Summer Peril OSCE by Anu Kumar

 
You have 3 minutes reading time. This OSCE will run for a maximum of 7 minutes.

Scenario:

You are the Consultant in charge of a rural ED. You have just been involved in the resuscitation of the child described below.

3 year old boy (Mattie) found face down in family pool. Unknown period of submersion. On arrival Emergency Services he is in a PEA arrest. He has been resuscitated for 20 minutes in the field and a further 40 minutes in the ED. He is intubated and ventilated. His rhythm has now degenerated to asystole. Bedside ultrasound shows no cardiac activity. You deem there to be no reversible factors.

The boy's mother Jane has been present during the resuscitation. She is being looked after by one of your senior nurses. It is your task to talk to her about Mattie's prognosis.

Instructions for the candidate

Domains being examined

  • Medical Expertise
  • Prioritisation And Decision Making
  • Communication
 
The candidate has 3 minutes reading time. This OSCE is expected to run for a maximum of 7 minutes.

For the actor

You are understandably extremely distressed by what has happened to your little boy. He is your only child. His father is away on business so you have been on your own with Mattie. Your mother does live in town and is available for support if this is explored.

For the examiner

VBG: pH 6.8
pCO2 45
pO2 95
HCO3 9
K+ 6.8
Na+ 140
Cl- 99



Domains Assessment Objectives

Medical Expertise
Recognition poor prognosis

Prioritisation And Decision Making
Decision to cease resuscitation

Communication
Breaking bad news

Other Assessment Notes

Recognition of poor prognosis and need for decision to terminate resuscitation efforts
Effective communication with parent
Attempts to provide support for parent


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Comments:

ASESSMENT POINT states that you decide to stop resuscitation wheeresas stem suggests that you have already stopped CPR

Tina at 14:55 11 Jun 2017