A-E Station 8
Station 8
Gasping for air.
Please note you will require access to drug guidelines (BNF) + a prescribing booklet for this station.
Candidate Instructions
Setting:
You are an FY1 doctor working in the Emergency Department. You have been called to see a patient who has come in by ambulance short of breath.
Emily Roberts
Tasks:
1. Please examine the patient using an A-E approach and manage as appropriate.
2. Give your differential diagnosis to the examiner.
3. Please prescribe the medication the examiner asks you to prescribe. Prescribing guidelines / a BNF is available for you to use.
Simulated Patient Instructions
Briefing
Please act as the patient and reveal signs and results only as the candidate performs actions or requests tests.
Diagnosis - Acute exacerbation of asthma (life threatening)
You are Emily Roberts at severly breathless 20 year old.
Appearance and Behaviour
You appear very short of breath, and very nervous.
Please act a fine resting tremor due to salbutamol overuse.
Start the Timer and Begin
Examiner Instruction
As the candidate enters please give them this handover (acting as the nurse on the ward)
“Doctor, I’m glad you’re here, Miss Roberts is struggling to breath, can you help please.”
Intro
Airway
Assessment
Breathing
Assessment
Treatment
Cardio
Assessment
Treatment
Disability
Assessment
Exposure
Assessment
Examiner Instruction
At this point please direct the candidate to give their differential diagnosis and any further management plans.
Diagnosis & Further Management
Diagnosis
Further Management
Examiner Instruction
At this point please direct the candidate to the prescribing task:
1. Ask the candidate to prescribe the appropriate steroid treatment as per the drug guideline guidance (note please supply a BNF/BNF app or equivalent guidance for your country)
Prescribing Task
Please see the below example;
Summary
-Asking asthma patients whether they have ever needed ITU/HDU treatment is crucial information. As always, senior support for acutely unwell patients is always indicated.
-See below for a reminder on classification of asthma severity. Peak flow is a useful tool for assessing acute asthma exacerbations.
Submit for Scoring
Tags | A-E | Asthma
Station Written by: Dr Joanna Mantio
Peer Reviewed by: Dr Megan Burns
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