The Lord cometh again! SAQ added anonymously 

 
This SAQ is worth 14 marks

The ambulance service has brought a 23 year old man to your ED. He was found wandering the streets naked. He became aggressive while being transported to hospital. On arrival to the triage desk, he is swearing loudly and trying to leave.

He is known to have a history of schizophrenia and drug use.

Question 1.
Give the 2 legislative principles of care that might allow you to keep this man against his will. For each principle of care, list 2 main conditions that must be met. (6 marks)

Legislative principle Conditions that mustbe met


 

 

 

 



 

 

 

 



Question 1.
List 5 main steps in restraint of this man, in escalating order. Where appropriate, give initial doses of medications. (5 marks)


1. _________________________________________________________________________________________________

2. _________________________________________________________________________________________________

3. _________________________________________________________________________________________________

4. _________________________________________________________________________________________________

5. _________________________________________________________________________________________________



Question 1.
During the management of this patient, one of your junior doctors has received a needle-stick injury from a hollow-bore needle used on the patient.

Complete the table about risk of transmissible disease in this scenario. (3 marks)

Source - known to have disease           Risk of transmission          

Hepatitis B

 

Hepatitis C

 

HIV

 



 
This SAQ is worth 14 marks

The ambulance service has brought a 23 year old man to your ED. He was found wandering the streets naked. He became aggressive while being transported to hospital. On arrival to the triage desk, he is swearing loudly and trying to leave.

He is known to have a history of schizophrenia and drug use.

Question 1.
Give the 2 legislative principles of care that might allow you to keep this man against his will. For each principle of care, list 2 main conditions that must be met. (6 marks)

Duty of care
- Have a physical condition causing behavioural disturbance
- Be at risk to himself or others
Mental Health Act
- Suspected mental health disorder
- No less restrictive means available

1 mark for each principle, 1 mark for each condition
Pass 4/6


Question 1.
List 5 main steps in restraint of this man, in escalating order. Where appropriate, give initial doses of medications. (5 marks)

  1. Verbal de-escalation
  2. Oral sedation eg diazepam 10mg
  3. Show of force
  4. Physical restraint – isolation or with manual handling
  5. Chemical restraint eg droperidol 10mg

Pass 3 of 5



Question 1.
During the management of this patient, one of your junior doctors has received a needle-stick injury from a hollow-bore needle used on the patient.

Complete the table about risk of transmissible disease in this scenario. (3 marks)

Hep B 30-60%
Hep C 3%
HIV 0.3%
(accept answers that are close)

Pass 2 of 3

Total pass 9/14 corrects to 6/10


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