Station - Instructions for candidate
You are an intern on the general surgical team of a metropolitan hospital in Perth. It is 7 pm.
Kevin Liu, 19, has been in the Emergency Department since this afternoon with 18 hours of abdominal pain. The surgical registrar has diagnosed acute uncomplicated appendicitis on clinical grounds, bloods and ultrasound, and has booked him for a laparoscopic appendicectomy tonight. The registrar has asked you to take the pre-operative history and go through the consent discussion with Kevin; the registrar will join you to sign the form. Kevin has had analgesia and is comfortable. His parents are in the waiting room.
Results
WCC 14.2 (neutrophils 11.8), CRP 45, Hb 148, UEC and LFT normal, lipase 30. Ultrasound: non-compressible blind-ending tubular structure 9 mm in the right iliac fossa with surrounding echogenic fat; no free fluid, no appendicolith, no collection.
Your tasks are to:
- Take a brief pre-operative history.
- Explain the diagnosis and why the operation is recommended.
- Obtain informed consent for the laparoscopic appendicectomy.
- You do NOT need to examine the patient, and you do NOT need to summarise your findings to the examiner.
- You do not need to complete the written consent form; the registrar will sign it with you.
- The anaesthetist will see Kevin separately.
This is a 10-minute station, with 2 minutes of reading time.