Fall with low blood sugar Scenario Overview:

(READ TO THE FIRST AIDER): You are teaching a hot yoga class in your studio. It is a hot summer
afternoon. Halfway through class, you decide to leave to the room to turn the fans on. When you return
one of your students is on the floor, holding their arm in evident pain and not entirely (full consciouness)
with it. The student has not eaten anything all day, you suspect they have low blood sugar levels
(hypoglycaemia) and has consequently collapsed, injuring their arm on the way down.

(FOR THE ASSESOR) Difficulty: Easy

How the scenario should progress: If the first aiders treats the low blood sugars level, then the patient
will become more orientated and feel better (although still have an injured arm!). If the first aiders do
not treat for low blood sugar levels, the patient will become more confused and will eventually become
unresponsive.

(FOR THE ACTOR/S) Actor Tips: Try to draw attention to the arm whilst also acting confused. The arm
injury is meant to be a bit of a red herring (distraction) that the first aiders should dig into further to find
out why you fell over. If asked if you tripped. answer that you don't think so and that you're not really
sure why you fell over. If asked if you have any medical conditions then tell them that you had your
appendix out 5 years ago. You might want to be a bit irritable whilst having the low sugars.

Patient 1: Name: Ravini Ji Age: 23 Sex: Female

Medication: Nil

Allergies: Shellfish

Past medical/family/social history: Patient had appendix out 5 years ago

(WHEN ASKED BY FIRST AIDER) Findings on examination: Pain in lower arm, lots of bruising and
perhaps some minor deformity (depending on how mean you are feeling). The patient is in pain and
concerned about their arm but is a bit confused and not totally orientated to place and time. The patient
last ate the night before and had just played in a football match this morning.

Possible treatment from first aiders: Take a thorough history of the events leading up to the collapse.
Treat for low blood sugars. Examine the arm and make appropriate treatment

Danger: Nil. Response: Verbal. Airway: Clear. Breathing: Slow.

Circulation: fine. Disability: fine. Environment: Fine (fan just got turned on)

Main Points:
If patient has shoulder treated first, then patient will move into an unconscious (unresponsive state).

Must treat with food or sugary beverage within 3 minutes of Scenario. After consuming the patient
becomes orientated. And wants to get back to class.
The window came at me... Scenario
(READ TO THE FIRST AIDER) Scenario Overview: You are teaching assisted headstands against a wall.
One of your students who were practicing against the glass, has put his legs through the window. Glass
is all over the floor and the man appears to be bleeding significantly.

(For the assessor) - This scenario tests major bleeds management and treatment of shock. Optional: You
could get the situation to happen in a more difficult environment with loud music or lots of people
around if you want to add some additional challenges.

Difficulty: Easy

How the scenario should progress: The patient will deteriorate in response but will be breathing
throughout unless bleeding is not controlled. The pulse will rise until bleeding is controlled. Respirations
will stay relatively high.

(FOR THE ACTOR/S) Actor Tips: Initially act quite confident but then get a bit more worried. Allow the
first aiders to treat you after your initial burst of confidence. Deteriorate in response fairly rapidly.

Patient 1: Name: Sushant Ji Age: 24 Sex: Male

Medication: Blue inhaler for asthma

Allergies: None

Known Past medical/family/social history: Asthma

(WHEN ASKED BY FIRST AIDER) Findings on examination: Cuts along arms and hands where patient has
put both arms through the window. Blood is spewing out profusely from his right leg (you could pick one
to have an arterial bleed with more minor bleeds to hands and other arm). No other big injuries. Patient
is initially very 'full of it', saying he is fine but then changes his mind when he realises just how much he
is bleeding.

(Main Points) Signs and symptoms of shock will develop (deteriorating response, pale skin, quickening
pulse etc.) Possible treatment from first aiders: Major bleeds controlled first, followed by other bleeds.
Treatment for shock. Re-assess regularly with changing response.
A Language Challenge Scenario:

(READ TO THE FIRST AIDER): You are on a working holiday (Ibiza, Fiji, Caribbean, Thailand) teaching a
yoga class in the local park / beach. You did not bring enough mats to class, so some of your students
are practicing on the grass/sand. You are moving through your first vinyasa when one of your students
cuts his arm on a stick.

(FOR THE ASSESSOR) The patient in this scenario has a relatively minor wound on their arm that in
theory should be fairly easy to deal with. However, the patient speaks another language (take your pick)
and speaks very little English creating a big communication barrier. The first aiders will need to find a
way to ask questions and give advice.

Difficulty: Easy

How the scenario should progress: The wound is minor so the patient will be stable throughout. This is
mainly a scenario testing communication skills.

Actor Tips: This scenario will work best if you stick to using another language for the majority of the
scenario and try and use signs and actions to help communicate with the first aider. You can understand
the odd word of English but not very much.

Patient 1: Name: Fernando (perhaps change dependent on language)

Age: 27 Sex: Male

Medication: Reliever Inhaler (although patient will struggle to communicate this)

Allergies: None Known

Past medical/family/social history: Had appendix out 5 years ago.

(WHEN ASKED BY FIRST AIDER): Findings on examination: Possible treatment from first aiders: The
wound on the patient's arm is about 4cm long and about 0.5cm wide and is actively bleeding (but is not
an arterial bleed or anything to severe). Patient is in minor pain (1/10) and it stays to the location of the
wound and is a stinging like pain. No loss of sensation or movement. Patient cut arm on the wall they
had been sitting on when they got off. Learn how to communicate with the patient.

Main Points: Re-assure the patient. Clean wound with what you have. Use body language for
communication or other effective methods.
Bumped Head Scenario:

(READ TO THE FIRST AIDER): You are teaching students how handstand, in preparation for a seated
flow. One of the students in your class flip to far over and hits the ground hard. It takes her a minute to
get back up to a seated position. She looks a little confused and asks for a pain killer.

This scenario is designed to test out the first aiders' head injury assessment and helps them practice
making the judgement of when to ask for more help.

Difficulty: Easy

How the scenario should progress: The patient actually has only a very minor head injury and doesn't
require further medical help and so will be completely stable throughout.

Actor Tips: You aren't that bothered about the injury but just thought you'd try your luck at getting some
paracetamol.

Patient 1: Name: Gauthami Age: 19 Sex: Female

Medication: Multi vitamin

Allergies: None Known

Past medical/family/social history: Patient usually fit and well. Lives at home with husband.

(WHEN ASKED BY FIRST AIDER): Findings on examination: Possible treatment from first aiders: Patient
fell and hit the back of their head on the wooden floor. There is pain in back of head where patient was
hit (rated 3/10) and described as 'annoying'. Pain gets slightly worse in the first couple of minutes or so
after the incident but has been pretty much the same since then. (Eyes) Pupils are reactive and equal in
size. Patient is able to feel and move all their limbs normally. She has no pain anywhere else. Patient not
feeling sick and has no visual disturbances. Patient did not lose consciousness and is able to remember
everything that happened. Patient is orientated to place and time. There is a small amount of swelling at
the point where she was hit but no bleeding is present. Patients says that she is fine and just wanted to
see if the first aiders had any pain relief. Thorough assessment and history take in order to assess the
severity of the injury to help guide decision making on how best to discharge.

(Extra information): Some signs of when to get further care for a head injury: Patient is unaware of
surroundings. Confused. Short Term memory loss. Vomiting. Pupils dilated severe headache. Ears have
fluid coming out. Under the age of 16
What’s wrong with my legs? Scenario:
(READ TO THE FIRST AIDER): You are supervising students on how to do a shoulder stand. One of the
students in your class over balances and falls awkwardly, with an audible ‘crunch’ sound. There is an
immediate scream, with the student yelling ‘I can't feel my legs’. They are trying to get their body to an
upright position.

Difficulty: Moderate

How the scenario should progress: The patient has possibly fractured there back. The first Aider must
make it a priority to assist the student to lay down (supporting a neutral head position) and not move.
Calling immediately for further medical assistance is vital.

Actor Tips: You are in disbelief and frightened. You are in a panicked state because you cannot feel your
legs. You feel pins and needles running down your back. You are constantly trying to sit up to see your
own legs.

Use phrases like ‘what is wrong’? ‘Why can't I feel my legs?’ ‘Will I walk again?’ ‘Let me try and walk it
off.’

Patient 1: Name: Kiki Age: 19 Sex: Female

Medication: Multi vitamin

Allergies: None Known

Past medical/family/social history: Patient usually fit and well. Lives at home with husband.

(WHEN ASKED BY FIRST AIDER): Findings on examination: Possible treatment from first aiders: Patient
fell and has damaged their spine. There is pain in back of head and neck area where patient was hit
(rated 3/10) and described as 'thumping'. Pain gets slightly worse in the first couple of minutes or so
after the incident but has been pretty much the same since then. (Eyes) Pupils are reactive and equal in
size.

Patient is able to feel and move only upper body (hips and above). She has no pain anywhere else.
Patient not feeling sick and has no visual disturbances. Patient did not lose consciousness and is able to
remember everything that happened. Patient is orientated to place and time. There is a small amount of
swelling at the point where she was hit but no bleeding is present. Patients says that she has pins and
needles below the waist and can't move their legs. Patient has wet themselves (urination due to bowel
control). This is a serious injury and help should be called as soon as possible.

(Extra information): Some signs of when to get further care for a head/spinal injury: Patient is unaware
of surroundings. Confused. Short Term memory loss. Vomiting. Pupils dilated severe headache. Ears
have fluid coming out. Incontinence. Under the age of 16. Pins and needles.
Discussion Cards

1. A middle aged man has turned up to your yoga class. He mentions he suffers from high blood
pressure (hypertension). On further questioning , you understand he takes medications and sees
his doctor every few months for a check up. He does not seem to be overweight.

Do you allow him to attend your class?

1. Yes. Question further on signs symptoms. He is probably at the yoga studio on the doctors
request. Let him know before class not to do certain postures or modify then. Ask him if his
Blood Pressure has been normal today (self testing). Doctors certificate is the gold standard
2. A type 1 diabetic woman (25 Years old), turns up to your studio to practice. She tells you she
forgot her insulin (needed for type 1 diabetics to keep a normal blood sugar level) at home. She
tells you that she forgets all the time, ‘it's no big deal’.

Do you let her join your class?

2. This is to be done at your own risk. If you are unsure about medication. Try to get a background
of when they should be taking it and how often. If you know they are on medication, but no
nothing of their last dose or type of medication, it does not bare well for you if something was
to happen to one of your students.
3. You are about to teach a hot yoga class (90 minutes) in the evening. One of your students sitting
outside look pale and slightly sweating. They tell you they haven't eaten or drunk anything
today. What actions do you take next?

3. Get them something to eat or drink. Snack