Trial OSCE exam: 'Victory' by Soe Naing

You are taking part in a trial exam created by Soe Naing. There are 9 OSCEs in this exam (90 minutes).
 

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

Scenario:

You are asked to see a 35/F, Jane Stephens, with an acute episode of palpitations. She states these palpitations started 1 hour before, with no associated symptoms. She has never had this before and has no significant past medical history.

HR 180
BP 110/75
RR 18
O2 sats 100% RA

She has been placed in your resus room and you have an experienced nurse and intern in attendance. Attached is her ECG.

View attached:   Attachment 1

Instructions for the candidate

You are to treat the patient, manage the situation as it unfolds, and provide teaching to the junior RMO.

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

Patient:
- you are a mildly anxious person who will be wary of medications (especially when adenosine and its adverse effects are explained to you) and will ask for non-medication options to be trialled before agreeing to medication.
- when asked, you have no past medical history, no family history, do not drink or do drugs, not on any medications

Intern:
- you are not very good at interpreting ECGs; you think this is sinus tachycardia
- you ask A LOT of questions
-- what is SVT? what causes it?
--what are the options for treatment? if only two treatments are discussed --what other treatment options are there?
--what are the considerations re: admission versus discharge?

Nurse: extremely capable, do not do anything without being told doses.

For the examiner

It's up to you to decide which treatment terminates the SVT.

Domains Assessment Objectives

Medical Expertise
Correct interpretation of ECG
Knowledge of SVT and its treatment options
-- Vagal maneuvres
-- Adenosine
-- Verapamil
-- Cardioversion


Prioritisation And Decision Making

Communication

Other Assessment Notes