House of Horrors OSCE by Anu Kumar

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

Scenario:

You receive pre-notification that the ambulance service are 5 minutes away with an 80 year old with rectal bleeding. They inform you that there are "large amounts of bright red blood all over the house". The patient is noted to be on warfarin for AF and has had a recent cardiac stent. His vital signs are: HR 60 BP 90/60 GCS 15 Sats 98% RA.

You have a few minutes to organise your team before the patient arrives. Once the patient arrives, proceed with the resuscitation.

Instructions for the candidate

You are the Consultant in an urban district ED with acute surgical facilities, radiology and an ICU.

Domains being examined

  • Medical Expertise
  • Communication
  • Leadership and Management
 
The candidate has 3 minutes reading time. This OSCE is expected to run for a maximum of 7 minutes.

For the actor

Resus nurses - you are skilled at your job but require specific instructions.

Junior doctor - you are capable of basic procedures but lack initiative.

For the examiner

Evidence of large amounts rectal bleeding - stained clothes, sheets, clots in bed.

Blood gas showing lactic acidosis and low Hb.

Domains Assessment Objectives

Medical Expertise

Communication

Leadership and Management

Other Assessment Notes

Early reversal of anticoagulation
Transfusion of packed cells
Definitive Rx of bleeding - early surgical review - angiography/embolisation


You must be logged in to add a comment

Comments:

There are no comments on this OSCE