Plenty more where it came from OSCE by Nadine Hughes

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

Scenario:

You are the ED Consultant on duty on a Saturday afternoon in a busy tertiary ED. You have just taken over from your colleague who said ‘It’s been crazy busy today – good luck! I'm outta here!”

Currently the department is ramping, there are three acutely unstable patients and you’ve just been informed a chopper with a major trauma will be landing in 30 minutes.

You are approached by the surgical registrar on call, who is a lovely man but is very junior. He has just been handed over many patients to see. He is asking for guidance on how to start. He will have a list of 7 patients to discuss

Instructions for the candidate

Domains being examined

  • Medical Expertise
  • Prioritisation And Decision Making
  • Teamwork and Collaboration
  • 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

You are a junior service surgical registrar who has just been handed over 7 patients by your colleague. She herself has been overwhelmed, so has taken quick referrals and jotted them down. She didn’t have more details. You know the ED department is heaving but you think you need some guidance as where to start in order to be more efficient. If asked questions you are competent to answer them. You are grateful for the ED consultant help.

You bring the handover sheet with you to show the ED consultant:

Handover List with Patient Details:

Mr A
LOS 3hrs. TC 3. 75yo. Abdominal pain, unknown cause. Vitals stable. Lactate 1
Mr B
LOS 2 hrs. TC 3. 55yo. Pancreatitis. Lipase 4500. Vitals stable. On IVF + analgesia
Ms C
LOS 5hrs. TC 4. 22yo. RIF pain ?appendicitis. SBP 80.
Ms D
LOS 5 hours. TC 4. 21yo. RIF pain ?appendicitis. Vital normal. bHCG neg
Mr E
LOS 2 hours. TC 2. 75yo PR bleeding. SBP 140. HR 110. History of AF
Mr F
LOS 30/60. TC 4. 49yo surgical expect with cholecystitis. WCC 11 Vitals stable, on IVABx
Mrs G
LOS 1 hr. TC 3. 45yo surg expect with cholecystitis. WCC 13 Bil 60 Temp 39 SBP 85. No IVABx

LOS – time in ED already
TC – triage category

For the examiner

Domains Assessment Objectives

Medical Expertise

Prioritisation And Decision Making

Teamwork and Collaboration

Leadership and Management

Other Assessment Notes


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javed at 13:32 08 Sep 2016