HeartSafe EMS
OFA Level 2
Minor Wound and Medical Problems / Notes
2
*******
NB. These are for your information and study only. The problem and notes
below represent some of the typical scenarios but do not cover all the
possible scenarios examined by WorkSafe BC Evaluators.
*******
Nosebleed – mechanism? any Hx? Lean forward, pinch nose and ice on bridge of nose
Hot welding slag in ear - cool, attempt to remove (if adhering > send to medical aid),
paperwork, RTW
Hands dry and cracked - new solvent used?, refer to MSDS, use of barrier creams
and/or appropriate gloves, paperwork
Back pain (strain?) – mechanism (lifting/twisting?) – expose, examine, ice?, rest, do
range of motion checks; RTW? Or MA? MA if limited range of motion
Chest Pain 1) cardiac history (angina) usual pain, sent by supervisor to be checked out
(can be sent back to work if pain is completely relieved by one nitro and a set of vitals are
within normal range) 2) cardiac history plus something unusual or worse than normal, not
relieved with rest and nitro is RTC 3) chest pain no previous history is RTC
Ear Avulsion – piece of ear torn away; Primary/secondary, bandage and refer to MA
Small burns – 2nd degree burn with blister (extent determines whether patient goes to
medical aid
1) steam burn (2nd degree burn) to thumb and first finger ( blister along both fingers at
least ½ “ in height )
2) minor blisters (x3) on forearm - cool, cover and return to work
Stroke (CVA) – with decreased level of consciousness, patient may have to be placed ¾
prone (recovery position) with blanket under thigh and upper chest
Diabetic Reaction – history? Medical Alert bracelet, decreased level of consciousness
>> ¾ prone on floor and sugar in mouth(gums)
Triage – multiple patient scenarios
Revised 30 June 2012
Page 1 of 4
HeartSafe EMS
Headache – get patient’s medical history / mechanism, changes in patient’s workplace?
(ozone air filter newly installed?); any MSDS sheets available? keep out of workplace
and talk to supervisor about correction
Stepped on nail – Hx / mechanism; with no bone involvement RTW, Soak for 20
minutes and bandage. FA Record. Ask patient about tetanus shot. Proper footwear worn?
Stuck by hypodermic needle – clean wound area with mild soapy solution, vitals and
transport to medical aid within 2 hours for treatment for poss HIV/Hep C
Anaphylactic reaction – history of allergies? / mechanism / Epi-pen?
Soap / chemicals in eyes – flush, MSDS?, RTC? Treat at workplace?, contacts?
Elbow Fracture or Dislocation – limb cold and pulseless, >> RTC Limb threatening;
see conditions for realignment
Dislocated shoulder – primary/secondary/MA- immobilize with sling/transverse
Dust in Eye – pt walking through work yard, dust blew into eye (rule out penetrating
history); eye exam; RTW
Ankle Sprain – don’t forget range of motion checks! Worker handout
ASTD / repetitive strain injury (RSI)– do not do same job, do range of motion checks
on affected area to determine extent; talk with supervisor re: light duties or different job,
working splint (if applicable) and cold; Worker handout; wrist, shoulders, Achilles
tendon or knee; with limited range of motion – refer to MA
Heat-stroke – remove from environment, cut off clothing, cool. Patient is RTC. No
blankets
Finger laceration – using sharp knife to open box, pt cut index finger approx. 2”; needs
sutures to close (over two joints), patient to be referred to medical aid; primary, complete
secondary and modified head to toe; clean around wound with mild soapy solution and
irrigate wound with sterile saline (if grossly contaminated) dry (no skin closures),
bandage with tube gauze; apply sling and transport to medical aid. Complete paperwork.
Arm laceration – 1 ½” laceration of forearm; primary and modified head to toe; clean
around wound with mild soapy solution and irrigate wound with sterile saline. Dry off
and apply skin closures, bandage and RTW. Complete paperwork
Nail through palm / Splinter through fingers
Arc Flash Conjunctivitis – patient exposed to welding flash
Revised 30 June 2012
Page 2 of 4
HeartSafe EMS
Concussion – patient stood up under cupboard and hit head; feels dizzy, saw ‘stars’ and
has neck pain; lay patient down with C-Spine control, assess ABC’s (non-RTC) and call
Ambulance – start secondary
NOTES:
SCENE SAFETY / ASSESSMENT – remember you may have to actually tell the
examiner what you would do to make the scene safe ie. Broken glass – sweep away, lay
blankets over top etc., turn off / lock out machinery, HAZMAT team for acid clean up
Make sure you know how to do all paperwork - patient assessment chart and first aid
record (all may have to be handed in to examiner); don’t forget to give your patient the
Worker Handout for follow up care at home if applicable (Appendix C)
Breathing Assessment – if the breathing rate is 3 breaths or less in 15 seconds you
should extend the count by 15 seconds
Types of shock – hypovolemic, neurogenic, cardiogenic, anaphylactic, septic, psycogenic
Pale, cool and trunk trauma = SHOCK
Pale, cool, clammy and trauma anywhere = SHOCK
*********
When using the bag-valve mask don’t forget to check the carotid pule between breaths
Slings used – large arm and triangular; broad transverse
RTC Upgrades
1) Developing shock – skin becomes pale, cool and clammy during secondary
2) Decreasing Level of Consciousness – GCS less than or equal to 13
In non – breathing patients you must check carotid pulse every five (5) minutes, with
ABC’s
Pressure Points – must be held for five (5) minutes after bandaging is complete; wound
areas must be checked when you do your ABC’s
Make sure that you assess all Chief Complaints / wounds with the PPQRRST assessment
Revised 30 June 2012
Page 3 of 4
HeartSafe EMS
Sitting/Standing Spinal – have standing patient sit keeping head up and then CSpine
control and lay supine with help
Hip and Knee dislocations are RTC Limb Threatening
Priority Action Approach – Minor Wounds
Scene Assessment – what happened?
Primary Survey
Primary Survey – assess visually patient’s condition- airway , breathing and circulation
(If patient visibly anxious, pale or sweaty – lie down supporting injury, give
oxygen)
Patient Going to Medical Aid?
YES
NO
Do secondary survey before assessing wound
and doing treatments
Expose and examine wound, do treatments and
paperwork, return patient to work
- if not sure whether or not patient is going to medical aid, expose and examine wound;
then if patient requires medical aid, do secondary survey
Revised 30 June 2012
Page 4 of 4
OFA Level 2
FOR ALL SITUATION PRACTICALS
ATTENDANT INFORMATION
Work Place:



All standard first aid equipment as per WCB regulations
Lots of bystander (untrained) assistance if required
All workplaces located less than 20 minutes from medical aid
To use these Situation Practicals:
Make sure that the ‘Helper’ reads the scenario through first so that she/he has the relevant
information available for the Attendant as required. Have the helper position the patient
as per the scenario.
The ‘Helper’ must provide those details that would be obvious to the Attendant as she/he
approaches the scene such as the patient’s level of consciousness, obvious breathing
distress, large amounts of blood etc.
The attendant must ask the Scene Assessment questions in order to begin the scenario.
The Helper will then tell the Attendant the relevant information and continue to do so as
the Attendant progresses through the Primary and Secondary Surveys, ABC rechecks and
Treatments.
Once the Attendant has completed the Situation Practical, all three students – Patient,
Helper and Attendant can go over the suggested Treatment Plan for any corrective action
required.
Should you have any questions, please do not hesitate to contact your Instructor.
Please note that while we strive to make these Situation Practicals and the suggested
Treatment Plans as accurate as possible, in the final practical exam, it is the WorkSafe
BC Evaluator, based on the standard marking criteria, who will make the final decision
on the correct protocol.
Thank you.
Paul Stone
HeartSafe EMS
Revised 30 June 2012
First Aid Attendant Information Sheet
OFA Level 2
Situation Practical #1
SITUATION PRACTICAL # 1
HELPER
SCENE ASSESSMENT
History /mechanism: worker struck in face by a board from edger machine, pt lying
supine with blood around mouth and nose
# of patients: one
Hazards:
none, the edger has been locked out
Location:
Building 51
Conscious/breathing status: unresponsive since accident
PRIMARY SURVEY FINDINGS
LOC: no response to verbal stimuli
Airway:
blood in nose and mouth, gurgling – clears if pt rolled lateral and finger
sweep; pt will accept oral airway if inserted
Breathing:
16 regular, effective
Circulation: radial pulse present
Skin – cool, pale and dry
RBS – no other injuries found
VITAL SIGNS
Respirations: 16 regular, effective
Pulse:
96 regular, easily felt
LOC:
eyes – no response (1)
verbal – mumbles to pain (2)
motor – withdraws to pain (4)
Pupils:
equal, reactive 4 mm
Skin:
cool, pale, dry
Chief Complaint:
Allergies:
Medications:
Medical history:
unconscious since accident (facial injuries)
unknown
unknown
unknown
HEAD TO TOE EXAMINATION
Physical:
facial injuries
Neurological: withdraws from pain in extremities
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 1
SITUATION PRACTICAL # 1
Suggested Treatment Plan


Scene Assessment
Call for medical aid (patient unresponsive)







C-Spine control: move head to mid-line and neutral if no resistance
Assess airway: with blood and broken teeth in airway, roll patient lateral with CSpine control; have assistant hold head
- clear airway with finger sweep
Roll patient back to supine, do jaw thrust and assess airway (clear); have assistant
maintain C-Spine control and jaw thrust
Measure and insert oral airway (patient accepts airway)
Assess breathing for 15 seconds (16 regular)
Assess radial pulse and skin; pulse present, skin – pale cool and dry
Perform RBS – no other injuries noted
Oxygen at 10 lpm and cover with blanket

RTC Decision: patient is RTC unresponsive & partial airway obstruction

Perform complete secondary survey including distal circulation and neurological
checks

Vital signs every 10 minutes; recheck ABC’s every 5 minutes until help arrives

Disclaimer: While we remain confident that these suggested treatment
plans are correct, the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 2
SITUATION PRACTICAL #2
HELPER
SCENE ASSESSMENT
History /mechanism: Forklift tipped forward throwing operator into the front of the cab
and out onto ground. The worker is supine with blood on face.
# of patients: one
Hazards:
no hazards, forklift is turned off
Location:
sawmill
Conscious/breathing status: unresponsive, not breathing
PRIMARY SURVEY FINDINGS
LOC:
unresponsive
Airway:
blood and broken teeth in mouth; lips cyanosed
Breathing:
no breathing or air entry on ventilations (PPV) even after airway is cleared
of fluids; (after one set of 30 chest compressions an additional piece of
broken jaw will be present in the mouth)
Circulation: no radial pulses, weak carotid pulse and skin pale, cool and clammy
RBS:
no other injuries found
VITAL SIGNS
Respirations: absent (lips cyanosed initially)
Pulse:
no radials, weak carotid at 56
LOC:
eyes – no response 1
verbal – no response 1
motor – no response 1
Pupils:
equal, sluggish and 6mm
Skin:
pale, cool and clammy
Chief Complaint:
unconscious since accident
Allergies:
unknown
Medications: unknown
Medical history: unknown
HEAD TO TOE EXAMINATION
Physical:
facial injuries
Neurological: no response to verbal or pain stimuli
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 2
SITUATION PRACTICAL # 2
Suggested Treatment Plan























Scene Assessment - safe
Patient is found supine
Patient unresponsive – activate the Worksite Emergency Response Procedures
C-Spine control; move head to mid-line and neutral (no resistance): jaw thrust
Assess airway – blood and broken teeth in airway; roll patient lateral with C-Spine
control and have helper support head; finger sweep out broken teeth and blood
Roll patient to supine – jaw thrust
Assess airway – no breathing (lips cyanosed); assistant to hold C-Spine
Check for a carotid pulse – carotid pulse present
Attempt to ventilate with pocket mask – air does not go in
Tongue/jaw lift and visualize airway
Attempt to ventilate – no air goes in
Visualize airway - Measure and insert correct oral airway (patient accepts airway)
Attempt to ventilate – no air goes in
Remove airway and perform 30 chest compressions
Visualize airway - Finger sweep and remove part of broken jaw from airway
Assess airway – no breathing; ventilate x2 with pocket mask – air goes in
Re-insert oral airway
Assess carotid pulse – patient has weak pulse
Assist breathing once every 5 seconds; train helper to assist and monitor helper, apply
oxygen at 10 lpm to pocket mask
Expose chest and assess breathing – 12 shallow, assisted
Assess radial pulse – no radials, re-assess carotid (present but weak) and skin – pale,
cool and clammy
Perform RBS – no other injuries found
Cover with blanket

RTC Decision – patient is RTC unresponsive and obstructed airway; call for medical
assistance if not already done

Re-check ABC’s every 5 minutes (lips less cyanosed– re-check carotid pulse each
time)
Perform secondary survey including distal circulation and neurological checks
Vital signs every 10 minutes


Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 3
SITUATION PRACTICAL #3
HELPER
SCENE ASSESSMENT
History /mechanism: supervisor found slumped over desk in office; hadn’t been seen up
and around for some time (no trauma)
Number of patients: one
Hazards:
none, site office (inside)
Location:
site office of new building under construction
Conscious/breathing status: unresponsive, breathing
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
unresponsive (withdraws from pain)
excessive drooling (if patient left supine they will have a gurgling airway)
24 effective (only if ¾ prone)
radial pulse – present (weak); skin – pale, cool and clammy
no injuries found, medical alert bracelet on left wrist – IDDM (diabetic)
Patient does not accept oral airway if tried
VITAL SIGNS
Respirations: 20 effective
Pulse:
84 weak, regular
LOC:
eyes – open to pain - 2
verbal – moaning - 2
motor – withdraws from pain - 4
Pupils:
equal, reactive (sluggish) – 7 mm
Skin:
pale, cool and clammy
Chief Complaint:
Allergies:
Medications:
Medical history:
decreased level of consciousness
unknown
insulin (co-worker)
diabetic (bracelet found)
HEAD TO TOE EXAMINATION
Physical:
no injuries found, weak distal pulses
Neurological: no deficits noted; withdraws from pain
Revised 30 June 2012)
Helper Information Sheet
OFA Level 2
Situation Practical # 3
SITUATION PRACTICAL # 3
Suggested Treatment Plan








Scene Assessment: inside site office, no hazards
LOC: unresponsive (withdraws from pain)
Activate the Worksite Emergency Response Procedures
C-Spine control: not required, patient found slumped over desk
With assistance lay patient supine on floor; open airway with head tilt/chin lift
Assess Airway: gurgling (saliva/drool); roll to ¾ prone and clear out – drool remains
flowing out (not gurgling in ¾ prone; measure and insert oral airway – patient does
not accept airway
Assess Breathing: 20 effective (only if ¾ prone)
Assess Circulation: radial pulse – present (weak); skin – pale, cool and clammy
RBS: no injuries noted; look for medical alert necklace or bracelet; bracelet found
‘IDDM” (diabetic)
Apply oxygen at 10 lpm
Cover with blanket

RTC Decision: patient is RTC – decreased level of consciousness



Make sure patient is ¾ prone
Administer sugar; rub into gums in mouth
Reassess ABC’s every 5 minutes

Complete Secondary survey

Assess vital signs every 10 minutes and recheck ABC’s



Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #4
SITUATION PRACTICAL #4
HELPER
SCENE ASSESSMENT
History /mechanism: fall 4 metres; patient’s chest struck protruding rebar in retaining
wall under construction
# of patients: one
Hazards: no dangers (make sure construction debris is cleared away from around
patient)
Location: rear of construction site
Conscious/breathing status: conscious, trouble breathing (obvious cyanosis around lips)
and trying to cough blood from airway; blood also seen on front of shirt; patient found
supine
PRIMARY SURVEY FINDINGS
LOC: conscious
Airway: coughing up frothy pink blood
Breathing: gasping and lips cyanosed; 24 if assisted; 32 if not assisted
If chest exposed, bubbling (open pneumothorax) chest wound on right hand side
Circulation: radial pulse present (weak)
skin: pale, cool and dry
RBS: other than chest, no other injuries noted
VITAL SIGNS
Respirations: 24 if assisted (becoming effective); 32 if not assisted (ineffective)
Pulse:
96 weak
LOC:
eyes – open spontaneously
verbal – oriented (SOB – not verbalizing well)
motor – obeys commands
Pupils:
equal, reactive and 6 mm
Skin:
pale, cool and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
short of breath
not known (unable to verbalize)
not known (unable to verbalize)
not known (unable to verbalize)
HEAD TO TOE EXAMINATION
Physical: open pneumothorax on upper right chest
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 4
SITUATION PRACTICAL # 4
Suggested Treatment Plan





Scene Assessment: make sure that construction debris is cleared away from around
patient
C-Spine control: attendant to main C-Spine control; roll patient from supine to
lateral with helper’s assistance; encourage patient to cough to clear airway (clears);
roll patient to supine; move head to mid-line and neutral (no resistance in neck –
caution patient to tell you if movement increases pain); have helper maintain C-Spine
Assess Airway: now clear, patient gasping (cyanosis seen around lips)
Activate the Worksite Emergency Response Procedures
Assist breathing with PPV – use pocket mask (caution patient not to fight the mask
before putting mask on face) timed to patient’s own rate of breathing and at least one
breathe every 5 seconds; train helper to assist breathing and monitor helper for
effectiveness
Apply oxygen at 10 lpm to pocket mask
Expose chest (open pneumothorax seen on upper right side); cover with gloved hand
and have another helper (gloved) maintain the airtight seal with their hand
Assess Breathing: 24 distressed though becoming more effective (less cyanosed)
Assess Circulation: radial pulse – present (weak); skin – pale, cool and dry
RBS: no other injuries noted
Cover with blanket

RTC Decision: patient is RTC – short of breath

Complete secondary survey including circulation and neurological checks






Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #5
SITUATION PRACTICAL #5
HELPER
SCENE ASSESSMENT
History /mechanism: fall 4 meters off roof; patient found supine propped up on one
elbow (right side down)
# of patients: one
Hazards:
no dangers
Location:
rear of construction site
Conscious/breathing status: conscious, obvious trouble breathing (lips cyanosed)
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
conscious
clear
32, gasping and lips cyanosed;
radial pulse: present
skin: pale, cool and clammy
RBS: if chest exposed - flail segment on upper right chest 3” x 3”; no
other injuries
VITAL SIGNS
Respirations: 24 if assisted
Pulse:
96 weak
LOC:
eyes – open spontaneously (4)
verbal – oriented (5)
motor – obeys commands (6)
Pupils:
equal, reactive and 6 mm
Skin:
pale, cool and clammy
Chief Complaint: short of breath
Allergies:
none known
Medications: none taken
Medical history: no major medical history
HEAD TO TOE EXAMINATION
Physical:
flail segment on upper right chest 3” x 3”; no other injuries
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #5
SITUATION PRACTICAL #5
Suggested Treatment Plan












Scene assessment – area safe
C-Spine control and with assistance lower patient to supine; realign head to midline and neutral; have helper maintain C-Spine control
Airway assessment: clear
Patient obviously gasping and lips are cyanosed
Activate the Worksite Emergency Response Procedures
Assist patient’s breathing with pocket mask, timed to each breath; caution
patient not to fight the mask
Train helper to assist breathing; monitor assistant and hook up oxygen at 10 lpm
to pocket mask
Expose chest: red mark on upper right chest; palpate area – flail segment found
(3”x3”); support area with hand and call in another assistant to support
Assess breathing: 32 gasping, laboured
Assess circulation: weak radial pulses, skin is pale, cool and clammy
RBS: no other injuries found
Cover patient with blanket
RTC Decision: patient is RTC – short of breath and flail chest
Re-check ABC’s every 5 minutes
Perform complete secondary survey including distal circulation and neurological checks
Vital signs every 10 minutes
NB. If still waiting for the Ambulance after the secondary the attendant must assist
the ventilations with the bag-valve-mask (O2 at 15 lpm)
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #6
SITUATION PRACTICAL #6
HELPER
SCENE ASSESSMENT
History /mechanism: municipal worker caught in suction intake in recreation centre
swimming pool
# of patients: one
Hazards:
none, patient has been rescued and brought to pool deck
Location:
pool at municipal recreation centre
Conscious/breathing status: patient unconscious, placed supine
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
unconscious and unresponsive
full of vomit
no breathing (lips are cyanosed)
no radial pulses, weak carotid found
no other injuries noted
VITAL SIGNS
Respirations: absent
Pulse:
carotid pulse weak
LOC:
eyes – no response 1
verbal – no response 1
motor – withdraws to pain
Pupils:
fixed and dilated 7 mm
Skin:
wet and cold
Chief Complaint:
Allergies:
Medications:
Medical history:
unconscious since accident
unknown
unknown
unknown
HEAD TO TOE EXAMINATION
Physical:
no injuries found
Neurological: no response
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #6
SITUATION PRACTICAL # 6
Suggested Treatment Plan






Scene Assessment: area safe, now on pool deck; patient unresponsive
Activate the Worksite Emergency Response Procedures
C-Spine control: patient found supine, support the C-Spine and bring head/neck to
mid-line and neutral (no resistance); jaw thrust to open airway
Assess Airway: mouth full of vomit – roll patient to lateral with C-Spine control;
have helper hold C-Spine; finger sweep vomit from mouth
Take over C-Spine and roll patient supine; re-align head to mid-line and neutral (no
resistance); re-assess airway (now clear) – no breathing; have helper hold C-Spine
Assess Carotid Pulse – present but weak
Ventilate – air goes in (x 2 breaths); measure and insert oral airway; patient accepts
airway
Ventilate patient once every 5 seconds; train helper to assist and monitor helper
Apply oxygen to pocket mask at 10 lpm
Expose chest and assess rate and quality of breathing – 12 assisted (lips less
cyanosed)
Assess Circulation: no radial pulses, check carotid - present
RBS: no injuries found
Cover with blanket

RTC Decision: patient is RTC unconscious, not breathing

Reassess ABC’s every 5 minutes

Secondary survey, including distal circulation and neurological checks

Assess vital signs every 10 minutes







NB. If still waiting for the Ambulance after the secondary the attendant must assist
the ventilations with the bag-valve-mask (O2 at 15 lpm)
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #7
SITUATION PRACTICAL #7
HELPER
SCENE ASSESSMENT
History /mechanism: city worker burning brush; smoke inhalation; no history of fall or
trauma
# of patients: one
Hazards:
none, patient has been removed from area
Location:
hillside off main road in city park
Conscious/breathing status: conscious, trouble breathing – gasping, coughing, lips
cyanosed (soot around mouth and nose)
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
conscious
clear (coughing)
gasping and lips cyanosed – rate 28
radial pulse present
skin – pale, cool and clammy
RBS – no injuries found
VITAL SIGNS
Respirations: if assisted – 20; if not assisted – 28 and laboured
Pulse:
96 regular
LOC:
eyes – open spontaneously
verbal – oriented
motor – obeys commands
Pupils:
equal, reactive and 6mm
Skin:
pale, cool and clammy
Chief Complaint:
Allergies:
Medications:
Medical history:
Short of breath
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical:
no injuries found
Neurological: normal nerve function
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #7
SITUATION PRACTICAL #7
Suggested Treatment Plan









Scene assessment: - no dangers
Activate the Worksite Emergency Response Procedures
Assess for C-Spine control: rule out; no history of fall or trauma
Support patient (co-worker) and sit in position of comfort – usually semi-sitting
for ease of breathing
Patient obviously having trouble breathing: gasping, cyanosed lips and coughing
Encourage patient to keep coughing to clear soot from airways
Assist breathing with pocket mask timed to patient’s owns breathing; caution
patient not to fight the mask (at least 1 breath every 5 seconds)
Train helper to assist breathing with pocket mask and monitor helper for
compliance
Hook up oxygen to pocket mask (10 lpm)
Expose chest – no obvious injuries: assess breathing - 28 assisted
Assess circulation: radials pulses present, skin pale, cool and clammy
RBS: no injuries found
Blanket: not required if patient hot

RTC Decision: patient is RTC short of breath

Assess vital signs every 10 minutes and recheck ABC’s every 5 minutes




NB. If still waiting for the Ambulance after the secondary the attendant must assist
the ventilations with the bag-valve-mask (O2 at 15 lpm)
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #8
SITUATION PRACTICAL #8
HELPER
SCENE ASSESSMENT
History /mechanism: Worker was eating lunch in cafeteria when she became
increasingly SOB; Hx of allergic reactions to peanuts; kitchen staff had made brownies
with nuts today in kitchen
Number of patients: one
Hazards: none
Location: company cafeteria; sitting in chair supported by co-worker
Conscious/breathing status: conscious, SOB (wheezy)
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
conscious
clear
SOB (cyanosis developing); 24 and ineffective with audible wheezing
radial pulses: present (weak)
Skin: pale, cool and dry with obvious hives and rashes around face/neck
and upper chest
RBS: no other obvious injuries found
VITAL SIGNS
Respirations: 24 and ineffective (wheezy)
Pulse:
96 weak
LOC:
eyes – 4
verbal – 5 (unable to vocalize fully)
motor – 6
Pupils:
equal, slow to react
Skin:
pale, cool and dry with obvious hives and rashes around face/neck and
upper chest
Chief Complaint:
Allergies:
Medications:
Medical history:
SOB (obvious)
peanuts
usually has Epi-Pen in pocket but doesn’t today; co-workers tell
you that they have seen her use an Epi-Pen previously
Hx of Allergic Reactions and has been hospitalized for same
HEAD TO TOE EXAMINATION
Physical:
no other injuries found
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #8
SITUATION PRACTICAL # 8
Suggested Treatment Plan





Scene Assessment: safe, in workplace cafeteria
Activate the Worksite Emergency Response Procedures
C-Spine control: not required, no Hx of fall/trauma, so position patient for ease of
breathing on floor, usually semi-sitting (supported by co-worker)
Assess Airway: clear
Assess Breathing: SOB (cyanosis developing) so assist breathing timed to patient’s
own breathing (at least 1 breath every 5 seconds) with Pocket Mask and caution
patient not to fight mask; train helper to use PM and monitor for compliance; assess
breathing rate and quality
Hook up Oxygen to PM at 10 lpm
Assess Circulation: radial pulses present (weak)
Skin – pale, cool and dry with obvious hives and rashes around face/neck and upper
chest
RBS: no other injures noted
Cover with blanket

RTC Decision: Patient is RTC (SOB)

Complete secondary survey including vitals signs

Monitor ABC’s at 5 minute intervals





Other Treatments:
No Epi-pen available
Disclaimer: We are confident that these suggested treatment plans are correct,
however the WorkSafe BC Evaluators remain the final authority on what constitutes a
correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 9
SITUATION PRACTICAL #9
HELPER
SCENE ASSESSMENT
History /mechanism: worker hit by log on right thigh and knocked down; lying supine
with massive bleed on right thigh area and puddle on ground
Number of patients: one
Hazards:
make sure that other logs are secured
Location:
log sort on outskirts of town
Conscious/breathing status: conscious and breathing
PRIMARY SURVEY FINDINGS
LOC:
conscious, yelling and screaming
Airway:
clear
Breathing:
20 regular and effective
Circulation: radial pulse – absent; skin – pale, cool and clammy
RBS: massive tissue avulsion right thigh (when exposed); bleeding not controlled with
direct pressure; pressure point controls; no other injuries found
VITAL SIGNS
Respirations: 20 regular and effective
Pulse:
no radial pulses; pulse at carotid – 84 weak, regular
LOC:
eyes – open spontaneously (4)
verbal – patient confused (4)
motor – obeys commands (6)
Pupils:
dilated, 5 mm, slow to react
Skin:
pale, cool and clammy
Chief Complaint:
Allergies:
Medications:
Medical history:
pain right thigh
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical:
massive tissue avulsion right thigh; circulation absent in right leg
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 9
SITUATION PRACTICAL # 9
Suggested Treatment Plan












Scene Assessment: make sure that all other logs are secured
C-Spine control: with C-Spine control, move head to mid-line and neutral (no
resistance in neck); patient conscious and yelling
Assess Airway: airway clear
With conscious patient who is apparently breathing effectively; go to right thigh and
expose wound; massive tissue avulsion 8” with heavy bleeding; attempt to control
with direct pressure (abdominal pads and pressure with two hands); direct pressure
does not control
Have helper maintain direct pressure and attendant to apply femoral pressure point –
this controls bleeding; have helper maintain pressure point
Activate the Worksite Emergency Response Procedures
Assess Breathing: breathing check for 15 seconds - 28 regular and effective
Assess Circulation: radial pulses – absent; check carotid – present; skin – pale, cool
and clammy
Intervene for shock with oxygen at 10 lpm (adult face mask)
RBS: full RBS, massive tissue avulsion right thigh; no other injuries noted
Cover with blanket
RTC Decision: patient is RTC – shock, pressure point applied

Bandage wound with abdominal pads, gauze and loop ties (cover entire wound area);
make note of time bandaging is complete – pressure point to be released after 5
minutes after bandaging complete

Secondary survey including distal circulation and neurological checks

ABC’s every 5 minutes; attendant to check wound area for any fresh bleeding
Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 10
SITUATION PRACTICAL #10
HELPER
SCENE ASSESSMENT
History /mechanism: worker struck in upper arm by concrete block falling off
scaffolding (no pain in neck, not knocked to ground)
Number of patients: one
Hazards:
machine must be turned off and locked out
Location:
small sawmill operation in town’s industrial centre
Conscious/breathing status: conscious, breathing; complaining of pain in upper left arm
– large amount of bleeding in upper arm/shoulder area; looks pale, sweaty and anxious
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
conscious; no pain in neck
clear, patient yelling
24 regular, effective (anxious)
radial pulse – present (weak); skin – pale, cool and clammy
large amount of bleeding in upper arm/shoulder area; if wound exposed
there is a large gash in upper left arm 4” long and bleeding heavily; direct
pressure will control bleeding
VITAL SIGNS
Respirations: 24 regular, effective (anxious)
Pulse:
100 regular, weak
LOC:
eyes – open spontaneously (4)
verbal – confused (5)
motor – localizes pain (6)
Pupils:
dilated, slow to react, 5 mm
Skin:
pale, cool and clammy
Chief Complaint:
Allergies:
Medications:
Medical history:
complaining of pain in upper left arm
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical:
weak pulse distal to injury; no other injuries noted
Neurological: tingling in left hand
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 10
SITUATION PRACTICAL # 10
Suggested Treatment Plan











Scene Assessment: area must be made safe; check scaffolding for other debris –
secure if necessary
Rule out C-Spine (no mechanism)
With help lay patient supine
Assess Airway: clear, patient yelling
Assess Breathing: 24 regular, effective (anxious)
Expose wound area with scissors; heavy bleeding from 4” long gash in upper left
arm – direct pressure with gauze and abdominal pad controls bleeding; have helper
maintain direct pressure and support / elevate arm
Assess Circulation: radial pulse – present (weak) in uninjured limb; skin – pale, cool
and clammy
Activate the Worksite Emergency Response Procedures
Intervene with oxygen at 10 lpm for shock
RBS: no other injuries noted
Cover with blanket

RTC Decision: RTC – shock (skin is pale, cool and clammy with a major trauma
to left arm)

Complete secondary survey while waiting for help to arrive; circulation (distal) in
injured arm is compromised – no ice
Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 11
SITUATION PRACTICAL #11
HELPER
SCENE ASSESSMENT
History /mechanism: patient struck and knocked down by dump truck backing up
without a traffic control person; worker’s head covered by hood and talking on cell phone
Number of patients: one, patient found supine
Hazards:
area to be controlled by a traffic control person
Location:
gravel pit access road
Conscious/breathing status: conscious and breathing
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
conscious, complaining of pain in lower abdomen and pelvis area
clear
24 regular, effective
radial pulse – present (weak)
skin – pale, cool and dry
RBS – pain and if exposed bruising/discolouration on left side of pelvis
and lower abdomen
VITAL SIGNS
Respirations: 24 regular, effective
Pulse:
96 regular
LOC:
eyes – open spontaneously 4
verbal – confused 4
motor – obeys commands 6
Pupils:
equal, slow 5 mm
Skin:
pale, cool and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
pain on left side of pelvis and lower abdomen
none known
none taken
no major history
HEAD TO TOE EXAMINATION
Physical:
pain and bruising/discolouration on left side of pelvis and lower abdomen
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 11
SITUATION PRACTICAL # 11
Suggested Treatment Plan









Scene Assessment: area to be controlled by traffic control person
C-Spine control: attendant to control C-Spine and move to mid-line and neutral if no
resistance (caution patient before moving head/neck as to an increase in pain); have
helper maintain C-Spine control
Assess Airway: clear
Assess Breathing: 24 regular, effective
Assess Circulation: radial pulses – weak; skin – pale, cool and dry
Activate the Worksite Emergency Response Procedures
Apply oxygen at 10 lpm
RBS: expose injured area - pain on palpation left side of pelvis and lower abdomen
Cover with blanket

RTC Decision: patient is RTC; skin pale, cool and dry & trunk trauma = Shock

Secondary survey, including distal circulation and neurological checks

Assess vital signs every 10 minutes and recheck ABC’s
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #12
SITUATION PRACTICAL #12
HELPER
SCENE ASSESSMENT
History /mechanism: worker struck in neck by fan blade that broke while worker was
performing a high-idle test over engine; patient found kneeling in front of vehicle with
blood spurting from neck
Number of patients: one
Hazards:
car must be shut off
Location:
mechanic’s shop
Conscious/breathing status: conscious and breathing
PRIMARY SURVEY FINDINGS
C-Spine not required
LOC: conscious
Airway:
clear (yelling)
Breathing:
appears effective (28 if counted)
Circulation: radial pulse - weak
skin – pale, cool and clammy
RBS: no other apparent injuries (if assistant’s asked to check)
VITAL SIGNS
Respirations:
Pulse:
LOC:
eyes –
verbal –
motor –
Pupils:
Skin:
NB. In this case the attendant will
probably not have the chance to complete
the secondary survey.
Chief Complaint:
Allergies:
Medications:
Medical history:
HEAD TO TOE EXAMINATION
Physical:
Neurological:
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #12
SITUATION PRACTICAL # 12
Suggested Treatment Plan











Scene Assessment: make sure that vehicle is shut off
C-Spine control: not required
Lay patient supine, control bleeding in neck with large abdominal dressing or
pressure dressing and apply direct pressure to wound; ask helper to maintain pressure
if possible
Activate the Worksite Emergency Response Procedures
Complete Primary Survey (if able to do so)
Assess Airway: clear
Assess Breathing: 28 regular, effective
Assess Circulation: radial pulse present, weak; skin – pale, cool and dry
RBS: laceration in neck, no other injuries
Oxygen at 10 lpm
Cover with blanket

RTC Decision: patient is RTC – severed carotid

Secondary survey – this survey may not be possible

Assess vital signs every 10 minutes and recheck ABC’s if able
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #13
SITUATION PRACTICAL #13
HELPER
SCENE ASSESSMENT
History /mechanism: At construction site, scaffolding collapsed and worker fell 10’;
patient dragged himself to sitting against concrete retaining wall; holding right side of
chest /abdomen
Number of patients: one
Hazards: collapsed scaffolding
Location: Northwest corner of construction site
Conscious/breathing status: conscious and breathing; holding right side of chest
/abdomen complaining of pain in that area
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
conscious
clear
24 effective (reluctant to take a deep breath)
radial pulse present; skin – pale, cool and dry
RBS – pain / red area URQ abdomen and lower rib cage right side (no
flail)
VITAL SIGNS
Respirations: 24 effective
Pulse:
88 regular, weak
LOC:
eyes – 4
verbal – 5
motor – 6
Pupils:
4mm, equal and light reactive; slow to react
Skin:
pale, cool and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
pain / red area URQ abdomen and lower rib cage right side
none known
none taken
no major medical conditions (Hx asthma as a child)
HEAD TO TOE EXAMINATION
Physical:
pain / red area URQ abdomen and lower rib cage right side (no flail)
Neurological: no deficits
30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 13
SITUATION PRACTICAL #13
Suggested Treatment Plan









Scene Assessment: scene not safe; co-workers need to clear away collapsed
scaffolding
C-Spine control: required, Hx of Fall 10’; Attendant needs to hold C-Spine with
patient sitting (anterior and posterior C-Spine control); with help move patient away
from wall a few inches (or as required) and have helpers, under the direction of the
Attendant, swing legs around 90 degrees and the lay patient supine; realign head /
neck to mid-line and neutral; have helper maintain C-Spine control
Assess Airway:
clear
Expose chest and palpate wound area
Assess Breathing:
24 effective (reluctant to take deep breath – pain)
Assess Circulation:
radial pulse present (weak); skin – pale, cool and dry
Activate the Worksite Emergency Response Procedures
RBS:
pain / red area URQ abdomen and lower rib cage right side
Cover with blanket
Administer Oxygen at 10 lpm (standard Adult face mask)

RTC Decision: patient is RTC – shock (trunk trauma and pale, cool, dry skin)

Complete Secondary Survey

Re-assess ABC’s every 5 minutes

Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final
authority on what constitutes a correct protocol in the final exam.
30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 214
SITUATION PRACTICAL # 14
HELPER
SCENE ASSESSMENT
History /mechanism: 64 year old Male with Sub-sternal Chest Pain for last 25 – 30
minutes
Number of patients: one
Hazards: none (patient walked into first aid room)
Location: First aid room
Conscious/breathing status: conscious and breathing (mild dypsnea and anxiety),
looking pale, sweaty and ashen
Doesn’t want to lie down but will semi-sit on first aid room cot
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
alert and oriented
clear
32 shallow (mild dypsnea and anxiety)
weak radials (equal): skin cool, pale, sweaty and ashen
VITAL SIGNS
Respirations: 32 shallow (mild dypsnea and anxiety)
Pulse:
104, weak and irregular
LOC:
eyes – 4
verbal – 5
motor – 6
Pupils:
equal and light reactive
Skin:
cool, pale, sweaty and ashen
P – sub-sternal
P – thinks it stress / overwork
Q – heavy, squeezing
R – into Left arm and neck
R – no relief
S – 8/10
T – 25 – 30 minutes
Has taken x 2 spray nitro with
no relief in last 20 minutes;
doesn’t feel like his regular
angina
Once PPQRRST has been completed the patient becomes
unresponsive. Attendant will be unable to rouse patient.
A – Clear (once two breaths are attempted)
B- no spontaneous breathing
C – no Carotid pulse is found
Chief Complaint: Chest Pain
Allergies: none Medications: nitro and ASA
Medical history: Angina last two years
HEAD TO TOE EXAMINATION
Physical: no injuries found and no neurological deficits noted
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 14
SITUATION PRACTICAL # 14
Suggested Treatment Plan










Scene Assessment: safe, patient walks into first aid room; ask for mechanism of
injury or chief complaint and Hx of Chief Complaint
C-Spine control: not required, did not fall
Lay patient on first aid room cot in position of comfort (semi-sitting)
Assess Airway: clear
Assess Breathing: mild dypsnea – provide 02 at 10 lpm (standard adult face
mask)
Assess Circulation: weak radials, skin cool, pale, sweaty and ashen
RBS: verbalized
Cover with blanket
Use PPQRRST to understand medical condition
Activate the Worksite Emergency Response Procedures

RTC Decision: Patient is RTC (Chest Pain with Hx and no relief with patient’s
own nitro spray)

Start Secondary survey

Patient arrests – lie patient flat on floor, do head tilt / chin lift – assess airway (no
breathing) and check carotid pulse (no pulse) ; set up AED, prepare chest by shaving
and/or drying off, attach electrodes (pads), push analyze making sure that everyone is
clear including yourself, shock or no-shock – if no response start CPR 30:2 (2
minutes). Re-analyze shock or no-shock – if no response start CPR (2 minutes)
and carry on at scene of arrest for 30 minutes if no response or until
help/Ambulance Arrives

Get additional help if available
Disclaimer: We are confident that these suggested treatment plans are correct, however
the WorkSafe BC Evaluators remain the final authority on what constitutes a correct
protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 15
SITUATION PRACTICAL #15
HELPER
SCENE ASSESSMENT
History /mechanism: worker found collapsed in boiler room of large industrial plant;
co-workers tell you that the worker had been complaining of being dizzy and nauseous
earlier today (wearing coveralls)
Number of patients: one
Hazards: boiler room very hot
Location: steam plant in industrial complex
Conscious/breathing status: unresponsive
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
unresponsive
breathing clearly
20 regular and effective
radial pulses present, skin very hot and dry; no injuries found on RBS
VITAL SIGNS
Respirations: 16 effective
Pulse:
72, strong and regular
LOC:
eyes – 2
verbal – 2
motor – 4
Pupils:
equal, slow to react
Skin:
hot and dry
Chief Complaint: none voiced
Allergies: not known
Medications: not known
Medical history: not known
HEAD TO TOE EXAMINATION
Physical: no injuries found
Circulation: pulses found in all limbs
Neurological: withdraws from pain in all limbs
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 15
SITUATION PRACTICAL # 15
Suggested Treatment Plan









Scene Assessment: scene not safe; have co-workers remove patient from boiler room
LOC – unresponsive
Activate the Worksite Emergency Response Procedures
C-Spine control: not required (no Hx trauma)
Assess Airway: head tilt / chin lift clear; have helper maintain head tilt / chin lift;
measure and insert oral airway (patient accepts oral airway)
Assess Breathing: 20 regular and effective
Assess Circulation: radial pulses present; skin is very hot and dry
RBS: no injuries found
Apply oxygen at 10 lpm by adult face mask

RTC Decision: RTC – Decreased level of consciousness and suspected heat stroke
Other Treatments:
Remove heavy outer clothing (coveralls) and start cooling the patient with water
Perform complete secondary survey including distal circulation and neurological checks
Vital signs every 10 minutes; recheck ABC’s every 5 minutes until help arrives
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #16
SITUATION PRACTICAL #16
HELPER
SCENE ASSESSMENT
History /mechanism: job superintendent (age 55, slightly overweight) found slumped
over in chair at desk in separate office
Number of patients: one
Hazards: none
Location: site office of new dam under construction
Conscious/breathing status: opens eyes to speech but not talking; obvious facial droop
seen on right side of face; breathing
PRIMARY SURVEY FINDINGS
LOC: opens eyes to speech; speech slurred
Airway: clear
Breathing: 24 effective
Circulation: radial pulse – strong and slow; skin – warm (flushed)
RBS: - no injuries noted; facial droop on right side of face; arm on right side hanging
limp, not moving
VITAL SIGNS
Respirations: 16 irregular (effective)
Pulse:
60 strong, irregular
LOC:
eyes – 3
verbal – 2
motor – 4
Pupils:
right – 5mm (reactive); left – 7mm (sluggish)
Skin:
warm (flushed)
Chief Complaint:
Allergies:
Medications:
Medical history:
none voiced
unknown
known to be on a high blood pressure medication (co-worker)
high blood pressure (from co-worker)
HEAD TO TOE EXAMINATION
Physical: facial droop right side of face
Neurological: deficits noted on right side of body (arm and leg)
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #16
SITUATION PRACTICAL # 16
Suggested Treatment Plan









Scene Assessment: inside office, no hazards, one patient, unknown history
LOC: opens eyes to speech; speech slurred
Activate the Worksite Emergency Response Procedures
C-Spine control: not required; with help move patient to floor (fore and aft lift)
Position patient supine
Open airway with head tilt / chin lift and assess – clear; have helper hold head
tilt/chin lift
Assess Breathing: 16 effective (irregular)
Assess Circulation: radial pulse – present (strong); skin – warm (flushed)
RBS: no obvious injuries; right arm/leg flaccid
Special Notes:
Look for medical alert tags (during RBS) and medications; ask co-workers about current
incident and/or medical history
Could consider ¾ prone if necessary to maintain airway

Oxygen at 10 lpm

RTC Decision: patient is RTC - decreasing level of consciousness and suspected
CVA

Complete Secondary survey

Assess vital signs every 10 minutes and recheck ABC’s every 5 minutes
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #17
SITUATION PRACTICAL #17
HELPER
SCENE ASSESSMENT
History /mechanism: worker digging trench for new drain field
Number of patients: one
Hazards:
none
Location:
long term care facility; patient walks into first aid room
Conscious/breathing status: conscious and breathing; complaining of chest pain, looks
pale and sweaty
PRIMARY SURVEY FINDINGS
LOC: conscious
Airway:
clear
Breathing:
28 regular, effective (anxious)
Circulation: radial pulse – present; skin – pale, cool and sweaty
RBS: chest pain (substernal); no other complaints
VITAL SIGNS
Respirations: 28 regular, effective
Pulse:
120 regular, weak
LOC:
eyes – open spontaneously (4)
verbal – oriented (5)
motor – obeys commands (6)
Pupils:
dilated, 6 mm reactive
Skin:
pale, cool and sweaty
P – under breast bone
P - nothing makes it worse
Q – heavy, squeezing (vise-like)
R – radiates to left shoulder / neck
R – nothing seems to make it better
S – 7/10
T – started approx. 40 minutes ago
Chief Complaint:
substernal chest pain
Allergies:
none known
Medications: none taken
Medical history:
no major medical history
HEAD TO TOE EXAMINATION
Physical:
substernal chest pain; no other complaints
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 17
SITUATION PRACTICAL # 17
Suggested Treatment Plan








Scene Assessment: patient walks into first aid room; determine mechanism – patient
complaining of chest pain (no trauma mechanism); lay patient down ( pale, cool and
sweaty skin seen on approach)
C-Spine control: not required
Assess Airway: clear
Assess Breathing: 28 regular, effective (anxious)
Assess Circulation: radial pulse – present; skin – pale, cool and sweaty
RBS: substernal chest pain (no actual RBS required); attendant should be asking how
long it has lasted for and previous history if any (in this case no previous history of
heart problems)
Administer oxygen at 10 lpm
Use PPQRRST to investigate chief complaint; don’t forget to confirm previous
medical history and any medications taken


Activate Worksite Emergency Response Procedures
RTC Decision: RTC – Chest Pain (cardiac; chest pain lasting longer than 30
minutes)

Start Secondary Survey – complete set of vitals

Head to toe – not required
Other Treatments:
Keep patient at rest, do not allow to stand or exert himself; monitor vitals until help
arrives
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 18
SITUATION PRACTICAL #18
HELPER
SCENE ASSESSMENT
History /mechanism: the worker (electrician) was changing a fluorescent bulb in an
overhead fixture when the ladder slipped; patient fell approx. 16’ (5m); patient is lying
supine
Number of patients: one
Hazards:
ladder must be secured
Location:
storage garage at pulp mill
Conscious/breathing status: patient is conscious and complaining of pain in lower back
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
conscious
clear
20 effective
radial pulse – present; skin – normal colour, warm and dry
pain in lower back (lumbar area) and pain & minor bleeding at right
elbow; if patient is asked, there is numbness and tingling in both legs
VITAL SIGNS
Respirations: 20 effective
Pulse:
88 regular
LOC:
eyes – open spontaneously - 4
verbal – oriented - 5
motor – obeys commands - 6
Pupils:
equal, reactive 4 mm
Skin:
skin – normal colour, warm and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
complaining of pain in lower back
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical:
pain in lower back (lumbar area) – no deformity and an increase in pain on
palpation; pain, minor bleeding and deformity at right elbow (compound
fracture – minor bleeding)
Neurological: numbness and tingling in both legs – no response to pain stimulus in legs
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #18
SITUATION PRACTICAL # 18
Suggested Treatment Plan





Scene Assessment: make sure that ladder is secure
C-Spine control: patient is supine; with C-Spine control move head/neck to mid-line
and neutral (no resistance, no increase in pain); caution patient to report any increase
in pain while moving neck; patient allows you to realign; have helper maintain CSpine control
Assess Airway: clear, patient is complaining of pain in lower back
Assess Breathing: 20 effective
Assess Circulation: radial pulse – present; skin – normal colour, warm and dry
RBS: pain in lower back on palpation (towards centre of back), no blood; small
injury on right elbow with minor bleeding, deformity (compound fracture) and pain
on palpation; have helper support arm; make sure that you ask patient about
numbness and tingling in legs/ feet – numbness and tingling are present
Activate the Worksite Emergency Response Procedures
Apply oxygen at 10 lpm
Cover with blanket

RTC Decision: patient is RTC – suspected spinal cord injury

Reassess ABC’s every 5 minutes

Secondary survey, including distal circulation and neurological checks; roll patient
lateral with C-Spine control and have helper hold C-Spine; expose and examine back;
expose wound area on arm and control bleed with gauze and abdominal pad (bandage
and splint arm fracture after secondary complete (if help has not arrived)

Assess vital signs every 10 minutes




Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #19
SITUATION PRACTICAL #19
HELPER
SCENE ASSESSMENT
History /mechanism: worker stuck screwdriver in electrical panel and was thrown back
approx. 10’ as a result
Number of patients: one
Hazards: main breaker must be turned off; extinguish smoldering clothing on patient’s
left arm
Location: electrical room of machine shop
Conscious/breathing status: conscious, breathing; complaining of pain in left forearm
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
conscious
clear
24 effective
radial pulse – present (in uninjured limb); skin – warm and dry
second and third degree burns covering half of left arm (4 – 5% surface
area); no other injuries noted
VITAL SIGNS
Respirations: 24 effective
Pulse:
84 regular
LOC:
eyes – 4
verbal – 5
motor – 6
Pupils:
4mm, brisk to react
Skin:
warm and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
pain in lower left forearm
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical: second and third degree burns in lower left forearm; good distal circulation in
all limbs (not able to assess the injured limb)
Neurological: no deficits noted (not able to assess the injured limb)
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #19
SITUATION PRACTICAL # 19
Suggested Treatment Plan








Scene Assessment: ensure that main breaker is turned off and smoldering clothing is
extinguished
Activate the Worksite Emergency Response Procedures
C-Spine control: Attendant to apply C-Spine control; move head/neck to mid-line
and neutral if no resistance; caution patient to notify you of any increase in pain on
movement; have helper maintain C-Spine
Assess Airway: clear
Assess Breathing: 24 effective
Assess Circulation: radial pulse – present (in uninjured limb); Skin – warm and dry
RBS: second and third degree burns on lower left forearm; no other injuries noted
Once area is exposed, cool with sterile saline and cover with sterile dressings
Apply oxygen at 10 lpm
Cover with blanket

RTC Decision: patient is RTC – severe third degree burns / electrical shock

Secondary survey, including distal circulation and neurological checks

Assess vital signs every 10 minutes and recheck ABC’s every 5 minutes


Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 20
SITUATION PRACTICAL #20
HELPER
SCENE ASSESSMENT
History /mechanism: 10’ high shelving unit collapsed and knocked worker down; a 5”
piece of the metal shelving unit penetrated workers abdomen (URQ)
Number of patients: one; found supine
Hazards:
collapsed shelving must be secured by co-workers
Location:
road maintenance shop
Conscious/breathing status: conscious and breathing; 5” piece of metal shelving unit
seen protruding from URQ abdomen with minimal bleeding
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
conscious and alert
clear
24 effective
radial pulse – present; skin – normal colour, warm and dry;
5” metal piece protruding from URQ abdomen (minimal bleeding); no
other injuries noted
VITAL SIGNS
Respirations: 24 effective
Pulse:
80 regular, easily felt
LOC:
eyes – open spontaneously (4)
verbal – oriented (5)
motor – obeys commands (6)
Pupils:
equal, reactive 5 mm
Skin:
normal colour, warm and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
pain URQ abdomen
none known
none taken
diabetic
HEAD TO TOE EXAMINATION
Physical:
5” metal piece protruding from URQ abdomen; no other injuries noted
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 20
SITUATION PRACTICAL # 20
Suggested Treatment Plan










Scene Assessment: make sure that the rest of the shelving unit is secured by coworkers
Activate the Worksite Emergency Response Procedures
C-Spine control: support C-Spine and move head to midline and neutral (no
resistance); caution patient to tell you if movement causes pain in neck
Assess Airway: clear, patient yelling
Assess Breathing: expose chest / abdomen - 24 effective
Assess Circulation: radial pulse – present; skin – normal colour, warm and dry
RBS: penetrating injury URQ abdomen (minimal bleeding); no other injuries
Cover with blanket
Oxygen at 10 lpm
Have 2nd helper stabilize metal piece (attendant must show helper how to do so; kneel
at patient’s side with elbows on knees and hands holding the metal piece)

RTC Decision: penetrating injury to torso

Secondary survey, including distal circulation and neurological checks

Assess vital signs every 10 minutes and recheck ABC’s every 5 minutes
Other Treatments: once secondary survey is complete, fully stabilize metal piece with
ring pads or ‘log cabin’ style support if still waiting for help to arrive
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #21
SITUATION PRACTICAL #21
HELPER
SCENE ASSESSMENT
History /mechanism: patient caught fingers in stamping press; patient walks with coworker to first aid room
Number of patients: one
Hazards: none
Location: first aid room of fabricating shop
Conscious/breathing status: conscious, breathing and agitated (pale and sweaty); open
wounds with bleeding on fingers of right hand
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
conscious and oriented
clear
24 and effective
radial pulse – present (checked on uninjured limb); skin – pale, warm and
sweaty
compound fractures (minimal bleeding) on all four fingers of right hand;
no other injuries noted
VITAL SIGNS
Respirations: 24 and effective
Pulse:
76 regular and easily felt (uninjured limb)
LOC:
eyes – 4
verbal – 5
motor – 6
Pupils:
equal and reactive, 5 mm
Skin:
pale, warm and sweaty
Chief Complaint: pain in right hand
Allergies: none known
Medications: none taken
Medical history: no major medical history
HEAD TO TOE EXAMINATION
Physical: compound fractures on all four fingers of right hand
Neurological: no deficits noted
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #21
SITUATION PRACTICAL # 21
Suggested Treatment Plan





Scene Assessment: no dangers (in first aid room)
C-Spine control: should be ruled out
Patient should be placed supine on treatment bed (clearly agitated and pale/sweaty)
with injured arm elevated; place drainage dressings under and over hand
Assess Airway: clear
Assess Breathing: 24 and effective
Assess Circulation: radial pulse – present (uninjured arm); skin – pale, warm and
sweaty
RBS: compound fractures on right hand (fingers); no other injuries noted
Apply oxygen at 10 lpm (to decrease agitation)

RTC Decision: non – RTC

Complete secondary survey (patient going to medical aid) including distal circulation
and neurological checks; apply ice to injury (on for 10 minutes and off for 5 minutes).

Splint arm from past fingertips to just short of elbow; support hand in position of
function; gauze between fingers

Sit patient up and apply triangular sling (if patient feels like walking and not dizzy or
nauseous); transport to medical aid by company vehicle



Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 22
SITUATION PRACTICAL #22
HELPER
SCENE ASSESSMENT
History /mechanism: golf course worker rolled ATV down small slope pinning worker
underneath machine; patient found supine
Number of patients: one
Hazards: machine to be turned off and secured
Location:
Fairwinds Golf Course – between 9th and 10th holes
Conscious/breathing status: patient conscious and complaining of pain across pelvis
and upper legs
PRIMARY SURVEY FINDINGS
LOC: conscious
Airway:
clear
Breathing:
28 effective
Circulation: radial pulse – present; skin – normal colour, warm and dry
RBS:
pain and an increase in pain on palpation across entire pelvis and upper
femurs; no bleeding
VITAL SIGNS
Respirations: 28 effective
Pulse:
84 regular
LOC:
eyes – open spontaneously - 4
verbal – oriented - 5
motor – obeys commands - 6
Pupils:
equal and reactive – 5 mm
Skin:
normal colour, warm and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
pain across entire pelvis and upper legs
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical: pain and an increase in pain on palpation across entire pelvis and upper femurs;
no bleeding but marked bruising/discolouration across pelvis and upper
legs
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 22
SITUATION PRACTICAL # 22
Suggested Treatment Plan



Scene Assessment: Make sure that machine is turned off and removed off patient;
watch for gasoline spill / fire hazard
Activate the Worksite Emergency Response Procedures
C-Spine control: Attendant to apply C-Spine control; move head/neck to mid-line
and neutral if no resistance; caution patient to notify you of any increase in pain on
movement; have helper maintain C-Spine
Assess Airway: clear
Assess Breathing: 24 effective
Assess Circulation: radial pulse – present; skin – normal colour, warm and dry
RBS: pain on palpation across pelvis and upper legs; no bleeding; have helper
support both legs
Apply oxygen at 10 lpm
Cover with blanket

RTC Decision: patient is RTC – crush injury to torso/femurs or rollover accident

Secondary survey, including distal circulation and neurological checks

Assess vital signs every 10 minutes and recheck ABC’s






Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 23
SITUATION PRACTICAL # 23
HELPER
SCENE ASSESSMENT
History /mechanism: a cement truck driver was struck on the head by the metal chute on
the back of the truck; patient lying prone, eyes closed and unresponsive; small amount of
blood matted in patient’s hair
Number of patients: one
Hazards:
make sure that chute is secured and truck turned off
Location:
building site next to foundation
Conscious/breathing status: unresponsive, patient is breathing
PRIMARY SURVEY FINDINGS
LOC: unresponsive to verbal stimuli
Airway:
clear
Breathing:
20 shallow and effective
Circulation: radial pulse – present
skin – normal colour, warm and dry
RBS – small amount of matted blood in hair; no other injuries
VITAL SIGNS
Respirations: 20 shallow and effective
Pulse:
72 regular
LOC:
eyes – opens to pain - 2
verbal – moans to pain - 2
motor – withdraws from pain - 4
Pupils:
equal and reactive, 5 mm
Skin:
normal colour, warm and dry
Chief Complaint:
unconscious since accident
Allergies:
unknown
Medications: unknown
Medical history:
unknown
HEAD TO TOE EXAMINATION
Physical:
small amount of matted blood in hair; no other injuries; good distal pulses
Neurological: withdraws from pain stimulus in all limbs
Revised 30 June 2012
Helper Information Sheet
OFA Level 3
Situation Practical # 23
SITUATION PRACTICAL # 23
Suggested Treatment Plan











Scene Assessment: truck turned off and all equipment secured
LOC – patient is unresponsive to verbal stimuli
Activate the Worksite Emergency Response Procedures
C-Spine control: patient is prone – support C-Spine and have helper roll patient to
lateral; have helper support head and assess airway – airway clear and patient is
breathing; retake C-Spine control and roll patient to supine; move head/neck to midline and neutral if there is no resistance; do jaw thrust (some resistance from patient)
Assess Airway: clear; have helper maintain C-Spine and jaw thrust
Measure and insert oral airway – patient gags (does not accept airway)
Assess Breathing: 20 shallow and effective
Assess Circulation: radial pulse – present; skin – normal colour, warm and dry
RBS: small amount of matted blood in patient’s hair; no other injuries
Apply oxygen at 10 lpm
Cover with blanket

RTC Decision: patient is RTC – unresponsive

Secondary survey, including distal circulation and neurological checks

Assess vital signs every 10 minutes and recheck ABC’s every 5 minutes and try and
re-insert oral airway on each ABC check
Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012-06-30
Helper Information Sheet
OFA Level 2
Situation Practical #24
SITUATION PRACTICAL #24
HELPER
SCENE ASSESSMENT
History /mechanism: Hydrochloric acid spill from drum that burst after shelving
collapsed contaminating worker on face, hands and clothing (coveralls); patient fell to
floor (onto concrete)
Number of patients: one, supine
Hazards: Hydrochloric acid spill from drum on floor around patient and on patient’s
clothing
Location: warehouse
Conscious/breathing status: conscious, breathing (screaming)
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
RBS:
conscious
clear
28 effective
radial pulse present, skin (abdomen): warm and dry
acid burns on face (both eyes and cheeks), hands and acid soaking into
coveralls
VITAL SIGNS
Respirations: 28 effective
Pulse:
92 and regular
LOC:
eyes – 4
verbal – 5
motor – 6
Pupils:
(eyes damaged from acid)
Skin:
burns to face; abdomen – warm and dry
Chief Complaint: facial burns
Allergies:
none
Medications:
none taken
Medical history: no major medical history
HEAD TO TOE EXAMINATION
Physical: burns to face (eyes) and hands
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #24
SITUATION PRACTICAL # 24
Suggested Treatment Plan









Scene Assessment: hydrochloric acid spill is still a hazard
Activate the Worksite Emergency Response Procedures
Summon company HAZMAT Team to deal with hydrochloric acid; patient may
have to be removed from area with appropriate safety gear (gloves, eye protection
etc.) and any contaminated clothing cut off
Have HAZMAT team start flushing patient with copious amounts of water or
saline – have helper continue flushing; do not flush acid onto unaffected parts of
the body
C-Spine control: realign head to mid-line and neutral (when safe to do so); no pain
and no resistance in neck
Assess Airway: clear (screaming)
Assess Breathing: 28 effective
Assess Circulation: radial pulse – present; skin (abdomen) – warm and dry
RBS: facial burns (both eyes and cheeks); burns to hands
Cover with blanket
Apply Oxygen at 10 lpm (may need to have helper hold mask near face)

RTC Decision: RTC – acid burns to the face and eyes

Send helper to get MSDS information on hydrochloric acid

Start Secondary Survey if time and treatments permit


Other Treatments:
Continue flushing eyes until help arrives; reassess ABC’s every 5 minutes
Disclaimer: We are confident that these suggested treatment plans are correct,
however the WorkSafe BC Evaluators remain the final authority on what constitutes a
correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 25
SITUATION PRACTICAL #25
HELPER
SCENE ASSESSMENT
History /mechanism: The worker was injured while cleaning sawdust from around a
table saw using a four-foot aluminum pipe nozzle extension. Aluminum pipe touched saw
(not locked out) and shattered sending aluminum shards into patient’s eye. Not wearing
safety glasses. Patient is supine.
Number of patients: one
Hazards: machine must be turned off and locked out
Location: resaw division
Conscious/breathing status: patient is conscious and breathing
PRIMARY SURVEY FINDINGS
Aluminum shard protruding from patient’s right eye approx. 3”
LOC:
conscious
Airway:
clear
Breathing:
24 effective
Circulation: radial pulse – present; skin – pale, cool and dry
RBS: eye injury, no other injuries found
VITAL SIGNS
Respirations: 24 effective
Pulse:
96 regular
LOC:
eyes – n/a (covered) – though consider a 4
verbal – oriented - 5
motor – obeys commands - 6
Pupils:
covered
Skin:
pale, cool and dry
Chief Complaint: penetrating eye injury right eye
Allergies:
sulfa drugs
Medications: wellbrutrin
Medical history:
depression
HEAD TO TOE EXAMINATION
Physical:
penetrating eye injury, right eye
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 25
SITUATION PRACTICAL # 25
Suggested Treatment Plan









Scene Assessment: make sure that machine is turned off and locked out
C-Spine control: support C-Spine and move head/neck to mid-line and neutral ( no
resistance); caution patient to tell you if movement increases pain; have helper
maintain
Activate the Worksite Emergency Response Procedures
Assess Airway: clear, patient yelling
Assess Breathing: 24 effective
Assess Circulation: radial pulse – present; skin – pale, cool and dry
RBS: no other injuries found
Apply oxygen at 10 lpm
Cover with blanket

RTC Decision: patient is RTC – penetrating eye injury; Call for medical assistance

Show 2nd helper how to support object; kneel with elbows on thighs and hands
supporting object; cover uninjured eye with eye pad and injured eye with sterile
gauze

Reassess ABC’s every 5 minutes

Secondary survey, including distal circulation and neurological checks

Assess vital signs every 10 minutes and recheck ABC’s
Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #26
SITUATION PRACTICAL #26
HELPER
SCENE ASSESSMENT
History /mechanism: patient thrown from dump truck as it was overturning
Number of patients: one
Hazards: vehicle is well off the road
Location: road into landfill site
Conscious/breathing status: conscious and no obvious breathing difficulty
PRIMARY SURVEY FINDINGS
LOC:
conscious
Airway:
clear
Breathing:
24 and effective; agitated
Circulation: radial pulse – present; skin – warm and dry
RBS: pain and small amount of blood at right ankle; no neurological deficits
VITAL SIGNS
Respirations: 24 and effective; agitated
Pulse:
84 regular, easily felt
LOC:
eyes – 4
verbal – 5
motor – 6
Pupils:
equal, reactive and 4 mm
Skin:
skin – warm and dry
Chief Complaint:
Allergies: `
Medications:
Medical history:
pain right ankle
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical: compound fracture right ankle with minimal bleeding; good distal circulation in
all limbs
Neurological: no neurological deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #26
SITUATION PRACTICAL # 26
Suggested Treatment Plan




Scene Assessment: area safe, vehicle well off road
C-Spine control: required (patient thrown from vehicle); move head to mid-line and
neutral if no resistance or complaints from patient (caution patient to tell you if
moving head increases pain)
Activate the Worksite Emergency Response Procedures
Assess Airway: clear
Assess Breathing: 24 and effective
Assess Circulation: radial pulse present; skin – warm and dry
RBS: small amount of blood noted on medial right ankle (do not expose, have
bystander support leg); no other injuries or complaints
Cover with blanket
Administer oxygen at 10 lpm

RTC Decision: RTC – patient thrown from moving motor vehicle

Complete secondary survey including distal circulation and neurological checks;
expose wound area during head to toe; re-assess ABC’s every 5 minutes and vitals
every 10 minutes





Other Treatments:
Bandage wound if time permits after secondary survey
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical # 27
SITUATION PRACTICAL #27
HELPER
SCENE ASSESSMENT
History /mechanism: worker fell approx. 3 m while climbing boxes stacked in
warehouse; patient supine
Number of patients: one
Hazards:
make sure that boxes will not fall
Location:
warehouse of auto parts store
Conscious/breathing status: conscious and breathing; complaining of pain in the neck
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
conscious
clear
24 effective
radial pulse – present; skin – normal colour, warm and dry
VITAL SIGNS
Respirations: 24 effective
Pulse:
64 regular
LOC:
eyes – open spontaneously - 4
verbal – oriented - 5
motor – obeys commands - 6
Pupils:
equal, reactive 4 mm
Skin:
normal colour, warm and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
pain in the neck
none known
none taken
no major medical history
HEAD TO TOE EXAMINATION
Physical:
pain, an increase in pain on palpation on left side of neck; no other injuries
noted
Neurological: no deficits
Revised 30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical # 27
SITUATION PRACTICAL # 27
Suggested Treatment Plan







Scene Assessment: make sure that remaining boxes will not fall
C-Spine control: patient is supine; attendant to apply C-Spine control and move
head/neck to mid-line and neutral (no resistance); caution patient to notify you of any
increase in the pain on movement; have helper maintain C-Spine
Assess Airway: clear; patient complaining of pain in the neck
Assess Breathing: 20 effective
Assess Circulation: radial pulse – present; skin – normal colour, warm and dry
RBS: pain (no deformity or bleeding) in neck; no other injuries; make sure that you
ask patient about numbness and tingling in extremities (no deficits)
Cover with blanket and administer oxygen at 10 lpm

RTC Decision: patient is non-RTC (for patient to be RTC there must be pain in the
neck or back AND numbness or tingling in the extremities); call for Ambulance –
spinal precautions

Secondary survey, including distal circulation and neurological checks (no deficits
noted)

Assess vital signs every 30 minutes and recheck ABC’s every 10 minutes
Other Treatments:
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
Revised 30 June 2012
Suggested Treatment Plan
OFA Level 2
Situation Practical #28
SITUATION PRACTICAL #28
HELPER
SCENE ASSESSMENT
History /mechanism: Patients walks into first aid room complaining of soreness in Right
heel; stepped on shard of metal on construction site (wearing running shoes)
Number of patients: one
Hazards: none
Location: First aid room
Conscious/breathing status: conscious and breathing
PRIMARY SURVEY FINDINGS
LOC:
Airway:
Breathing:
Circulation:
Alert and oriented
Clear
24 effective
radial pulse present; skin – normal, war and dry
RBS: complaining of soreness in Right heel
VITAL SIGNS
Respirations:
24 effective
Pulse:
72 regular
LOC:
eyes – 4
verbal – 5
motor – 6
Pupils:
5mm, equal and reactive
Skin:
normal, warm and dry
Chief Complaint:
Allergies:
Medications:
Medical history:
soreness Right heel
none known
none taken
no major medical Hx
HEAD TO TOE EXAMINATION
Physical:
small puncture wound Right heel
Neurological: no deficits
30 June 2012
Helper Information Sheet
OFA Level 2
Situation Practical #28
SITUATION PRACTICAL #28
Suggested Treatment Plan














Scene Assessment: In first aid room; no dangers/hazards; scrap metal on job site
C-Spine control: ruled out; not required
Assess Airway: clear
Assess Breathing: 24 effective
Assess Circulation: radial pulse present; skin – normal, warm and dry
RBS: complaint of minor pain in right heel
Expose and examine wound area - small puncture wound
Determine how deep did the metal shard penetrate heel (approx ½”); palpate area –
no bone involvement
Ask patient about tetanus shot – last one three years ago
Soak heel in anti-bacterial solution for 20 minutes after cleaning wound area of any
obvious dirt seen; dry off area
Bandage wound – bandaid
Complete First Aid record and give out Worker Handout Sheet (minor wounds and
cuts) – review with worker first
See if patient can stand and bear weight on area (no pain)
Make sure worker is wearing footwear appropriate for job site before RTW – speak
with supervisor?
Disclaimer: We are confident that these suggested treatment plans are
correct, however the WorkSafe BC Evaluators remain the final authority
on what constitutes a correct protocol in the final exam.
30 June 2012
Suggested Treatment Plan