
eye
-Discharge

Patient 243
Case: Dropped rubble on foot

S.O.A.P. Questions

S: 4th and 2nd choices
O: 4th and 1st choices
A: 1st choice
P: 2nd and 3rd choices

Examination room
-Sphygmomanometer on upper arm
-Stethoscope on heart
-Magnifying glass and glove on right foot

Imaging room
-X-ray foot

Laboratory
-Blood test CBC, H/H and type/cross on elbow
-Urine microbiology/chemistry/cytology on pelvis

Treatment
-Sponge (1st), bandage (2nd) and compress (3rd) on right foot
-IV (4th) and IV med (5th) on forearm)
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Immobilize
	-Elevate
	-Continue neurovascularity checks
	-Take nothing by mouth (NPO)

Patient 244
Case: Jammed thumb lifting rubble

S.O.A.P. Questions

S: 4th and 2nd choices
O: 1st and 1st choices
A: 4th choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on right hand

Imaging room
-X-ray right hand

Treatment
-Compress (1st) and splint (2nd) on right hand
-Discharge
-Hospital orders
	-Immobilize
	-Elevate
	-Reduction by traction, reposition, recheck

Patient 245
Case: Fell, hurt upper arm

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 2nd and 4th choices
A: 2nd choice
P: 2nd and 1st choices

Examination room
-Magnifying glass and glove on left upper arm

Imaging room
-X-ray left shoulder

Treatment
-Ice (1st) and wrap (2nd) on upper arm
-Splint (3rd) on left shoulder
-Discharge
-Hospital orders
	-Immobilize

Patient 246
Case: Jammed toe

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 4th and 2nd choices
A: 3rd choice
P: 2nd and 1st choices

Examination room
-Magnifying glass and glove on left foot

Imaging room
-X-ray foot

Treatment
-Compress (1st) and splint (2nd) on left foot
-Discharge
-Hospital orders
	-Immobilize
	-Elevate area

Patient 247
Case: Forearm crushed by falling rubble

S.O.A.P. Questions

S: 3rd and 2nd choices
O: 4th and 2nd choices
A: 1st choice
P: 3rd and 3rd choices

Examination room
-Magnifying glass and glove on left forearm
-Glove on left wrist

Imaging room
-X-ray left forearm

Laboratory
-Blood test CBC and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Sponge (1st), compress (2nd) and bandage (3rd) on left forearm
-IV (4th) and IV med (5th) on forearm
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Immobilize
	-Elevate
	-Take nothing by mouth (NPO)
	-Continue neurovascularity checks

Patient 248
Case: Puncture wound

S.O.A.P. Questions

S: 3rd and 3rd choices
O: 1st and 2nd choices
A: 4th choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on right hand

Treatment
-Sponge (1st), topical med (2nd) and bandage (3rd) on right hand
-Discharge

Patient 249
Case: Vision obstructed

S.O.A.P. Questions

S: 4th and 3rd choices
O: 1st and 3rd choices
A: 3rd choices
P: 4th and 3rd choices

Examination room
-Magnifying glass, penlight and othalmoscope on left eye

Treatment room
-Call in opthalmologist to continue care and admit
-Hospital orders
	-Advise bedrest position

Patient 250
Case: Broken glass pane, cut arm

S.O.A.P. Questions

S: 4th and 3rd choices
O: 1st and 2nd choices
A: 1st choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on left forearm

Treatment
-Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th),
gauze (5th), topical med (6th) and bandage (7th) on forearm
-PO meds in mouth (8th)
-Discharge
-Hospital orders
	-Lift glass slivers with tape

Patient 251
Case: Hit on side

S.O.A.P. Questions

S: 1st and 4th choices
O: 2nd and 4th choices
A: 1st choice
P: 3rd and 1st choices

Examination room
-Stethoscope on heart
-Magnifying glass and glove on left flank
-Glove on abdomen and chest

Imaging room
-X-ray abdomen

Laboratory
-Urine test dipstick on pelvis

Treatment
-IV on forearm
-Discharge
-Hospital orders
	-Take no food or drink by mouth (NPO)

Patient 252
Case: Periorbital area cut by debris

S.O.A.P. Questions

S: 4th and 3rd choices
O: 2nd and 3rd choices
A: 4th choice
P: 3rd and 2nd choices

Examination room
-Glove on neck
-Magnifying glass, glove, penlight and eye dye on left eye

Imaging room
-X-ray skull and neck

Treatment
-Cervical collar on neck (1st)
-Sponge (2nd), forceps (3rd) and bandage (4th) on left eye
-Med syringe on upper arm (5th)
-Call in plastic surgeon to continue care and treatment

Patient 253
Case: Knocked down, hurt chest

S.O.A.P. Questions

S: 2nd and 1st choices
O: 2nd and 4th choices
A: 2nd choice
P: 4th and 1st choices

Examination room
-Magnifying glass, glove and stethoscope on chest
-Stethoscope on heart

Imaging room
-X-ray chest

Treatment
-Compress (1st) and splint (2nd) on chest
-Discharge
-Hospital orders
	-Rest

Patient 254
Case: Hit in nose by blown debris

S.O.A.P. Questions

S: 1st and 1st choices
O: 4th and 1st choices
A: 2nd choice
P: 3rd and 1st choices

Examination room
-Magnifying glass, glove and nasoscope on nose
-Tongue depressor in mouth
-Glove on both cheeks

Imaging room
-X-ray skull

Treatment
-Ice (1st), sponge (2nd) and nasal spray (3rd) on nose
-PO meds in mouth (4th)
-Nasal splint on nose (5th)
-Discharge

Patient 255
Case: Drowned

S.O.A.P. Questions

S: 1st and 3rd choices
O: 4th and 1st choices
A: 2nd choice
P: 2nd and 4th choices

Examination room
-Stethoscope on chest and heart
-Magnifying glass and tongue depressor in mouth
-EKG on heart
-Pulsometer on hand

Treatment
-EKG on heart (1st)
-ET tube (2nd) and ambu bag (3rd) on mouth
-IV (4th) on upper arm
-Aero med in mouth (5th)
-Transfer to trauma unit

Patient 256
Case: Stung on foot by sting ray

S.O.A.P. Questions

S: 1st and 1st choices
O: 1st and 3rd choices
A: 2nd choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on left foot
-Stethoscope on chest
-Tongue depressor in mouth

Treatment
-Forceps (1st), sponge (2nd) and topical med (3rd) on left foot
-Discharge
-Hospital orders
	-Soak in hot water

Patient 257
Case: Got stabbed in chest

S.O.A.P. Questions

S: 2nd and 1st choices
O: 4th and 1st choices
A: 4th choice
P: 1st and 3rd choices

Examination room
-Stethoscope on chest and heart
-Respirometer in mouth
-Magnifying glass and glove on chest

Imaging room
-X-ray chest

Treatment
-Med syringe (1st), gel (2nd) and bandage (3rd) on chest
-Call in thoracic surgeon to continue care and admit

Patient 258
Case: Impaled by piece of wood, unconscious

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 2nd and 2nd choices
A: 4th choice
P: 2nd and 4th choices

Examination room
-Stethoscope on heart
-Tongue depressor and respirometer in mouth
-Sphygmomanometer on upper arm
-Magnifying glass on nose
-Penlight on right eye
-Othoscope in left ear
-Magnifying glass and glove on forehead

Imaging room
-X-ray skull

Treatment
-Cervical collar on neck (1st)
-IV (2nd) and IV med (3rd) on forearm
-Tongue guard in mouth (4th)
-Transfer to trauma unit

Patient 259
Case: Ate something she shouldn't have

S.O.A.P. Questions

S: 2nd and 1st choices
O: 4th and 2nd choices
A: 2nd choices
P: 1st and 3rd choices

Examination room
-Stethoscope on heart
-Sphygmomanometer on upper arm
-Magnifying glass, tongue depressor and respirometer in mouth

Treatment
-Call in pediatrician to continue care and admit
-Hospital orders
	-Contact Poison Control
	-Obtain name of ingested substance

Patient 260
Case: Drowned in ocean

S.O.A.P. Questions

S: 1st and 2nd choices
O: 2nd and 1st choices
A: 2nd choice
P: 2nd and 4th choices

Examination room
-Stethoscope on chest and heart
-Magnifying glass and tongue depressor in mouth
-Pulsometer on hand

Treatment
-ET tube (1st) and ambu bag (2nd) on mouth
-IV (3rd) on upper arm
-Aero med in mouth (4th)
-Transfer to trauma unit

Patient 261
Case: Gunshot wound to head, unconscious

S.O.A.P. Questions

S: 4th and 4th choices
O: 4th and 4th choices
A: 2nd choice
P: 1st and 4th choices

Examination room
-Magnifying glass and glove on forehead
-Stethoscope on heart
-Respirometer and tongue depressor in mouth
-Penlight on right eye
-Othoscope in left ear
-Magnifying glass on nose

Imaging room
-X-ray skull

Treatment
-Cervical collar on neck (1st)
-IV (2nd) and IV med (3rd) in forearm
-Tongue guard in mouth (4th)
-Transfer to trauma unit

Patient 262
Case: Chills, sore throat, coughing, fever

S.O.A.P. Questions

S: 2nd and 1st choices
O: 1st and 2nd choices
A: 1st choice
P: 2nd and 3rd choices

Examination room
-Sphygmomanometer on upper arm
-Tongue depressor, respirometer and thermometer in mouth
-Stethoscope on chest and heart
-EKG on heart

Imaging room
-X-ray chest

Laboratory
-Blood gas test O2/CO2 on wrist
-Blood test CBC and H/H on elbow

Treatment
-EKG on chest (1st)
-PO meds in mouth (2nd)
-O2 mask in mouth (3rd)
-IV med in forearm (4th)
-Call in pulmonologist to continue care and admit

Patient 263
Case: Water broke early

S.O.A.P. Questions

S: 4th and 4th choices
O: 2nd and 4th choices
A: 3rd choice
P: 1st and 3rd choices

Examination room
-Stethoscope on heart
-Sphygmomanometer on upper arm
-Magnifying glass and glove on chest and abdomen
-Magnifying glass on pelvis

Imaging room
-Ultrasound on pelvis

Laboratory
-Blood test CBC and H/H on elbow

Treatment
-IV on forearm
-Call in obstetrician to continue care and admit
-Hospital orders
	-Inform of uterine pregnancy, normal size

Patient 264
Case: Stepped on rubble, hurt ankle

S.O.A.P. Questions

S: 3rd and 2nd choices
O: 2nd and 4th choices
A: 2nd choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on right ankle

Imaging room
-X-ray right ankle

Treatment
-Compress (1st) and splint (2nd) on right ankle
-Discharge
-Hospital orders
	-Immobilize
	-Elevate area
	-Crutches

Patient 265
Case: Can't get air, can't talk

S.O.A.P. Questions

S: 2nd and 3rd choices
O: 1st and 4th choices
A: 4th choice
P: 4th and 3rd choices

Examination room
-Stethoscope on heart and chest
-Sphygmomanometer on upper arm
-Tongue depressor in mouth
-Magnifying glass on neck
-Glove on both hands and chest
-Pulsometer on hand

Imaging room
-X-ray chest

Treatment
-Call in thoracic surgeon to continue care and admit
-Hospital orders
	-Insert chest tube to release pneumothorax
	-Seal wound area with gel
	-Dress wound

Patient 266
Case: Drowned

S.O.A.P. Questions

S: 1st and 3rd choices
O: 2nd and 1st choices
A: 2nd choice
P: 2nd and 4th choices

Examination room
-Stethoscope on chest and heart
-Pulsometer on hand
-Magnifying glass and tongue depressor in mouth
-EKG on heart

Treatment
-ET tube (1st) and ambu bag (2nd) in mouth
-IV in forearm (3rd)
-Aero med in mouth (4th)
-Transfer to trauma unit

--end of scenario--

Freeway Pile-up Scenario
--------------------------

Patient 267
Case: In car wreck, hurt elbow

S.O.A.P. Questions

S: 2nd and 2nd choices
O: 1st and 3rd choices
A: 3rd choices
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on right elbow
-Glove on right wrist

Imaging room
-X-ray right elbow

Treatment
-Sponge (1st), forceps (2nd), topical med (3rd), bandage (4th) and wrap (5th)
on right elbow
-Discharge
-Hospital orders
	-Immobilize

Patient 268
Case: Fell, hurt elbow

S.O.A.P. Questions

S: 3rd and 2nd choices
O: 2nd and 1st choices
A: 3rd choice
P: 3rd and 3rd choices

Examination room
-Magnifying glass and glove on right elbow

Imaging room
-X-ray right elbow

Laboratory
-Blood test CBC, H/H and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Compress on elbow (1st)
-IV on forearm (2nd)
-Call in orthopedic surgeon to continue care and admit
-Hospital orders
	-Immobilize
	-Elevate
	-Advise patient to take nothing by mouth (NPO)
	-Continue neurovascularity checks

Patient 269
Case: In car wreck, hit on side

S.O.A.P. Questions

S: 2nd and 1st choices
O: 1st and 4th choices
A: 4th choice
P: 3rd and 1st choices

Examination room
-Stethoscope on heart
-Magnifying glass and glove on left flank
-Glove on abdomen and chest

Imaging room
-X-ray abdomen

Laboratory
-Urine test dipstick on pelvis

Treatment
-IV on forearm (1st)
-Sponge (1st), topical med (2nd) and bandage (3rd) on left flank
-Discharge
-Hospital orders
	-Advise to take nothing by mouth(NPO)

Patient 270
Case: Scraped chin, dental pain

S.O.A.P. Questions

S: 1st and 3rd choices
O: 4th and 2nd choices
A: 4th choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on chin
-Glove on mouth

Treatment
-Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on chin
-Discharge

Patient 271
Case: Hurt toe in bus wreck

S.O.A.P. Questions

S: 3rd and 4th choices
O: 3rd and 3rd choices
A: 2nd choice
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on left foot

Imaging room
-X-ray left foot

Treatment
-Ice (1st) and splint (2nd) on left foot
-Discharge
-Hospital orders
	-Immobilize
	-Elevate
	-Continue neurovascularity checks

Patient 272
Case: Hurt ribs in accident

S.O.A.P. Questions

S: 4th and 1st choices
O: 1st and 4th choices
A: 1st choice
P: 4th and 1st choices

Examination room
-Magnifying glass and glove on chest
-Stethoscope on chest and heart

Imaging room
-X-ray chest

Treatment
-PO meds in mouth
-Discharge
-Hospital orders
	-Rest

Patient 273
Case: Hit elbow on side of car, hurt elbow

S.O.A.P. Questions

S: 4th and 2nd choices
O: 3rd and 2nd choices
A: 1st choice
P: 3rd and 1st choices

Examination room
-Magnifying glass and glove on right elbow
-Glove on right shoulder and right wrist

Imaging room
-X-ray right elbow

Treatment
-Compress (1st) and wrap (2nd) on elbow
-Discharge
-Hospital orders
	-Rest
	-Elevate

Patient 274
Case: Headache, nausea

S.O.A.P. Questions

S: 3rd and 3rd choices
O: 1st and 2nd choices
A: 4th choice
P: 2nd and 2nd choices

Examination room
-Glove on forehead
-Penlight on eyes

Imaging room
-CAT Scan on skull

Laboratory
-Blood test CBC, H/H and glucose on elbow

Treatment
-PO meds in mouth
-Call in neurologist to continue care and treatment

Patient 275
Case: Hurt forehead on dashboard

S.O.A.P. Questions

S: 4th and 4th choices
O: 4th and 3rd choices
A: 1st choice
P:

Examination room
-Magnifying glass and glove on forehead
-Glove on neck

Imaging room
-X-ray skull and neck

Treatment
-Cervical collar on neck (1st)
-Compress on forehead (2nd)
-Discharge

Patient 276
Case: Headache

S.O.A.P. Questions

S: 4th and 2nd choices
O: 2nd and 3rd choices
A: 2nd choice
P: 2nd and 1st choices

Examination room
-Sphygmomanometer on upper arm
-Penlight and othalmoscope on both eyes
-Glove on forehead

Treatment
-PO meds in mouth
-Discharge

Patient 277
Case: Ear hurts, hearing normal

S.O.A.P. Questions

S: 3rd and 1st choices
O: 3rd and 1st choices
A: 1st choice
P: 1st and 1st choices

Examination room
-Thermometer in mouth
-Othoscope on right ear

Treatment
-Nasal spray in nose (1st)
-Drops in right ear (2nd)
-PO meds in mouth (3rd)
-Discharge

Patient 278
Case: Hurt knee in car wreck

S.O.A.P. Questions

S: 4th and 2nd choices
O: 3rd and 2nd choices
A: 3rd choice
P: 1st and 1st choices

Examination room
-Magnifying glass and glove on left
-Glove on left ankle

Imaging room
-X-ray knee

Treatment
-Compress (1st) and wrap (2nd) on left
-Discharge
-Hospital orders
	-Rest
	-Elevate

Patient 279
Case: Hurt head and neck in car accident

S.O.A.P. Questions

S: 3rd and 3rd choices
O: 4th and 3rd choices
A: 2nd choice
P: 1st and 2nd choices

Examination room
-Magnifying glass and glove on forehead
-Glove on neck

Laboratory
-X-ray skull and neck

Treatment
-Cervical collar on neck (1st)
-Sponge (2nd), forceps (3rd) and bandage (4th) on forehead
-Med syringe on upper arm (5th)
-Call in plastic surgeon to continue care and admit

Patient 280
Case: Forehead struck seat, headache

S.O.A.P. Questions

S: 1st and 2nd choices
O: 1st and 4th choices
A: 3rd choice
P: 1st and 2nd choices

Examination room
-Stethoscope on heart
-Magnifying glass and glove on forehead
-Glove on neck
-Penlight and othalmoscope on both eyes

Imaging room
-X-ray neck
-CAT Scan head

Laboratory
-Blood test CBC, H/H, glucose and type/cross on elbow
-Urine test microbiology/chemistry/cytology on pelvis

Treatment
-Cervical collar on neck (1st)
-IV on forearm (2nd)
-Tongue guard in mouth (3rd)
-Call in neurologist to continue care and admit