Bangor EFA H/W Task
Jungle Triage

You’re exploring the remote lowland forests of the Democratic Republic of Congo, with a particular interest in locating a grouping of Bonobos. 

You are equipped with a substantial medical kit, including a wide array of antibiotics, a satellite phone and a helicopter is available, but which has limited space available should there be any need for it. If you need it for a casualty evacuation, it will take one casualty accompanied by one other person who must be well enough to escort them. 

Tony

Tony, who is a fit healthy 58 years old, complains at breakfast that he is not feeling quite right. He’s a bit confused, but describes having had an intense headache, “the worst he’s ever had”. 

As the morning progresses he seems to be lapsing in out of coherent speech, and he is struggling to coordinate/lift his leg and arm. 

You check his radial pulse which is 70 and his temp is 36. 

Fearing the worst, you are able to make the call for the helicopter, which is now about 1 hour out. That was the last call you made on your sat phone, since it now no longer appears to work.

The helicopter only flies in daylight hours and the return trip is 3 hours, including time for refueling etc.

Sarah

Sarah who is a fit healthy 43yo was seen at breakfast this morning, but she didn’t really have any appetite. 

Since then, she’s returned to her tent, and with a moment to spare you check up on her. She has started to feel an abdominal pain in the middle of her belly.

Jim

Jim is a fit guy aged 27. He was recently diagnosed with T1 diabetes. He seems to manage this with the help of constant glucose moniter attached to his arm. He injects himself with slow acting insulin twice daily, plus faster acting insulin 15 minutes before every meal. 

He didn’t come to breakfast this morning. When checked upon he complains he’s been up all night with diarrhoea and vomiting.

When you check his vital signs you see he has a temperature of 38 and find his pulse is 80 – though you struggle to find the radial pulse and so you decide to measure his carotid pulse instead. 

When he checks his sugars he notices that they are running high at 20.

10 minutes before the helicopter is due

Tony has severely deteriorated. He has now lapsed into unconsciousness and is responsive to pain only. 

Sarah is now feeling worse on the right lower quadrant. It is soft when you examine her though it is clearly uncomfortable. Her temperature is 37.8 and her pulse is 85 which she considers to be high for her. Since you last saw her she has been to the toilet twice with diarrhoea. 

Jim is passing copious amounts of liquid stool and his sugars are measuring in the high 20s now. His breath smells of pear drops (a sweet sickly smell) and he looks really unwell. 

What are your thoughts? What might your course of action be? Who will be the first to be evacuated by helicopter?