💫A-E Station 5💫
Station 5
An unwell breathless patient
YOU WILL REQUIRE A DRUG CARD TO COMPLETE THE PRESCRIBING ELEMENT OF THIS STATION
This station’s special - be aware the obs, results, and managment will change every time you refresh. You can also change them by clicking the button in the obs tab!
Candidate Instructions
Setting:
You are a Foundation Year doctor working in ED. You are asked to review a patient who looks unwell.
Ronald Johnson
Tasks:
1. Please examine the patient using an A-E approach.
2. Give you differential diagnosis to the examiner.
3. Give you management plan to the examiner.
4. Prescribe the appropriate antibiotic therapy.
Simulated Patient Instructions
Briefing
Please act as the patient and reveal signs and results only as the candidate performs actions or requests tests.
Diagnosis: Sepsis
You are Ronald Johnson (aged 85)
You have come into ED for a cough and have become unwell whilst waiting to be seen.
Appearance and Behaviour
You appear flustered during the exam. You are alert and oriented. You keep coughing. You are breathing heavily (please don’t hyperventilate and pass out whilst acting - although we appreciate the commitment to the cause).
Patient Observations and Results
Already been through this once? Click here to change the results, and possibly (spoilers!) the management!
Name: Ronald Johnson
DoB: 05/01/1937
Date of Results:
| Observations | |
|---|---|
| Respiratory Rate | |
| Heart Rate | |
| Blood Pressure | |
| Oxygen Saturation | |
| Temperature | |
| Blood | Value | Normal Range |
|---|---|---|
| Haemoglobin | 135-180 g/L | |
| Platelets | 150-400x109/L | |
| White Cell Count | 4.0-11.0 x109/L | |
| CRP | <5 mg/L | |
| Sodium | 135-145 mg/L | |
| Potassium | 3.5-5 mg/L | |
| Urea | 2-7 mg/L | |
| Creatinine | 55-120 umol/L | |
| eGFR | >90 ml/min |
Antibiotic guidelines
Start the Timer and Begin
Examiner Instruction
As the candidate enters please give them this handover (acting as the nurse in ED)
“Doctor, this patient is waiting to be seen. He doesn't look well at all and seems to have difficulty breathing.”
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
Examiner Instruction
Given the Antibiotic guidance provided - please show the student the observation and results in the tab above, ask them to calculate the curb score, and prescribe the appropriate antibiotics.
Please use the following guidance and the given clinical findings to calculate a curb score and prescribe antibiotics.
Prescribing & Further Management
Prescribing Task
Further Management
Submit for Scoring
Tags | A-E | Sepsis | Sepsis 6 | Generally unwell patient
Station Written by: Dr Ewa Kunysz
Peer Reviewed by: Dr Rhys Taylor
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