A-E Station 11

Station 11

That seems a bit fast

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, Mr Lane has been complaining of a funny feeling in his chest. His heart rate seems very fast.”

Intro

Candidate introduces self with full name and role.

Identifies patient with 2 pieces of information (or by wrist band if patient is unconscious)

Adheres to appropriate infection control measures.

Gains consent.

Takes a brief history - identifies new onset palpitations.

Specifically asks if patient has experienced chest pain or syncope.

Airway

Assessment

Identifies airway is patent (patient is talking / no added stridor or upper airway sounds)

Breathing

Full marks

Assessment

End of the bed o'gram (verbalised) - eg candidate states "The patient looks generally well"

RR - 23 with no accessory muscle use

Oxygen Sats - 96% on room air

Trachea - Central

Chest expansion - equal

Percussion - resonant

Auscultation - Clear throughout, no added crepitations or wheeze.

Disability

Assessment

Consciousness - alert, GCS 15

Pupils - equal and reactive

BM - 7.4

Temp - 37.2C

Exposure

Assessment

Adequately exposes patient to inspect full body for rashes / bleeding / bruising / scars - nil present

Abdomen - no skin changes, non-distended, soft non-tender throughout, not guarding.

Inspects calves for signs of DVT - calves soft, non-tender bilaterally.

Examiner Instruction

At this point please direct the candidate to give their differential diagnosis and any further management plans.

Diagnosis & Further Management

Diagnosis

Main differential - SVT (please inform the candidate of the correct diagnosis once they have given their differentials, regardless of whether their answer was correct or not).

Further Managemnet

Initiating an emergency call and places defib pads on patient

Suggests attempting vagal manoeuvers

Suggests adenosine (6mg -> 12mg -> 12mg) if vagal manoeuvers fail

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Tags | A-E | SVT | Supraventricular Tachycardia | Generally unwell patient

Station Written by: Dr Rishil Patel

Peer Reviewed by: Dr Benjamin Armstrong

A-E Station 11

Station 11

Candidate Instructions

Setting:

Name: Kevin Lane

Tasks:

Simulated Patient Instructions

Briefing

Appearance and Behaviour

Start the Timer and Begin

Examiner Instruction

Intro

Airway

Breathing

Cardio

Please interpret these results

Disability

Exposure

Examiner Instruction

Diagnosis & Further Management

Submit for Scoring