Saturday, April 27, 2013

FEMA EXERCISE ACTOR BRIEFING

Posted by George Freund on April 27, 2013 at 8:35 AM

EXERCISE “VICTIM”

SYMPTOMATOLOGY TAG



Date of Exercise: [MM/DD/YYYY] Casualty #: ________







VISIBLE SYMPTOMS:




Excited and anxious
Vomiting
Pinpointed pupils







PHYSICAL FINDINGS:




Resp: 26
Pulse: 64
BP: 120/80







OTHER PATIENT INFORMATION:




Aware; knows name and location
Able to walk






Actor Exercise Assessment Form



Please complete the following questions at the conclusion of the exercise. This card is to be turned in at the checkout station at the exercise site. Please be accurate with your answers. Your cooperation is important and is appreciated.



Field Assessment and Treatment:

1. Initial Contact and Triage

a. How long did it take response personnel to contact you? _______

b. How long did it take response personnel to begin decontaminating you? ____________

c. Were you examined on the scene more than once? £ Yes £ No

d. Whom did you talk to, or whom were you assessed by (list all)? £ Fire £ EMS £ Police £ Other ______________

e. If you received a multicolored triage tag, what was the BOTTOM color when it was first given to you? £ Green £ Yellow £ Red £ Black £ Never received a tag

f. What actions did response personnel take as a result of their assessment of your condition?



________________________________________________________



________________________________________________________



________________________________________________________



2. Treatment:

a. If conscious, did someone explain your treatment? £ Yes £ No

b. If conscious, were you given clear instructions? £ Yes £ No

c. What treatment was given?



________________________________________________________



________________________________________________________



________________________________________________________



3. Did you observe any outstanding actions among the response personnel you observed?



________________________________________________________



________________________________________________________



________________________________________________________



Hospital (if applicable)

1. Which hospital did you go to? ________________________________

2. Once at the hospital, how long was it until someone examined you?
£ Less than 5 minutes £ 5 minutes £ 10 minutes £ 15 minutes £ Over 15 minutes £ I was never examined at the hospital



Exercise Design: Did you observe any problems during your participation in the exercise? What improvements would you suggest?



________________________________________________________



________________________________________________________



________________________________________________________



DO NOT LOSE THIS CARD!

DO NOT LET ANYONE TAKE THIS CARD FROM YOU!

















A ride has been scheduled to return you to the exercise site. If you are not picked up, please call: [Insert number].



Thank you for your participation!



EXERCISE “VICTIM”

SYMPTOMATOLOGY TAG



Date of Exercise: [MM/DD/YYYY] Casualty #: ________







VISIBLE SYMPTOMS:




Worried
Concerned and frantic Complaining of being hot







PHYSICAL FINDINGS:




Resp: 14
Pulse: 68
BP: 118/72







OTHER PATIENT INFORMATION:




Aware; knows name, location, and time but slow to respond
Able to follow directions
Able to walk








Actor Exercise Assessment Form



Please complete the following questions at the conclusion of the exercise. This card is to be turned in at the checkout station at the exercise site. Please be accurate with your answers. Your cooperation is important and is appreciated.



Field Assessment and Treatment:

1. Initial Contact and Triage

a. How long did it take response personnel to contact you? _______

b. How long did it take response personnel to begin decontaminating you? ____________

c. Were you examined on the scene more than once? £ Yes £ No

d. Whom did you talk to, or whom were you assessed by (list all)? £ Fire £ EMS £ Police £ Other ______________

e. If you received a multicolored triage tag, what was the BOTTOM color when it was first given to you? £ Green £ Yellow £ Red £ Black £ Never received a tag

f. What actions did response personnel take as a result of their assessment of your condition?



________________________________________________________



________________________________________________________



________________________________________________________



2. Treatment:

a. If conscious, did someone explain your treatment? £ Yes £ No

b. If conscious, were you given clear instructions? £ Yes £ No

c. What treatment was given?



________________________________________________________



________________________________________________________



________________________________________________________



3. Did you observe any outstanding actions among the response personnel you observed?



________________________________________________________



________________________________________________________



________________________________________________________



Hospital (if applicable)

1. Which hospital did you go to? ________________________________

2. Once at the hospital, how long was it until someone examined you?
£ Less than 5 minutes £ 5 minutes £ 10 minutes £ 15 minutes £ Over 15 minutes £ I was never examined at the hospital



Exercise Design: Did you observe any problems during your participation in the exercise? What improvements would you suggest?



________________________________________________________



________________________________________________________



________________________________________________________





DO NOT LOSE THIS CARD!

DO NOT LET ANYONE TAKE THIS CARD FROM YOU!















A ride has been scheduled to return you to the exercise site. If you are not picked up, please call: [Insert number].



Thank you for your participation!



EXERCISE “VICTIM”

SYMPTOMATOLOGY TAG



Date of Exercise: [MM/DD/YYYY] Casualty #: ________







VISIBLE SYMPTOMS:




Complaining of headache Lightheadedness
Broken bones







PHYSICAL FINDINGS:




Resp: 18
Pulse: 120
BP: 120/80







OTHER PATIENT INFORMATION:




Aware; knows name and location


















Actor Exercise Assessment Form



Please complete the following questions at the conclusion of the exercise. This card is to be turned in at the checkout station at the exercise site. Please be accurate with your answers. Your cooperation is important and is appreciated.



Field Assessment and Treatment:

1. Initial Contact and Triage

a. How long did it take response personnel to contact you? _______

b. How long did it take response personnel to begin decontaminating you? ____________

c. Were you examined on the scene more than once? £ Yes £ No

d. Whom did you talk to, or whom were you assessed by (list all)? £ Fire £ EMS £ Police £ Other ______________

e. If you received a multicolored triage tag, what was the BOTTOM color when it was first given to you? £ Green £ Yellow £ Red £ Black £ Never received a tag

f. What actions did response personnel take as a result of their assessment of your condition?



________________________________________________________



________________________________________________________



________________________________________________________



2. Treatment:

a. If conscious, did someone explain your treatment? £ Yes £ No

b. If conscious, were you given clear instructions? £ Yes £ No

c. What treatment was given?



________________________________________________________



________________________________________________________



________________________________________________________



3. Did you observe any outstanding actions among the response personnel you observed?



________________________________________________________



________________________________________________________



________________________________________________________



Hospital (if applicable)

1. Which hospital did you go to? ________________________________

2. Once at the hospital, how long was it until someone examined you?
£ Less than 5 minutes £ 5 minutes £ 10 minutes £ 15 minutes £ Over 15 minutes £ I was never examined at the hospital



Exercise Design: Did you observe any problems during your participation in the exercise? What improvements would you suggest?



________________________________________________________



________________________________________________________



________________________________________________________



DO NOT LOSE THIS CARD!

DO NOT LET ANYONE TAKE THIS CARD FROM YOU!

















A ride has been scheduled to return you to the exercise site. If you are not picked up, please call: [Insert number].



Thank you for your participation!



EXERCISE “VICTIM”

SYMPTOMATOLOGY TAG



Date of Exercise: [MM/DD/YYYY] Casualty #: ________







VISIBLE SYMPTOMS:




Muscle twitching
Nausea







PHYSICAL FINDINGS:




Resp: 28
Pulse: 84
BP: 110/70







OTHER PATIENT INFORMATION:




Drowsy
Confused
Unsteady on feet
























Actor Exercise Assessment Form



Please complete the following questions at the conclusion of the exercise. This card is to be turned in at the checkout station at the exercise site. Please be accurate with your answers. Your cooperation is important and is appreciated.



Field Assessment and Treatment:

1. Initial Contact and Triage

a. How long did it take response personnel to contact you? _______

b. How long did it take response personnel to begin decontaminating you? ____________

c. Were you examined on the scene more than once? £ Yes £ No

d. Whom did you talk to, or whom were you assessed by (list all)? £ Fire £ EMS £ Police £ Other ______________

e. If you received a multicolored triage tag, what was the BOTTOM color when it was first given to you? £ Green £ Yellow £ Red £ Black £ Never received a tag

f. What actions did response personnel take as a result of their assessment of your condition?



________________________________________________________



________________________________________________________



________________________________________________________



2. Treatment:

a. If conscious, did someone explain your treatment? £ Yes £ No

b. If conscious, were you given clear instructions? £ Yes £ No

c. What treatment was given?



________________________________________________________



________________________________________________________



________________________________________________________



3. Did you observe any outstanding actions among the response personnel you observed?



________________________________________________________



________________________________________________________



________________________________________________________



Hospital (if applicable)

1. Which hospital did you go to? ________________________________

2. Once at the hospital, how long was it until someone examined you?
£ Less than 5 minutes £ 5 minutes £ 10 minutes £ 15 minutes £ Over 15 minutes £ I was never examined at the hospital



Exercise Design: Did you observe any problems during your participation in the exercise? What improvements would you suggest?



________________________________________________________



________________________________________________________



________________________________________________________



DO NOT LOSE THIS CARD!

DO NOT LET ANYONE TAKE THIS CARD FROM YOU!













A ride has been scheduled to return you to the exercise site. If you are not picked up, please call: [Insert number].



Thank you for your participation!







EXERCISE “VICTIM”

SYMPTOMATOLOGY TAG



Date of Exercise: [MM/DD/YYYY] Casualty #: ________







VISIBLE SYMPTOMS:




Excessive sweating
Disorientation
Drooling







PHYSICAL FINDINGS:




Resp: 22
Pulse: 88
BP: 124/82







OTHER PATIENT INFORMATION:




Aware; knows name
Able to walk
























Actor Exercise Assessment Form



Please complete the following questions at the conclusion of the exercise. This card is to be turned in at the checkout station at the exercise site. Please be accurate with your answers. Your cooperation is important and is appreciated.



Field Assessment and Treatment:

1. Initial Contact and Triage

a. How long did it take response personnel to contact you? _______

b. How long did it take response personnel to begin decontaminating you? ____________

c. Were you examined on the scene more than once? £ Yes £ No

d. Whom did you talk to, or whom were you assessed by (list all)? £ Fire £ EMS £ Police £ Other ______________

e. If you received a multicolored triage tag, what was the BOTTOM color when it was first given to you? £ Green £ Yellow £ Red £ Black £ Never received a tag

f. What actions did response personnel take as a result of their assessment of your condition?



________________________________________________________



________________________________________________________



________________________________________________________



2. Treatment:

a. If conscious, did someone explain your treatment? £ Yes £ No

b. If conscious, were you given clear instructions? £ Yes £ No

c. What treatment was given?



________________________________________________________



________________________________________________________



________________________________________________________



3. Did you observe any outstanding actions among the response personnel you observed?



________________________________________________________



________________________________________________________



________________________________________________________



Hospital (if applicable)

1. Which hospital did you go to? ________________________________

2. Once at the hospital, how long was it until someone examined you?
£ Less than 5 minutes £ 5 minutes £ 10 minutes £ 15 minutes £ Over 15 minutes £ I was never examined at the hospital



Exercise Design: Did you observe any problems during your participation in the exercise? What improvements would you suggest?



________________________________________________________



________________________________________________________



________________________________________________________



DO NOT LOSE THIS CARD!

DO NOT LET ANYONE TAKE THIS CARD FROM YOU!

















A ride has been scheduled to return you to the exercise site. If you are not picked up, please call: [Insert number].



Thank you for your participation!



EXERCISE “VICTIM”

SYMPTOMATOLOGY TAG



Date of Exercise: [MM/DD/YYYY] Casualty #: ________







VISIBLE SYMPTOMS:




Lightheaded







PHYSICAL FINDINGS:




Resp: 18
Pulse: 70
BP: 110/60







OTHER PATIENT INFORMATION:




Aware; knows name and location
Unable to walk


























Actor Exercise Assessment Form



Please complete the following questions at the conclusion of the exercise. This card is to be turned in at the checkout station at the exercise site. Please be accurate with your answers. Your cooperation is important and is appreciated.



Field Assessment and Treatment:

1. Initial Contact and Triage

a. How long did it take response personnel to contact you? _______

b. How long did it take response personnel to begin decontaminating you? ____________

c. Were you examined on the scene more than once? £ Yes £ No

d. Whom did you talk to, or whom were you assessed by (list all)? £ Fire £ EMS £ Police £ Other ______________

e. If you received a multicolored triage tag, what was the BOTTOM color when it was first given to you? £ Green £ Yellow £ Red £ Black £ Never received a tag

f. What actions did response personnel take as a result of their assessment of your condition?



________________________________________________________



________________________________________________________



________________________________________________________



2. Treatment:

a. If conscious, did someone explain your treatment? £ Yes £ No

b. If conscious, were you given clear instructions? £ Yes £ No

c. What treatment was given?



________________________________________________________



________________________________________________________



________________________________________________________



3. Did you observe any outstanding actions among the response personnel you observed?



________________________________________________________



________________________________________________________



________________________________________________________



Hospital (if applicable)

1. Which hospital did you go to? ________________________________

2. Once at the hospital, how long was it until someone examined you?
£ Less than 5 minutes £ 5 minutes £ 10 minutes £ 15 minutes £ Over 15 minutes £ I was never examined at the hospital



Exercise Design: Did you observe any problems during your participation in the exercise? What improvements would you suggest?



________________________________________________________



________________________________________________________



________________________________________________________



DO NOT LOSE THIS CARD!

DO NOT LET ANYONE TAKE THIS CARD FROM YOU!















A ride has been scheduled to return you to the exercise site. If you are not picked up, please call: [Insert number].



Thank you for your participation!



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