CH 10: Scene Size-Up - Critical Thinking

Question 1

You are called to the scene of a shooting at a fast food restaurant. En route, you plan your scene size-up strategy. What actions do you anticipate taking upon arrival?

Answer 1

First, make certain the police have secured the scene before you enter it. If you fail to do so, you could easily find yourself and your partner hostages or shooting victims. Once the scene is secure, you will proceed with normal scene size-up steps:

Take standard precautions.
Confirm mechanism of injury (reported to be gunshot)
Establish number of patients.
Decide if more resources are necessary.

Question 2

A patient has stab wounds to the anterior lower ribs and the lower posterior ribs. What organs are most at risk of injury from the wounds located:

Lower left lateral ribs?
Lower right lateral ribs?
Lower posterior ribs on either side?

Answer 2

Lower left lateral - liver, spleen, intestines and pancreas.
Lower right lateral - liver, intestines, pancreas, gallbladder.
Posterior side - kidneys, depending on length (other organs above)

Question 3

Would any of your answers change if you discovered that the patient was in the fetal position, trying to defend himself when he was stabbed?

Answer 3

If the patient were able to protect himself somewhat by lying in a fetal position, he might be able to shield the liver, spleen, intestines, pancreas and gallbladder. However, the kidneys are more likely to be exposed to penetrating trauma because of their posterior location.