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OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-01
INJURY
Severe asthma attack (3)
Degree of Difficulty = 3
ENVIRONMENT
PERSONNEL
Back side of mountain at
Bystanders (0)
warming hut (0)
Trained rescuers (0)
GENERAL SCENARIO DESCRIPTION
Patient is found at the warming hut having difficulty breathing
INFORMATION GIVEN TO TRAINEE
You receive a call to check on someone at the backside warming hut. Equipment and available personnel
to be sent upon request.
PATIENT SUMMARY
Patient is having an asthma attack brought on by an allergic reaction to two cats being in the warming hut.
VITAL SIGNS
Time in minutes
Pulse and respirations
Initial
P = 112, r = 22 labored
5 min
P = 118, r = 25 labored
10 min
P = 100, r = relaxing
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
15 min
P = 75, r = 20
SCENARIO OBJECTIVES
Assessment
Verify scene safety; obtain permission to assist
Primary assessment reveals a patient who is having an acute asthma attack
Remove the patient from contact with cats and residue of cat presence, i.e., the warming house
Request additional help and equipment
Secondary assessment, no other injuries found
Rote Skills
Standard Precautions
Medical emergency - asthma; assist with inhaler use per protocols
Oxygen administration
Problem Management
Direct others appropriately with confidence
Continue communication with patient and rescuers
Ensure correct OEC skills of rescuer when appropriate
Demonstrate knowledge of inhaler use issues and legal issues related to assistance
Transportation plan
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-01
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: Backside warming hut or anywhere transport would be delayed
Equipment: Toboggan with standard area equipment
(Spine-boarding equipment if not included in the standard toboggan, following local protocols)
Moulage: inhaler
Weather: Must be the same as the day of scenario use
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position
You are sitting in the tripod position and straining to breathe when rescuer arrives. Your breath sounds are
audible wheezes. Bystander offers his own inhaler.
Answers to SAMPLE
Signs and symptoms: skin is cool and dry, audible wheezing breath sounds
Allergies:
dust, pollen, cats, and penicillin
Medication:
Ventolin inhaler
Past history:
asthma
Last meal:
actual
Events leading: just came in to warm up
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Behaviors
You are leaning forward, straining to catch your breath. You can only answer in short three-to-four word
sentences. You can’t believe there would be cats out here on the hill. You finally remember that you have
an inhaler in your backpack and your respirations decrease when it is used.
SPECIFIC COMMENTS FOR EVALUATORS
Local protocols would determine if oxygen would be brought out to the scene, or if the patient would be
transported to it. Rescuer needs to demonstrate clear knowledge of medical issues related to patientspecific inhalers and legal issues related to assisting person usage.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-02
INJURY
Obstructed airway (4)
Degree of Difficulty = 4
ENVIRONMENT
Lodge (0)
PERSONNEL
Trained rescuers (0)
GENERAL SCENARIO DESCRIPTION
A guest in the resort cafeteria is holding his throat and turning red.
INFORMATION GIVEN TO TRAINEE
You are in line in the cafeteria when you notice a guest holding his/her throat and turning red. Equipment
and available personnel to be sent upon request.
PATIENT SUMMARY
You are waiting to pay for your lunch and were nibbling on your food when something “goes down the
wrong way.” You are suffering from a complete airway obstruction.
VITAL SIGNS
Time in minutes
Initial
Pulse and respirations
Pulse and respirations
Appropriate Care
Heimlich maneuver
Choking
Choking
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
5 min
P + 16, r = gasping
Choking
10 min
As found
Based on action
15 min
As found
Based on action
SCENARIO OBJECTIVES
Assessment
Verify scene safety, with awareness of crowds; obtain permission to assist
Primary assessment reveals complete airway obstruction, and need for Heimlich maneuver
Request additional help and EMS - indicate a specific person to call 911
Secondary assessment, no other injuries found
Rote Skills
Standard Precautions
Respiratory emergency management: Heimlich maneuver if reaching patient before collapse; if patient
becomes unresponsive determine the need for CPR
Oxygen administration
Transportation plan
Problem Management
Crowd control; develop a treatment and transport plan to address airway and breathing issues; appropriate
use of rescuers and equipment, recommend medical attention for choking patient
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-02
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: Inside lodge, cafeteria, etc. This also could be done outside at any seating area where
food would be consumed.
Equipment: none
Moulage: none
Weather: Must be the same as the day of scenario use
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position: You could be standing or seated at a table.
Answers to SAMPLE
Signs and symptoms: choking
Allergies:
unknown
Medication:
unknown
Past history:
unknown
Last meal:
unknown
Events leading: eating
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Behaviors: You are clutching your throat. It takes several thrusts of the Heimlich maneuver to clear the
obstruction, and then you gasp a bit for a few minutes. If proper care is not given, you collapse for lack of
oxygen. You are shaken and feel a bit weak and respond positively if asked if you want to go to the aid
room. You agree to the suggestion to seek medical attention as a follow-up.
SPECIFIC COMMENTS FOR EVALUATORS
Be sure not to send in help until the choking is handled. Trainee should have ample opportunity to
complete scenario by him/herself. Proper use of bystanders by rescuer would be extremely helpful.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-03
INJURY
Pulmonary embolism (4)
Degree of Difficulty = 5
ENVIRONMENT
Lodge (0)
PERSONNEL
No trained help (1)
GENERAL SCENARIO DESCRIPTION
Patient is sitting in the lodge, unable to ski because he is recuperating following knee surgery. Wife
returns from skiing to find husband having chest pain and difficulty breathing.
INFORMATION GIVEN TO TRAINEE
Dispatched to main lodge for apparent chest pain and dyspnea (shortness of breath or difficulty
breathing). Equipment and available personnel to be sent upon request
PATIENT SUMMARY
You are having chest pain on the right side and difficulty breathing.
VITAL SIGNS
Time in minutes
Pulse and respirations
Initial
P + 10, r + 20
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
5 min
P + 15, r + 25
10 min
P + 25, r = tachypnea (rapid)
15 min
P + 30, r = tachypnea (rapid)
SCENARIO OBJECTIVES
Decision Making
Verify scene safety; patient assessment - SAMPLE, correctly identify patient condition; recognize “load
and go” situation; request oxygen; request EMS for ALS transport; rapid transport to base or EMS
transfer point.
Problem Management
Standard Precautions; OEC Skills: oxygen administration; assign tasks to bystanders with clear
instructions; rapid transport to base and/or EMS; lift techniques and toboggan decisions.
Leadership
Direct others with confidence, continued communication with patient and family. Communicate with
base. Provide basic information for EMS personnel. Documentation.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-03
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: Lodge
Equipment: Transportation device (wheelchair/gurney) if needed to move to aid room
Moulage: Cyanosis of the lips
Weather: not a factor, indoors
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position: Sitting
Answers to SAMPLE
Signs and symptoms: blue lips and rapid respirations
Allergies:
none
Medications:
percocet for pain
Past history:
recent knee surgery
Last meal:
report actual
Events leading:
released from hospital two weeks ago
Behaviors: When questioned about chest pain, you state you have no history of heart trouble but have just
been released from hospital for knee surgery. Onset of pain was sudden and was accompanied by
difficulty breathing. You have been on bed rest for the last two weeks. Your chest hurts and it is pleuritic
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
in nature (sharp, stabbing pain that worsens by a deep breath); it becomes progressively harder to breathe.
Your level of responsiveness also deteriorates, particularly if not given oxygen or transported within 10
minutes.
SPECIAL COMMENTS TO EVALUATORS
This scenario helps trainees or rescuers demonstrate knowledge of medical issues. They also are required
to demonstrate rapid transport decision making and use of bystanders.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-04
INJURY
Choking (4)
Degree of Difficulty = 7
ENVIRONMENT
Mogul hill (0)
Elbow dislocation (2)
PERSONNEL
Multiple patients (1)
Trained rescuers (0)
GENERAL SCENARIO DESCRIPTION
A skier falls in the moguls, landing hard on his/her elbow. Another skier (friend of the first) stops to see if
there is anything s/he can do. The friend starts to poke fun and laugh at the injured skier and chokes on a
piece of hard candy.
INFORMATION GIVEN TO TRAINEE
Dispatch: received a call to respond to an injured skier on the mogul hill.
Equipment and available personnel to be sent upon request.
PATIENT SUMMARY
Patient #1 has a dislocated elbow with extreme pain in a fixed position. There is no neurovascular
compromise.
Patient #2 chokes on a piece of hard candy shortly after arriving on the scene.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
VITAL SIGNS
Time in minutes
Patient #1
Patient #2
Pulse and respirations
Pulse and respirations
Appropriate care
Heimlich maneuver not given
p + 16 to
as found
as found
(passes out with no breathing)
throughout
SCENARIO OBJECTIVES
Decision Making
Verify scene safety; Patient Assessment - correctly identify patient's condition; notify
management for risk management concerns; prioritize choking over elbow injury; keep choking patient
on the scene for a follow-up interview
Problem Management
Appropriate use of rescuers and equipment; appropriate treatment and transport plan; OEC skills
according to skill performance guidelines; Managing Medical Emergencies - airway, choking;
Fracture/dislocation management - elbow; Lifting Techniques; use of Standard Precautions.
Leadership
Direct others appropriately and with confidence; continued communications with patient and
team members; ensure correct OEC skills of helpers where appropriate
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-04
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: A mogul hill with no other obstacles
Moulage: None, other than the candy for “choking” on
Weather: Must be the same as the day of scenario use
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position: Patient #1 - you are sitting on the snow holding your injured elbow
Patient #2 - you ski up to the scene shortly after the trainee arrives
Answers to SAMPLE
Signs and symptoms: Pt. 1 elbow pain; Pt. 2 blocked airway
Allergies:
none
Medications:
none
Past history:
none
Last meal:
report actual
Events leading:
Patient #1 - you were skiing fairly fast through the moguls, caught an
edge, almost fell, recovered, then did fall, landing very hard on your
elbow. You felt a stabbing pain in your elbow.
Behaviors: Patient #1 - you are holding your elbow, which is flexed and locked, in its most comfortable
position. Any attempt to change the angle is painful. Circulation and sensation are good. You are in
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
extreme pain, but try to put on a good front for your friend (you know you will be the butt of many
“wimp” jokes if s/he sees how much you hurt).
Patient #2 - you begin to give your friend a hard time about his/her lack of coordination, and
begin to laugh. This causes you to inhale the piece of hard candy you are eating. You begin to choke,
showing the traditional sign of clutching at your throat. You cannot speak or breathe. If you are not
treated immediately you will pass out after about one minute. If the Heimlich maneuver is begun, you spit
out the candy after the second thrust. After that you are okay, but embarrassed. You want to leave the
scene but you are willing to stay without an argument if asked to do so.
SPECIFIC COMMENTS FOR EVALUATORS
The timing of the arrival of Patient #2 is vital - s/he must arrive during the secondary exam of patient #1,
and well before the toboggan and helpers. Local protocol would determine if EMS would be contacted.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-05
Degree of Difficulty = 8
INJURY
ENVIRONMENT
Choking (4)
Bottom of the hill (0)
Head/neck pain (3)
PERSONNEL
Multiple patients (1)
Trained rescuers (0)
GENERAL SCENARIO DESCRIPTION
A skier finishing the last bites of lunch is walking toward the ski racks when s/he is hit by an out-ofcontrol skier. The impact causes him/her to “inhale” the food in his/her mouth. The out-of-control skier
gets up to walk away, but is moving very stiffly.
INFORMATION GIVEN TO TRAINEE
Dispatch: A bystander calls for the rescuer to hurry over to where someone is choking.
Equipment and available personnel to be sent upon request.
PATIENT SUMMARY
Patient #1 is choking and needs the Heimlich maneuver.
Patient #2 appears unhurt, but is holding his/her head and neck in a stiff position.
VITAL SIGNS
Time in minutes
Patient #1
Patient #2
Pulse and respirations
Appropriate care
Heimlich maneuver not given
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Initial
choking
choking
5 mins
p + 16, r - gasping
choking
10 mins
as found
based on action
15 mins
as found
based on action
as found
SCENARIO OBJECTIVES
Decision Making
Verify scene safety; Patient Assessment - correctly identify patient's condition; call EMS; notify
management for risk management concerns; prioritize choking over back/neck pain; recognize need for
standing backboard
Problem Management
Appropriate use of rescuers and equipment; appropriate treatment and transport plan; OEC skills
according to skill performance guidelines - Managing Medical Emergencies -choking; Spinal
Immobilization - head and neck injury; Lifting Techniques; use of Standard Precautions; recommend
medical attention for choking patient; direct witness to area management for a statement; use witness to
monitor choking patient while dealing with head/neck patient before help arrives
Leadership
Direct others appropriately and with confidence; continued communications with patient and
team members; ensure correct OEC skills of helpers where appropriate
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-05
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: Any bottom-of-the-hill location where such an occurrence might take place. This could
be done at a location on the hill if food might be consumed there, except if being staged for a non-skiing
senior auxiliary trainee.
Moulage: None
Weather: Must be the same as the day of scenario use
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position: both are standing.
Answers to SAMPLE
Signs and symptoms: Pt. 1 blocked airway; Pt. 2 head and neck discomfort
Allergies:
none
Medications:
none
Past history:
none
Last meal:
report actual
Events leading:
patient #2 - you say you just lost it at the bottom of the hill and bumped
into patient #1
Behaviors: Patient #1 - you are clutching your throat. It takes several thrusts of the Heimlich maneuver to
clear the obstruction, and then you gasp a bit for a few minutes. You are shaken, feel a bit weak, and will
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
likely want to sit down for a while. You are willing to come to the aid room, and respond positively if the
suggestion is made to seek medical attention as a follow-up to your experience.
Patient #2 - you are just getting up when the trainee approaches. Try to be directly in the sight
line of the rescuer to be sure your actions are observed. If you are not in the rescuer’s sight line, then you
will need to make some expression of pain to call attention to yourself when you go to remove your skis.
You should move your head and shoulders as a unit and wince when bending down to try and pick up
your skis, or when attempting to twist or turn your upper body. You do admit that you hit your head and
twisted your neck when you fell, but try to downplay being hurt. You do cooperate with being put on the
spine board.
SPECIFIC COMMENTS FOR EVALUATORS
Be sure not to send helpers until the choking is handled and the trainee has determined the need for the
standing backboard. A toboggan would not necessarily be used if another method of transport is available
for the bottom of the hill. If this is done in an area near to the aid room, supplies could be brought directly
from there.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-06
INJURY
Asthma (2)
Degree of Difficulty = 6
ENVIRONMENT
More difficult slope (0)
Lower leg fracture (2)
PERSONNEL
Multiple patients (1)
Trained rescuers (0)
Facial abrasions (1)
GENERAL SCENARIO DESCRIPTION
Three school-aged friends were skiing very close to each other coming down the hill and collided with
each other. They think this is all kind of a joke.
INFORMATION GIVEN TO TRAINEE
Dispatch: Received a call to respond to injured skiers on the more difficult hill.
Equipment and available personnel to be sent upon request.
PATIENT SUMMARY
Patient #1 has stress-induced asthma, and is having an attack as the trainee arrives. Patient has his inhaler,
and breathing eases after he uses it.
Patient #2 has a facial abrasion from hitting the snow, and is the major jokester.
Patient #3 has a lower leg fracture that hurts if he tries to move it, but is stable otherwise.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
VITAL SIGNS
Time in minutes
Patient #1
Patient #2
Patient #3
Pulse and respirations
Pulse and respirations
Pulse and respirations
Initial
p = 112, r = labored
as found
p + 20
5 min
p = 96, r = relaxing
10 min
p = 80, r = relaxing
15 min
p = 74, r = 14
to as found
SCENARIO OBJECTIVES
Decision Making
Verify scene safety; Patient Assessment - correctly identify patient's condition; notify
management for risk management concerns; prioritize breathing first, fracture second, abrasions last;
determine if EMS transport would be necessary
Problem Management
Appropriate use of rescuers and equipment; appropriate treatment and transport plan; OEC skills
according to skill performance guidelines – Injury/Fracture Management - lower leg; Medical
Emergency management - asthma, Bleeding control and bandaging - minor facial abrasions;
Lifting Techniques; use of Standard Precautions; control bleeding, bandaging, deal with joking behavior;
plan to locate responsible adult(s)
Leadership
Direct others appropriately and with confidence; continued communications with patient and
team members; ensure correct OEC skills of helpers where appropriate
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-06
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: A more difficult slope with no obstacles
Moulage: Inhaler for patient #1; facial abrasions for patient #2
Weather: Must be the same as the day of scenario use
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position: All three are sitting fairly close to each other on the hill, no skis are on (those that didn’t come
off in the fall were taken off by the patients themselves)
Answers to SAMPLE
Signs and symptoms: Pt. 1 difficulty breathing and wheezing; Pt. 2 facial abrasions; Pt. 3 lower
leg pain
Allergies:
patient #1 has “a bunch” of allergies (dust, mold, etc.);
patients #2 and #3 - none
Medications:
patient #1 Proventil inhaler;
patients #2 and #3 - none
Past history:
patient #1 has stress-induced asthma;
patients #2 and #3 - none
Last meal:
report actual
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Events leading:
all three were weaving in and out and generally goofing around when
they just ran into each other. Patient #3’s leg was twisted when he fell
over one of the others and his binding didn’t release immediately.
Behaviors: All three of you are laughing and joking around, often to the distraction of the attempts made
by the rescuers to care for you. Patient #1 is the most concerned about his own condition, and is telling
the others that he needs to get his inhaler just as the trainee arrives on the scene. Patients # 1 and #2 are
able to walk if asked (as long as #1 uses his inhaler). If asked, someone reports that you are all here with a
school group, and that your advisor has emergency medical forms for everyone.
SPECIFIC COMMENTS FOR EVALUATORS
Local protocols would determine if either the asthma or the lower leg fracture patients would require
transport via rescue squad. If high school-aged patients are available, they would be preferable.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-07
Degree of Difficulty = 4
INJURY
Severe respiratory distress (4)
ENVIRONMENT
Site does not add to difficulty (0)
PERSONNEL
Trained rescuers (0)
GENERAL SCENARIO DESCRIPTION: The patient is outside of the lift operator’s building on the
back side of the mountain on a cold day.
INFORMATION GIVEN TO TRAINEE: There is a man with difficulty breathing at the lift operator’s
building on the back side of the mountain. Equipment and personnel to be sent upon request.
PATIENT SUMMARY: The patient is a 35-year-old male. He is having difficulty breathing and can
only speak in three- or four-word bursts. He has a history of hypertension for which he takes no
medication and asthma for which he takes medication. His asthma medication is at the base area and is
accessible.
VITAL SIGNS
Time in minutes
Pulse and respirations
Initial
5 min
P = 112 R = 24
10 min
P = 116 R = 24
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
15 min
SCENARIO OBJECTIVES
Assessment
Verify scene safety
Primary assessment reveals shortness of breath, asthma attack, recognize potentially life-threatening
nature if untreated
Request needed assistance and equipment
Secondary reveals no other injuries
Rote Skills
Standard Precautions
Oxygen administration
Rapid transport to base
Develop plan to have inhaler accessed and brought as quickly as possible
Problem Management
Develop and execute a plan as part of your transportation plan to have the inhaler brought to you ASAP;
identify inhaler as belonging to patient; person administers inhaler himself. Appropriate use of rescuers
and equipment; appropriate treatment and transport plan. Trainee should demonstrate knowledge of legal
issues related to assistance with inhalers.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-07
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: outside of the lift operator’s building on the back side of the mountain
Moulage: none
Weather: a cold day
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position: sitting hunched over
Answers to SAMPLE
Signs and symptoms: shortness of breath, difficulty breathing
Allergies:
penicillin
Medications:
Ventolin for asthma
Past history:
hypertension and asthma
Last meal:
report actual
Events leading:
The patient started to have difficulty breathing on the ride up the lift
from the base. Breathing became more difficult after skiing down the
backside trail.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Behaviors: gasping breaths, speaking in short bursts of three or four words between breaths, voice has
strained quality, tightness in chest. The patient is able to direct rescuer to location of medication at base
when asked.
SPECIFIC COMMENTS FOR EVALUATORS
The patient should be coached to present accurate symptoms of cold/exercise-induced asthma. The
rescuer must recognize this as a possible life-threatening emergency. The patient’s breathing will become
normal when patient uses his inhaler. The patient should be monitored during and after treatment and
taken to a medical facility for evaluation.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
OUTDOOR EMERGENCY CARE 5TH EDITION
Chapter 13
Scenario #13-08
INJURY
Choking (4)
Degree of Difficulty = 4
ENVIRONMENT
Site does not add to difficulty (0)
PERSONNEL
Single patient (0)
Trained rescuers (0)
GENERAL SCENARIO DESCRIPTION: The patient is sitting outside on the deck eating at the midmountain lodge.
INFORMATION GIVEN TO TRAINEE: A person at the mid-mountain lodge was having difficulty
breathing.
Equipment and available personnel to be sent upon request.
PATIENT SUMMARY: The patient is sitting upright and unable to breathe because of food caught in
his/her throat. S/He is frightened and clutching at his/her throat.
VITAL SIGNS
Time in minutes
Pulse and respirations
Initial
P 104 R 0
5 min
P 92 R 18
10 min
P 84 R 14
15 min
As found
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
SCENARIO OBJECTIVES
Assessment
Verify scene safety, obtain permission to assist
Primary assessment - correctly identify obstructed airway; recognize a potential life-threatening situation
Request needed assistance and equipment and ALS if Heimlich maneuver is not successful
Secondary assessment, no other injuries found
Rote Skills
Standard Precautions
Clear airway with Heimlich maneuver
Management of respiratory distress, administer oxygen
Problem Management
Appropriate use of rescuers and equipment; Verbalize appropriate treatment and transportation plan.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
Scenario #13-08
INFORMATION FOR SCENARIO PLANNING AND OEC INSTRUCTORS
Location/terrain: outside the lodge
Moulage: pale face and food in mouth to expel
Weather: Must be the same as the day of scenario use
SPECIFIC INSTRUCTIONS FOR INJURED PATIENT
Position: sitting up
Answers to SAMPLE
Signs and symptoms: choking, clutching at throat
Allergies:
none
Medications:
none
Past history:
none
Last meal:
was just having lunch
Events leading: was eating and got food caught in his/her throat
Behaviors: Patient gives the choking sign and is unable to speak; no air exchange; frightened
SPECIFIC COMMENTS FOR EVALUATORS
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.
The rescuer must clear the airway quickly. After the airway is cleared, the patient should be monitored for
any aftereffects of the incident. Further examination by physician is advisable due to the potential for
swelling caused by trauma to the soft tissues of the throat from the complete airway obstruction.
Use caution—avoid an actual airway obstruction because the patient/actor is holding food in their mouth.
©2012 National Ski Patrol
Outdoor Emergency Care, 5th Ed.