Early Morning handover panic OSCE by Adam

You have 4 minutes reading time. This OSCE will run for a maximum of 7 minutes.


You are a consultant in rural ED coming onto your morning shift and your SRMO from nights approaches you in a distressed state. She explains that she has just put a chest drain in on the wrong side of a patient whom presented with a Ptx overnight.

Instructions for the candidate

Please make a plan for the patient, counsel the SRMO and consider ways of mitigating such incidents in future

Domains being examined

  • Medical Expertise
The candidate has 4 minutes reading time. This OSCE is expected to run for a maximum of 7 minutes.

For the actor

The patient is stable, alert and orientated on 2L 02 nasal prongs
They have a large secondary Ptx (emphysema) right side of the chest.
The new falsely inserted chest drain is swniging, no bubbling and there is no Ptx obvious

For the examiner

1. Management:
- Chest drain for secondary Ptx and admission
- remove other drain
- Antibiotics
- Respiratory referral
2. Open disclosure
- Explain the error made to the patient when not sedated
- Apologise, explain the potential harm
- Inform ED director and hospital executive.
3. Professionalism
- Manage SRMOs distress and assess state of mind
- Safe hand over of other patients
- Plan for quality improvement and safety issues
- Time out and check list policies
- Individual and system issues

Domains Assessment Objectives

Medical Expertise

Other Assessment Notes

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