Scenario#1 - Individual Scout Skills - rv.ppbsa.orgrv.ppbsa.org/Activities/First Aid...

2013 District First Aid Meet - Post-Event Scoring – “What Was Expected”

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Scenario#1 - “Individual Scout Skills”

1.0 Description

For this scenario, individual scouts will demonstrate specific first aid skills. There is no written scenario

description to give to the Patrol Leader. The judge will verbally assign each required skill to the entire patrol.

Thus, we are not scoring on an overall first aid treatment plan (e.g., shock, send for help), just on specific skills.

There are four separate assignments: demonstrate choking abdominal thrust technique (a.k.a Heimlich

Maneuver), apply a simple full lower arm sling, tie a full scalp head bandage, tie a sprained ankle.

For this scenario, there will be no coaching or discussion among patrol members. Scoring for teamwork does

not apply since the activity is a demonstration of individual skills and is set up such that every patrol member

has specific assignments given to him by the judge. Good scout behavior is still a judging factor.

Note: if you see a scout looking at others to get help, immediately caution them to focus on their

own task – no help allowed.

2.0 Some general guidance on scoring and dealing with certain ambiguities

As with many first aid activities, the Handbook and First Aid merit badge book have gray areas in

defining specific treatment steps. The following are notes on some issues that may come up and the First

Aid Committee’s assessment of how they should be handled in the scoring:

All tied bandages should be tied with square knots.

the Handbook and First Aid books are somewhat non-specific in identifying the types of slings and the

techniques for tying them (illustrations are hard to connect with instructions). Thus, for this scenario,

scoring will be kept simple.

The equipment list states that triangular bandages should have a long side measurement of at least 40”. It is

possible that a Patrol may have bandages that are not big enough for larger scouts to tie the ankle sprain and

full head bandages. If that is the case, judges will have to use their own discretion in deciding whether each

Scout understands the associated technique.

3.0 Some things Judge should look for

For every patrol, be sure to include scoring for “Possible General Deductions” at the end of the scoresheet. If

no deductions are involved, be sure to enter ‘0’ so scoring table knows you made a conscious decision.

In particular, since this scenario is expecting each scout to display specific skills, you should not allow

assistance (or peeking for hints).


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Attachments:

Choking Abdominal Thrust Technique


3

Tying a Full Scalp Head Bandage using Triangular Bandage

Tying a Sprained Ankle Bandage


4

Scoresheet: Scenario#1 “Individual Scout Skills

Task #1 Choking - Abdominal Thrusts (see illustration for techniques)

Note: Count off scouts by 1 and 2, and tell #1 scouts to treat closest #2 scout.

If there is an odd number of scouts, the last #1 will not participate.

Note: for this task, ask treating scouts to face away from each other to avoid roving eyes.

Remind them there is no assistance allowed. If you notice “roving eyes” remind them to stay focused on their

own activities. If it persists, use Possible Deductions section at the end of the scoresheet.

Scoring factors: 25 maximum (per group of 2)

Note: no partial scores, only ‘0’ or ‘5’

1. Treater stood behind victim Either ‘0’ or ‘5’ points

2. Treater forms fist with one hand Either ‘0’ or ‘5’ points

3. Treater clasped hands above navel and below rib cage Either ‘0’ or ‘5’ points

4. Treater used fist’s thumb knuckle against victim’s waist Either ‘0’ or ‘5’ points

5. Treater abdominal thrust is inward and upward Either ‘0’ or ‘5’ points

For each 2-scout grouping:

1 2 3 4 5

1.

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Treater stood behind victim Either ‘0’ or ‘5’ points

2. ‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Treater forms fist with one hand Either ‘0’ or ‘5’ points

3.

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Treater clasped hands above navel and below

rib cage

Either ‘0’ or ‘5’ points

4. ‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Treater used fist’s thumb knuckle against

victim’s waist (per illustration): Either ‘0’ or ‘5’ points

5. ‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Treater abdominal thrust is inward and

upward

Either ‘0’ or ‘5’ points Head Scoring Table Use:

Total Score for Each group


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Task #2 Tie Simple Full Lower Arm Sling on Another Scout

JUDGE: Advise the patrol that it is a sling that covers the entire lower arm.

Note: Count off scouts by 1 and 2, and tell #2 scouts to treat closest #1 scout.

If there is an odd number of scouts, one of the #1’s will not participate.

Note: for this task, ask treating scouts to face away from others to avoid roving eyes.

Note: it does not matter which arm is used on the victim.

Note: scoring is very simple – no judgment on arm positioning or special techniques for

securing (other than square knot behind neck).

Scoring factors: 25 maximum (per scout)

1. sling covers entire lower arm Either ‘0’, ‘5’, or ‘10’ points

2. hand raised slightly higher than elbow Either ‘0’ or ‘5’

3. square knot used at back of neck Either ‘0’ or ‘10’ points

For each #1 Scout in the Patrol:

1 2 3 4 5

1.

‘0’

‘5’

‘10’

‘0’

‘5’

‘10’

‘‘0’

‘5’

‘10’

‘‘0’

‘5’

‘10’

‘‘0’

‘5’

‘10’

10 points: sling covers entire

lower arm.

5 points: wrist/palm not

covered

Either ‘0’, ‘5’, or ‘10’

2.

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Hand raised slightly higher

than elbow


3 ‘0’

‘10’

‘0’

‘10’

‘0’

‘10’

‘0’

‘10’

‘0’

‘10’

Square knot used at back of

neck.


Head Scoring Table Use:

Total Score for Each Group


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Task #3 Tie Full Scalp Head Bandage on Another Scout

(see illustration for technique)

Note: Tell #1 scouts to treat closest #2 scout, that is, change the scout who does treatment.

If there is an odd number of scouts, one of the #1’s will not participate.

Note: for this task, ask treating scout to face away from others to avoid roving eyes.


1. correct technique (incl. knot in front) Either ‘0’ or ‘15’ points (see illustration)

2. tied with square knot Either ‘0’ or ‘5’ points

3. extra back material tucked in Either ‘0’ or ‘5’ points

Note: the bandage may not be long enough for some larger scouts. *******

For each #2 Scout in the Patrol:

1 2 3 4 5

1.

‘0’

‘15’

‘0’

‘15’

‘0’

‘15’

‘0’

‘15’

‘0’

‘15’

Correct technique.


2.

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Tied with square knot.


3. ‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Extra bandage material in

back tucked in.



Total Score for Each

Scout Group


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Task #4 Tie Sprained Ankle Using Triangular Bandage (see illustration for technique)

Note: Instruct each scout to quickly get a triangular bandage. Ask scouts to face away from each other to avoid

coaching. Remind them there is no assistance allowed. If you notice “roving eyes” remind them to stay

focused on their own activities. If it persists, note that there is a Possible Deductions section at the end of the

scoresheet.

Note: if patrol does not have enough bandages, those without bandage receive score of ‘0’.

Note: it does not matter which foot scout selects.

Note: for this task, we are not scoring how the bandage is rolled/folded before tying.


1. kept shoe on foot Either ‘0’ or ‘5’ points

2. correct technique Either ‘0’, ’5’, or ‘10’ points (see illustration)

3. tied with a square knot Either ‘0’ or ‘5’ points

4. result is snug on foot Either ‘0’ or ‘5’ points (physically check each one)

Note: the bandage may not be long enough for some larger scouts.

For each Scout in the Patrol:

1 2 3 4 5 6 7 8 9 10

1.

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Shoe left on foot


2.

‘0’

‘5’

‘10’

‘0’

‘5’

‘10’

‘

1

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

‘0’

‘5’

‘10’

‘

1

0

’

‘

0

’

Correct technique per

illustration:

10 points: complete

5 points: minor

problems with technique

3.

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Tied with square knot


4. ‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

‘0’

‘5’

Result is snug/effective



Total Score for Each

Scout


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Possible General Deductions:

**** JUDGE: if no deductions, please enter ‘0’ for each item so scorers know

these were considered for each patrol.

The scoring table will subtract these points from the scenario total on previous pages.

1. First Aid Supplies/Kit neatly restored before start of scenario: SUBTRACT ______ points (Max -2)

Materials stored neatly in box/backpack: no deduction

Materials not in box/backpack but neatly organized: no deduction

Materials in box/backpack, but not organized: subtract 1 points

Materials not in box/backpack and not neatly organized: subtract 2 points

2. Patrol Teamwork/Behavior: (subtract up to 5 points) SUBTRACT ______ points (Max -5)

- scout(s) ignore judge warning to not get clues from other patrol members

- a scout disconnects himself from the scenario and stays outside treatment activities

- not displaying appropriate scout behavior

- scouts ignoring square boundaries, impacting adjacent patrol(s)

- scout(s) ignore judge warning to not observe other Patrol squares to get clues to other scenarios

Judge - if Teamwork/Behavior points are subtracted, please make brief note on why deduction

was made.


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Scenario#2 - “Rocks and Hot Coffee”

1.0 Description:

As your patrol climbs out of their tents at camp it is a cold morning. Your Scoutmaster passes you

heading to his tent carrying a large cup of super steaming hot coffee. As he turns to say good morning,

he catches his foot on a rock and falls down. You hear a snapping sound, followed by a thud as he hits his

head on a log and begins to scream. You run over to him to find him lying on his back, clutching his

right forearm, which is starting to swell badly and is somewhat deformed. His lower left pant leg is

totally wet with coffee and steaming in the cold air. There is a fairly large red bump on the right side of

his forehead, but there is NO cut or bleeding. Since it is so early in the morning it will be an unknown

time before you can locate help. You must find and treat all injuries to make your Scoutmaster

comfortable in the mean time.

Note: your first aid kit is locked in the Troop trailer. You look around and spy several items

that may assist you in rendering first aid (see box from your judge). These are the ONLY items

you are allowed to use in this scenario.

Exception: use the gloves and goggles from your own first aid equipment.

Note: once treatment is done, demonstrate how you might carry your Scoutmaster using one

of the pieces of equipment provided by your judge.

2.0 Background

KEY NOTE: For this scenario, each judge will have a “mystery box” containing items that the patrol may use for

treatment. ONLY those items area allowed for this scenario. They cannot use any of their own first aid equipment.

Exception: patrols should gloves and googles from their own equipment.

Contents of “mystery box”: Possible Uses

. magazines/newspapers splinting

. sticks splinting

. socks splint padding, wet burn cooling

. ropes tying splints, sling

. sheet bedding sling

. water bottle (simulated water) burn treatment (cooling)

. contractor plastic bag protection/warming, sling

. towels splint padding, wet burn cooling

. folding camp chair victim transport

This scenario involves a victim with injuries to the right forearm and lower left leg, and a possible neck/head/spine

injury. The situation is complicated by the potential delay in assistance. It is conceivable that, were help more

readily available, they would leave the splinting and immobilization of limbs to the professional responders.

Treatment activity notes:


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- Check the Scene/Approach Safely before proceeding - The scene is safe now.

- Check whether victim is conscious - part of asking for permission to assist

- Send for Help, including relevant information – at least 2 scouts should go for help.

- Make a thorough victim examination, i.e., check for other injuries

- Provide Treatment: Because symptoms (bump on forehead) indicate a potential head/spine/neck injury, the

neck and spine should be stabilized throughout all phases of treatment.

- Provide Treatment: Apply splint to right wrist and forearm. Bandages should not constrict circulation.

Note: at end of these notes, see sling pictures from First Aid Merit Badge book.

- Provide Treatment: The lower left leg has a second degree burn caused by very hot coffee. The description

only mentioned steaming, so patrol is expected to inspect the area to identify the specific injury.

- Protect from Further Injury (i.e., potential neck/spine injury)

- Treat for Shock - the victim’s feet should NOT be raised, due to the potential head/ neck/spine injury.

The following is the additional information that you, as the judge, will tell the patrol AT APPROPRIATE

POINTS during the treatment process. The scoresheet will identify the time you should provide each piece of

information:

The area is safe

When making “victim examination” indicate no other injuries

Splinting tightness – checking blood circulation– if asked, respond that circulation is good

At end of treatment, request them to demonstrate victim carry – they should use the supplied camp chair

(Chair carry)


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Victim bump on the head- books do not give treatment for simple bumps. If scouts do treatment, e.g.,

cooling to avoid swelling, this is not a scoring issue, i.e., no credit or deduction.

book says to stabilize head/neck - handbook picture shows a scout holding victim’s head/neck while

other treatments are being done. Scoring assumes a scout will continue to stabilize victim’s head

throughout the treatment.

The Handbook and MB book both show different sling techniques for fractures of upper arm, shoulder,

and lower arm (see illustration attachment). We (First Aid Committee) believe that either a full arm or

partial arm sling are acceptable for a lower arm fracture. Further, while not required, it is assumed

acceptable if a bandage is used to secure the upper arm to the chest.

shock - book says raise feet 12 inches if no suspicion of back/neck/head injury. The Patrol should

assume possibility of neck injury. Thus, they should NOT raise his feet

Anyone who could potentially come in contact with bodily fluids should wear gloves and goggles.

Since this potential exists in any injury scenario, all scouts should wear gloves and goggles.

Note: to avoid excessive expense the scoring only requires 3 sets of goggles per patrol


4.0 Some things Judge should look for

The Patrol should demonstrate teamwork and attempt to involve all its members in treatment activities. In this

scenario, possible assignments include:

Overall management of situation

Ongoing stabilization of head/neck

Make a thorough examination

Splinting right forearm

Treating second degree burn on left lower leg

Treating for shock

Ongoing victim status assessment and reassurance that everything possible is being done

Calling for help

Transporting victim using Chair Carry




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Chair Carry


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Scoresheet: Scenario#2 “Rocks and Hot Coffee”

Description Points Max Guidelines for Judging

1 Check Scene/Approach safety?

Judge Note: in response, Judge

tells Patrol there are no other

dangers, it is safe to proceed.

‘0’ or ‘5’

5

Patrol should give some indication they

are checking. Either ‘5’ or ‘0’ points

2 Recognized that victim is

responsive/conscious and asked him

for permission to do treatment?

‘0’ or ‘5’

5 Done immediately and quickly after

safety assured Scouts should get victim’s attention and

ask if OK to pursue treatment.


3 Immediately reassured victim he is

being taken care of/things will be

OK?

‘0’ or ‘5’

5


4 Make a Thorough Examination, i.e.,

Check victim’s body for other

injuries? Ask victim?

JUDGE NOTE: if asked, tell them

there are no other injuries

‘0’ ‘1’ ‘3’

3

Consciously checked for other injuries?

3 points if overtly check victim’s body

and ask victim for other concerns

1 point if only check body or only ask

victim (or only ask Judge)

0 points if neither is done.

5 Sent at least 2 scouts to get help ?

JUDGE: ask those scouts for “key

info”. The “Help” scouts can be

allowed back into scenario treatment

after providing info.

‘0’ ‘1’

‘3’ ‘5’

5

Note: award Max. points if sent

immediately, but:

- only one scout sent, subtract 2 points

- subtract 2 points if scout(s) missing any

of the following key info:

nature of injuries; when it occurred;

trained scouts doing first aid

6 Recognized possible head/neck/spine

injury and began head stabilization at

beginning of treatment(one scout

holding head)

‘0’ ‘3’ ‘5’

5

0 points if no recognition

3 points if recognized, but no action

5 points if recognized and head stabilized

Treat Right Forearm Fracture

7 Scouts realized that it is necessary to

splint right forearm?

‘0’ or ‘3’

3

Since have to make victim comfortable for

possible extended period.



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8 During splinting care taken that

fractured area is not moved?

‘0’ ‘2’ ‘4’

4

0 points if arm is obviously moved

2 points if care taken, but still moved

4 points if no movement

9 Splint(s) padded for comfort?

‘0’ or ‘3’

3

No points awarded if padding not used, or

if excessive padding interferes with

immobilization of the arm.

10 Splints secured both above and

below wound?

JUDGE NOTE: physically check

that splinting is secure.

‘0’ ‘1’

‘2’ ‘4’

4

0 points if ties done over the fracture.

1 point if all else correct, but splinting

loose/could not be expected to hold.

Only award 2 points if anything other

than square knots used

11 Does splinting extend beyond the

wrist and beyond the elbow, that is

beyond the joints above and below

the fracture?

‘0’ ‘4’

4


12 Judge should physically verify

splinting provides immobilization

support.

‘0’ ‘2’ ‘4’

4

0 points if loose/no support

2 points if some

4 points if immobilized

13 Checked that circulation not affected

by splinting?

JUDGE NOTE: if asked, Judge

should indicate circulation is good

unless obvious the securing method

is too tight.

‘0’ ‘2’

‘3’ ‘4’

4

Award max. points only if 2 or more of

the following are used:

1) feel for warmth

2) ask victim if he has feeling beyond the

splint

3) observe color beyond the splint

4) gently squeeze and release a fingernail

or toenail beyond the split - pink color

should return in 1-2 sec.

Award 3 points if any check made.

Award 2 points if no specific checks, but

verbal recognition it is important to

check.


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14 Apply sling for additional

stabilization.

Note: can use either full arm sling or

partial (see illustrations in Judge

Notes).

Note: no credits or deductions if they

also use bandage to secure arm to

chest.

‘0’ ‘1’

‘2’ ‘3’

‘5’

5

2 points if arm managed gently during

sling creation

2 points if hand raised slightly higher

(@3”) higher than elbow

1 point if ends of sling tied with square

knot

Treat Left Lower Leg Burn

15 Patrol discovered burn under pant leg

And recognized as second-degree

burn.

‘0’

‘2’

‘4’

4 0 points no check is made

2 points if checked/recognized burn

occurred

4 points if identified as second-degree

burn

16 Cooled down the burned area with

water and/or cloth soaked in water.

‘0’ or ‘4’ 4 Either ‘4’ or ‘0’

17 Leave cloth cover over burn.

‘0’ ‘2’ ‘3’

3

Award max. points if loosely wrapped and

not tied down.

Subtract 1 point if tied down

18 Did not apply creams, ointments, or

sprays.

‘0’ or ‘3’

3


19 Did not break any blisters.

‘0’ or ‘3’

3


Shock Treatment

20 Covered victim to keep him warm?

‘0’ or ‘4’

4


21 Did NOT raise feet?

‘0’ or ‘4’

4

Since possible neck/spine injury, the feet

should not be raised. If raised, score ‘0’.

22 Monitored breathing and other

shock-caused symptoms?

‘0’ or ‘2’

2



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Other Treatment Factors

23 Stabilized head/neck throughout

treatment?

‘0’ or ‘4’

4

Single scout held head/neck during entire

scenario.

24 Throughout treatment, verbally

reassured victim that everything

possible is being done to help?

‘0’ ‘1’ ‘2’

2

0 points if no interaction after first check

1 point if more checks, but not ongoing

2 points if ongoing throughout

25 All scouts doing treatment work

wearing non-latex gloves?

‘0’ ‘3’

3


26 All scouts (up to 3) doing treatment

wearing goggles?

‘0’ ‘2’

2


27 Transport Scoutmaster using supplied

camp chair (see illustration in Judge

Notes)

‘0’ ‘3’

3

Either ‘3’ or ‘0’



these items were considered for each patrol.








- not demonstrating ability to work together

- obviously not involving as many Patrol members as they could





Judge - if Teamwork/Behavior points are subtracted, please make brief note on why deduction was made.


17

Scenario#3 - “Canoe Joy Ride”

1.0 Description: On a spring-like day in March, after a very long, cold winter, you and several of your friends, both

Scouts and non-Scouts go for a hike. You come across a lake with a partial rim of ice around some of the

shore and you split up and start exploring. You are drawn back to the lake by the sound of water to see

your friend, a non-Scout, paddling off in an unsecured canoe that he found. You call to him to stop but

he paddles on, finally stopping a distance from shore. At this point he stands up and starts

taunting/yelling to "look at him". The canoe starts to rock, he loses his balance and falls into the water,

with the canoe capsizing. He surfaces, thrashing around screaming, with his face covered in blood from a

4" laceration to his forehead that he received when he struck the paddle while falling into the water. You

know he is a fair swimmer at best and his water logged clothes are clearly dragging him under. You can

see already that the cold water is affecting his ability to move. He is too far from shore to be reached by

any branch or stick and there are no other boats or floating objects to use to rescue him. You estimate

the water temperature to be about 40 degrees Fahrenheit, if that. You must get him to shore. When you

do, you observe that the laceration is still bleeding profusely and he is unconscious. He also has a badly

twisted right ankle that must be treated in case he needs to try to walk. As you proceed the judge will

have valuable information for you. You must treat all his injuries and get him to the nearest road, about

a quarter of a mile away.

Notes:

. the rope in your first aid equipment is magically long enough for a rescue.

. at the end or treatment, you must demonstrate the following two-man carries:

- Two-person walking assist

- Two-handed seat

- Four-handed seat

2.0 Background

This scenario involves initial handling of a possible “Hurry Case” (victim is unconscious after a water rescue)

where quick assessment of life functions (breathing/pulse) is required. Scenario judging will involve whether

the patrol follows the steps in the “First Aid Method”:

- Check the Scene/Approach Safely before proceeding – the scene is safe.

- Initial rescue of victim from water (equipment list includes rope for rescue)

- Hurry Case steps:

. check whether victim is conscious – part of asking for permission to assist.

. is victim breathing?

. does victim have a pulse?

- Make thorough victim examination, i.e., check for other injuries

- Send for Help, including relevant information

- Provide Treatment: profusely bleeding head laceration

- Provide Treatment: severely twisted right ankle (See attachment for treatment illustration)


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- Protect from Further Injury/Check for Other Injuries: hypothermia

- Treat for Shock

Please read the attached Scenario writeup at this point (what you will give to each Patrol).

The following is the additional information that you, as the judge, will tell/ask the patrol AT APPROPRIATE


information:

Judge Note: position victim FACE DOWN to start the scenario (patrol expected to roll over on back).

Ensure victim “plays unconscious” through first part of scenario.

the area is safe (patrol must check even before performing water rescue)

the victim is unconscious, but is Breathing and has a Pulse (key point – do NOT do CPR)

when victim (judge) is asked, tell them there are no other injuries (at two points: initially when victim is

unconscious, and after regaining consciousness)

during treatment victim regains consciousness - scouts can/should speak with him throughout treatment

victim potential for hypothermia- judge will question patrol on related treatment

the head wound will not completely stop bleeding throughout treatment – Scouts won’t be able to stop

compression to tie a bandage. Judge will inform them one (or more) times that blood has soaked

completely through the compress. The Patrol must know they should not remove old compress(es) – they

should add another on top and continue compression.

At end of treatment, the patrol will be asked to demonstrate three multiple-rescuer victim movement assists:

two-person walking assist, two-handed seat, and four-handed seat (see illustrations attachment).


19





The book gives “Urgent Treatment” steps as “is person conscious and breathing?”, followed by “is the heart

beating?”. The scoresheet is set up in this order, but deductions should not be given if done in a different

order, although these should be the first treatment actions taken.

book says to roll victim onto back to check breathing, but the ”First Aid Method” says: avoid moving

victim if possible, especially if possible spinal injury (not the case for this scenario). Thus, the victim

should be rolled onto his back.

book says victims, even if appearing unconscious, may be able to hear, so we expect Patrols to verbally

reassure victim both initially and periodically throughout treatment.

book says check pulse at carotid artery, but partial credit will be given for checking elsewhere, e.g., wrist.

shock – book says raise feet 12 inches if no suspicion of back/neck/head injury. Since no neck injury,they

should raise the victim’s feet.

Anyone who could potentially come in contact with bodily fluids should wear gloves and goggles. Since

this potential exists in any injury scenario, all scouts should wear gloves and goggles.

Note: to avoid excessive expense the scoring only requires 3 sets of goggles per patrol.


4.0 Some things Judge Should look for




Water rescue itself

Hurry case checking of breathing and pulse

Head wound treatment

Sprained ankle treatment

Treat for Hypothermia

Treat for shock


Go for help




20

Apply Sprained Ankle Bandage

Two Person Walking Assist


21


22

Scoresheet: Scenario#3 “Canoe Joy Ride”

Description Points Max. Guidelines for Judging



tells Patrol there are no other

dangers, it is safe to proceed.

‘0’ or ‘5’

5


are checking. Either ‘5’ or ‘0’ points

Note: the Patrol is not required to do any

crowd control.

Water Rescue: using Rope from

Equipment

2 Patrol uses “magically long” rope to

pull victim from water.

‘0’

‘2’

‘3’

3

Patrol does not have rope in equipment,

score is ‘0’.

Patrol goes into water themselves: ‘0’

Bowline loop tied in rope: ‘3’ (full score)

No bowline loop: 2

JUDGE NOTE: Ensure victim

starts out laying FACE DOWN.

Check Victim Breathing

Done immediately upon reaching shore

3 Verified whether victim is

responsive/conscious – part of asking

for permission to treat?

‘0’ or ‘5’

5

Scouts should tap victim on shoulder and

ask if OK (or some other technique to get

his attention). Either ‘5’ or ‘0’ points

Since no response, they should assume the

victim will accept treatment.

4 Rolled victim onto back ? ‘0’ or ‘2’ 2 Either ‘2’ or ‘0’

5 Checked for breathing/air movement?

JUDGE NOTE: in response, Judge

tells Patrol victim is breathing

‘0’

‘3’

‘5’

5

Ear/cheek next to mouth to listen for air

and/or watch for breathing motion of

chest. Max score for either. Only 3 points

if not done immediately ASAP.

NA Open airway

Note: this is not a scoring item; no

deduction if done (see note)

0

0

Note: books indicate should tilt head back:

press on forehead with one hand, lift chin

with other hand.

6 Reassured victim that everything


‘0’ or ‘3’

3

Must do it out loud even though victim

unconscious – victim may still hear.



23

Check Heartbeat Done immediately and quickly after

Breathing assured.

7 Checked pulse?

JUDGE NOTE: in response, Judge

tells Patrol victim has a pulse

‘0’

‘1’

‘3’

‘5’

5

5 points if check for pulse on carotid

artery in neck

3 points if check elsewhere, e.g., wrist.

If not done immediately ASAP, reduce

above score by 2 points

8 Was CPR performed ?

Note: CPR should NOT be done

‘0’ or ‘4’

4

Patrol should NOT perform CPR since

should have assessed victim already

breathing:

0 points if CPR is done.

4 points if CPR NOT performed.

Send For Help

9 Thorough victim examination, i.e.,

check victim’s body for other

injuries?

JUDGE NOTE: if asked, indicate

there are no other visible injuries

‘0’ ‘1’ ‘2’

2



1 point if just ask Judge

0 points otherwise

10 Sent at least 2 scouts to get help?

‘0’ ‘2’ ‘4’

4

Reduce to 2 points if scouts not sent

ASAP after vital signs checked.

11 Ensured key information given to

emergency assistance?

Note: if they send scouts before

checking breathing/pulse, they won’t

have all the info.

‘0’

‘2’

‘4’

4

Key info required:

-location; victim pulled from water

-trained scouts giving attention

-describe injuries: serious bleeding head

wound/shock

-patient status: was unconscious, but now

breathing/has pulse.

If any above info missing, award only 2

points. No points if injuries/status not

accurately identified.

Treat Severe Head Laceration

12 Using compress, applied direct

pressure to the wound throughout

entire treatment?

‘0’ ‘3’ ‘5’

5

5 points: constant pressure throughout

3 points: occasional lapse in pressure

0 points: not applied or haphazard


24

13 Judge Note: after brief time, Judge

tells Patrol the compress is

saturated with blood.

Scout should add another compress,

WITHOUT removing first compress

‘0’ or ‘5’

5

Note: judge may decide to tell patrol

compress is soaked more than once, for

example, if scouts start to tie a bandage

over the compress, tell them the wound is

still bleeding heavily. For this scenario,

the bleeding doesn’t stop, so can’t tie

bandage. No points if remove old

compress.

Victim Regains Consciousness

Judge Note: Judge should tell

Patrol soon after second head

compress added that the victim has

regained consciousness.

14 Victim now conscious:

Patrol tell victim who they are/what

they are doing and provide

reassurance he is being taken care of?

Ask victim about other complaints?

JUDGE NOTE: if victim asked,

tell no other injuries.

‘0’ ‘2’ ‘4’

4

2 points for providing identification and

reassurance

2 points for asking for other complaints or

injuries; ‘0’ otherwise

Apply Sprained Ankle Bandage

15 Kept shoe on foot?

‘0’ or ‘2’

2


16 Done with correct technique (see

illustration in Judge Notes)

‘0’ ‘1’ ‘3’

3

1 point if used rolled/folded triangular

bandage

2 points if correct tying technique (0 if

ANY mistake)

17 Finished with a Square Knot? ‘0’ or ‘1’ 1 Either ‘1’ or ‘0’ points

18 Judge: have victim stand, verify

bandage is snug.

‘0’ ‘1’ ‘2’

2

2 points if tight and victim feels

pressure/support

1 point if appears snug, but victim doesn’t

feel it

0 points if appears loose


25

Treat Hypothermia

19 Took action to warm victim?

Note: patrol should have 2 blankets.

Shock treatment below includes

covering victim.

‘0’ ‘1’

‘2’ ‘3’

3

2 points - recognized coat wet and

removed it.

1 point - placed blanket under/around

victim

20 Judge Note: judge verbally assess

Patrol’s understanding of

hypothermia treatment. Ask the 3

questions.

Note: easy scoring; give points if

they have a general understanding

of Answers

‘0’ ‘1’

‘2’ ‘3’

3

1 point per Question:

Q: symptoms of hypothermia

A: feel cold/numb; shivering; irritable;

stumbling/lose consciousness; tired/can’t

think straight; poor decisions

Q: basic treatment for hypothermia

A: prevent from getting colder; bring

body temperature up to normal

Q: techniques to help get warmer

A: get to warmer place; remove wet

clothing; drink warm liquids.

Shock Treatment


‘0’ or ‘3’

3


22 Raised victim’s feet

‘0’ or ‘3’

3

Either ‘3’ or ‘0’ points.

23 Monitored breathing and other shock-

caused symptoms?

‘0’ or ‘2’

2


Victim Movement Assists

24 Two-Man Walking Assist

(see illustration in Judge Notes)

‘0’ ‘1’

‘2’ ‘3’

‘4’ ‘5’

5

Victim instructed to put arms around

helper’s shoulders – 2 points

Both helpers grasp victim:

. arms around victim’s back – 2 points

. hold victim’s hand on their own

shoulders - 1 point

25 Two-Handed Seat


‘0’ ‘1’

‘2’ ‘3’

‘4’ ‘5’

5

Carriers’ lower arms – wrists grasped (per

illustration) – 2 points

Carrier’s arms on each-others’

shoulders – 2 points

After victim sits, carriers’ arms move to

victim’s back – 1 point


26

26 Four-Handed Seat


‘0’ ‘2’

‘3’ ‘5’

5

Carriers’ wrists interlocked correctly (per

illustration) – 3 points

Victim instructed to put arms over

carriers’ shoulders - 2 points





‘0’ ‘1’ ‘2’

2




28 All scouts doing treatment wearing

non-latex gloves?

‘0’ ‘3’

3



wearing goggles?

‘0’ ‘2’

2






1. First Aid Supplies/Kit neatly restored before start of scenario: minus ______ points (Max -2)





2. Patrol Teamwork/Behavior: (subtract up to 5 points) minus ______ points (Max -5)









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Scenario#4 - “Tornadoes in New Jersey”

1.0 Description:

After an all day Tornado Watch, you and your friends venture outside after a storm that was like nothing

you have ever experienced. The winds sounded like a freight train, the rain was coming in sideways and

there was hail the size of marbles. Your neighborhood looks like a war zone with trees and tree limbs

everywhere, arcing power lines and all sorts of debris from buildings. You notice your neighbor lying on

his back near his car which is draped in power lines. He is partially in a water puddle.

You can see debris around that may have struck him. His right arm is badly swollen and severely

misshapen and there is blood on his shirt sleeve. His lower left pant leg is charred/burned. It is cold, and

from a distance you can see that he is not warmly dressed and is shivering uncontrollably. Trees are

down all around such that vehicles cannot get in or out of your area so you must treat your neighbor for

an extended period of time. He is approximately 100 feet from his house with easy access to his garage.

Cell phones are functional with access to 911.

2.0 Scenario Background

While this scenario is not a “Hurry Case” requiring urgent treatment, it involves a victim in a serious safety

situation with several injuries:

- compound fracture to his right lower arm

- third degree burn to lower portion of his left leg

- possible neck/spine injury

Further, the victim is at risk for hypothermia (uncontrolled shivering) as well as shock. The scene is only 100 feet

from the victim’s garage, i.e., protection (warmth) is accessible. The situation is complicated by the fact that

emergency services cannot reach the location and may not be available for some time, which means that

splinting/limb immobilization is implied. If help were more readily available, splinting and immobilization of

limbs could have been left to the professional responders.

First Aid Method Factors:

- Check the Scene/Approach Safely before proceeding – clearly, the power cables in close proximity to the

victim are a serious concern. No one should approach the victim until it is proven safe. As indicated below,

the judge will explain that the area is safe right now, but may become unsafe again shortly. Thus, the scouts

will need to move the victim quickly.

- Check whether victim is conscious - part of asking for permission to assist.

- Transport to safety: immediately after asking permission, move victim away from power cable danger

- Make thorough victim examination, i.e., check for other injuries/ask victim

- Call for Help, including relevant information – even though they can’t get through to 911, they still must

have the relevant information in mind and continue trying to reach emergency services. Since they are in

their neighborhood, it is acceptable if they delegate this to parents/neighbors.

- Provide Treatment: Because symptoms indicate a potential head/spine/neck injury, the neck and spine

should be stabilized throughout all phases of treatment. Given the unsafe environment, however, they must

risk an initial victim move to a safe location.

- Check for Injuries: Patrols must look to find the lower right arm fracture and recognize it as compound.

- Provide Treatment: The blood on victim’s shirt is caused by a compound fracture (bone penetrating skin).


28

The bleeding should be treated with pads (GENTLY - no hand pressure applied) packed around the wound.

Once the bleeding has stopped, the arm should be immobilized via splint and sling. See “General Guidance”

section from more information.

- Provide Treatment: lower left leg has third degree burns with clothing burned into wound. Should be

wrapped in clean cloth, without removing any clothing that might be part of the wound.

- Provide Treatment: the victim is showing stages of hypothermia (shivering). Since in their own

neighborhood, expect victim movement to a warm place, probably in a home.

- Protect from Further Injury (i.e., potential neck/spine injury)

- Treat for Shock - victim’s feet should not be raised, due to the potential head/ neck/spine injury.

The following is the additional information that you, as the judge, will tell the patrol AT APPROPRIATE


information:

The area is safe, but only temporarily. A utility worker checking the area walks by – notifies you that all

power is currently shut down, but that a test of the electrical network in about 10 minutes may cause a

power surge at that time.

The patrol should immediately check the victim for consciousness/ask for permission for treatment. At that

point the judge should tell them the victim says his legs “feel tingly” and that he is having trouble moving

them. This is an indication of possible neck/spine injury.

When victim (or judge) is asked, tell them there are no other injuries.

When the patrol calls 911 via cell phone, tell them the number is busy.

Bleeding of the arm wound will be controlled during treatment. The Patrol must know they should not apply

direct pressure, lest they disturb the fracture.





book says to stabilize head/neck - handbook picture shows a scout holding victim’s head/neck while

other treatments are being done. Scoring assumes a scout will continue to stabilize victim’s head

throughout the treatment.

There is a seeming contradiction between the handbook and MB book on cleaning a compound fracture:

o Handbook says to use stream of water to clean wound if medical help not available within an hour

o MB book says “do not try to clean the wound.

Thus, scoring does not include cleaning the wound. If a patrol does indicate using water, do not make a

deduction.

The Handbook and MB book both show different sling techniques for fractures of upper arm, shoulder,

and lower arm (see illustration attachment). We (First Aid Committee) believe that either a full arm or

partial arm sling are acceptable for a lower arm fracture. Further, while not required, it is assumed

acceptable if a bandage is used to secure the upper arm to the chest.

shock - book says raise feet 12 inches if no suspicion of back/neck/head injury. The Patrol should

assume possibility of neck injury. Thus, they should NOT raise his feet

Anyone who could potentially come in contact with bodily fluids should wear gloves and goggles.

Since this potential exists in any injury scenario, all scouts should wear gloves and goggles.


29

Note: to avoid excessive expense the scoring only requires 3 sets of goggles per patrol.


4.0 Some things Judge Should look for




Compound fracture treatment

Third degree burn treatment

Ongoing stabilization of head/neck

Treating for shock and for hypothermia


Continued 911 calls for help



Arm Slings


30


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Scoresheet: Scenario#4 “Tornadoes in New Jersey”

Description Points Max. Guidelines for Judging



tells Patrol a utility employee says

area is safe, but only for a short

time (@10 minutes)

‘0’ or ‘5’

5


are checking.

Either ‘5’ or ‘0’ points.

2 Recognized that victim is

responsive/conscious and asked him

for permission to do treatment?

Judge Note: in response: tell

victim says OK to treat; Legs “feel

tingly” and having trouble moving

them.

‘0’ or ‘5’

5

Done immediately and quickly after

safety assured Scouts should get victim’s attention and

ask if OK to pursue treatment.


3 Immediately reassured victim he is

being taken care of/things will be

OK?

‘0’ or ‘3’

3


4 Recognize possible neck/spine

injury?

‘0’ or ‘5’

5 Either ‘5’ or ‘0’ points

5 Patrol quickly moves victim away

from electrical danger?

‘0’ or ‘5’

5 Begins quickly to move victim:

Either ‘5’ or ‘0’.

6 Proper carry technique

Note: can be either Stretcher

(preferred) or Hammock carry.

See Judge Notes for illustrations.

‘0’ ‘1’

‘2’ ‘3’

‘4’ ‘5’

5

If Stretcher:

2 points correctly created stretcher

2 points supported head in moving onto

stretcher

1 point stretcher supported victim

If Hammock Carry:

2 points proper technique, incl. linked

hands under victim

2 points supported head in pickup/carry

1 point able to transport victim safely


32

7 Made attempt to call 911 for help

Note: AFTER victim is moved

JUDGE NOTE: in response, tell

them 911 is busy. Ask for “key info”

they will provide. Note: further

scoring later for re-trying 911 help

call.

‘0’ ‘1’

‘2’ ‘3’

‘4’ ‘5’

5

Note: award Max. points if sent as soon as

possible – in most cases after victim

moved, unless enough scouts to do both,

but:

- subtract 2 points if scout(s) missing any

of the following key info:

nature of injuries; when it occurred;

trained scouts doing first aid

8 Make a Thorough Examination, i.e.,

Check victim’s body for other

injuries? Ask victim?

JUDGE NOTE: if asked, tell them

there are no other injuries

‘0’ ‘1’ ‘3’

3



and ask victim for other concerns

1 point if only check body or only ask

victim (or only ask Judge)

0 points if neither is done.

Treat Right Arm – Compound

Fracture

9 Packed sterile gauze/pads around

bleeding wound?

JUDGE NOTE: once done, tell

patrol that bleeding is controlled

‘0’ ‘1’

‘2’ ‘3’

3

Award max. points if use gauze/pads and

do not apply direct pressure, and, do not

tie bandage over the wound to hold

packing. Only 2 points if tie bandage.

Only 1 point if direct pressure applied to

the wound. Otherwise, ‘0’ points.

Non-Scoring Note

OK if use water bottle stream to wash

the wound.

0

0

Contradictions in treatment between

Handbook/MB books.

10 Scouts realized that splint is

necessary to stabilize?

‘0’ or ‘3’

3

Since have to prepare for extended period

before assistance, need to stabilize the

fracture.


11 Splint(s) padded for comfort?

‘0’ or ‘3’

3

No points awarded if padding not used, or

if excessive padding interferes with

immobilization of the arm.

12 During splinting care taken that

fractured area is not moved?

‘0’ ‘3’ ‘4’

4

0 points if arm is obviously moved

3 points if care taken, but still moved

4 points if no movement


33

13 Splints secured both above and

below wound?

Judge: physically check that

splinting is secure.

‘0’ ‘1’

‘2’ ‘4’

4

0 points if ties done over the fracture.

1 point if all else correct, but splinting

loose/could not be expected to hold.

Only award 2 points if knots other

than square knots used for cravats or

other tied materials - OK if gauze

rolls/tape used to fasten.

14 Does splinting extend beyond the

wrist and beyond the elbow, that is,

beyond the joints above and below

the fracture?

‘0’ or ‘3’

3


15 Checked that circulation not affected

by splinting?

JUDGE NOTE: if asked, Judge

should indicate circulation is good

unless obvious the securing method

is too tight.

‘0’ ‘1’

‘2’ ‘3’

3

Max. (3) points only if 2 or more of

the following are used:

1) feel for warmth

2) ask victim if he has feeling beyond the

splint

3) observe color beyond the splint

4) gently squeeze and release a fingernail

or toenail beyond the split - pink color

should return in 1-2 sec.

2 points if any check made.

1 point if no specific checks, but verbal

recognition it is important to check.

16 Apply sling for additional

stabilization.

Note: can use either full arm sling or

partial (see illustrations in Judge

Notes).

Note: no credits or deductions if they

also use bandage to secure arm to

chest.

‘0’ ‘1’

‘2’ ‘3’

‘5’

5

2 points if arm managed gently during

sling creation

2 points if hand raised slightly higher

(@3”) higher than elbow

1 point if ends of sling tied with square

knot

Treat Burn on Lower Left Leg

17 Correctly recognize Third Degree

(Full Thickness) burn

‘0’ or ‘3’

3


18 Wrap in clean cloth.

‘0’ ‘2’ ‘3’

3

Award max. points if loosely wrapped and

not tied down.

Subtract 1 point if tied down

19 Did not apply creams, ointments, or

sprays.

‘0’ or ‘2’ 2 Either ‘2’ or ‘0’ points


34

20 Did NOT remove cloth piece that

was “burned” into the wound.

Judge: make sure the cloth is

refastened before starting next patrol

‘0’ or ‘2’

2


Hypothermia

21 Took action to warm victim?

Note: equipment includes 2 blankets.

If move into victim’s home, patrol

can assume other warming activities.

‘0’ ‘1’

‘2’ ‘3’

‘4’ ‘5’

5

2 points if moved into victim’s home

1 point if blanket under/around victim

2 points – if (verbally express) at least 2

of following:

- Remove wet clothing

- Drink warm liquids

- Other warming activities, e.g., hot

water bottles, additional clothing,

blankets (each one counts as separate

technique)

Shock Treatment


‘0’ or ‘3’

3


23 Did NOT raise feet?

‘0’ or ‘3’

3

Since possible neck/spine injury, the feet

should not be raised. If raised, score ‘0’.


24 Monitored breathing and other

shock-caused symptoms?

‘0’ or ‘2’

2



25 Continue to try 911 for assistance;

Judge – if they try at least one more

time, tell them they completed the

call, but assistance will be delayed.

‘0’ or ‘2’

2


Note: OK if they delegated this

responsibility to neighbor – full score.

26 Stabilized head/neck throughout

treatment?

‘0’ or ‘4’

4

Single scout held head/neck during entire

scenario.




‘0’ ‘1’ ‘2’

2




28 All scouts doing treatment wearing

non-latex gloves?

‘0’ ‘3’

3



wearing goggles?

‘0’ ‘2’

2



35


















Scenario#1 - Individual Scout Skills - rv.ppbsa.orgrv.ppbsa.org/Activities/First Aid...

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