Emergency Room: Disaster Strikes FAQ Version .59A Copyright of Paul Pike [KawaiiNeko333@aol.com] 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 Here come the patients ====================== Appartment Fire 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 Freeway Pile-up Scenario -------------------------- 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