Case Scenarios

A number of actual MOAS cases are presented below to help better understand documentation and communication as well as the 4 level ROLE assignment of level of hospital care.

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  • Who: 30s male

  • MOI: GSW to lower legs bilaterally

  • Allergies: NKDA

  • Injuries: wounds to lower legs bilaterally. Fractured right tibia with projectile still in leg. Through and through GSW to left leg no fracture.

  • Interventions: 1gm TXA, 2gm Ceftriaxone, 10mg Nalbuphine, NS 500mL bolus, NS 1000mL KVO, right subclavian double lumen central line, tourniquet in place on right leg but loosened.

  • VITAL SIGNS: BP 108/78, HR 89, O2 99% RA, RR 18, A/O x4


  • New Patient: late middle age male presented to Role 1 with shrapnel injury to head and right arm:

  • -Laceration to back of head (suspected closed head injury / TBI-moderate to severe) be

  • -Right upper arm laceration / Frag vehicle


  • Patient sedated, airway controlled with OPA, breathing on his own

  • 1 unit of blood started, 1 unit of plasma given, transporting crew

  • Patient transported on mannitol, 10%. ETA 16:15-16:30. Would you like to review this patient in the ambulance pad and consider sending direct to Role 3 for CT head, or come up to ICU? Thank you


  • Patients en route now: Yellow:

  • Soft tissue injuries R Hand, R shoulder, Right side of face, airway patent, patient alert, vitals within normal limits; nil medications running


  • Patient 2: Green: walking wounded. ETA: 19:15-19:30

  • All MOAS team to the pad for arrival to support with staircase transport.

  • Patient en route


  • Patient en route

  • 1 red

  • Late middle aged male

  • multiple shrapnel wounds to lower extremities

  • 1 gsw to right upper arm

  • All bleeding controlled

  • 1 unit of plasma and 1 unit of whole blood at Role 1

  • HR 100 BP 132/90 spo2 92 room air

  • Airway patent, spontaneous respirations


  • Medic 12

  • En route to Role 2

  • 1 Yellow

  • 45 y/o Female Medic

  • Fragmentation wound R bicep

  • Vitals WNL

  • PWD


  • LSCA

  • 2 blood

  • 2 plasma

  • Surgeons notes accompanying


  • 50 year old female blast I jury patient en route to you now. Right hand/right wrist injury, right upper arm injury, right lower abdomen eviceration injury with surgical repair and drain in situ. Pulse = 100, BP=154/palp. Patient is intubated and breathing spontaneously with ketamine. ETA = 22:30 - 22:45.

  • Artery didn’t work after 1 rol, and after operation work


  • MOAS 15

  • 1 red patient

  • Artillery round and frag to cranium and occiput, open head injury

  • BP = 174/130

  • p= 45

  • Intubated, ventilated. Crossmatched blood administered. ETA = 08:40. Please come to the ambulance pad and direct on Role 2/Role 3

  • Mid 40s male blast injury Severe TBI, right side open temporal/parietal injury, brain matter showing. Right elbow fragmentation wound not actively bleeding. Patient is intubated, ventilated, sedated, 1 unit of crossmatched blood, urinary catheter in situ, vitals stable. ETA to Role 2= 15:00-15:15.


  • MOAS 19 are en route to Role 3 - Losova Location - with one red patient, blast to right shoulder and chest. 56 year old male. Pnuemohemorhorax with chest tube in situ. Right arm injury splinted. Vitals stable. Received DCR, antibiotics, TXA, pain management and plasma. Currently pain free in transport to Role 3. If any issues or if patient becomes unstable while en route, Role 2 will be contacted and support requested. If patient remains stable, transport direct to Role 3.


  • 32 year old male