Emergency · History + examination

Drowsy after oxygen in the ambulance - Emergency Department

MediumYear 5 · Curtin style · 15 min + 2 min reading · 5 tasks

2 min reading · 15 min station · reminders at 2 min

Station - Instructions for candidate

You are an intern in the Emergency Department of a Perth teaching hospital.

Bruce Whitlock, a 71-year-old retired boilermaker, has been brought in by ambulance with three days of worsening breathlessness and green sputum. The paramedics found his saturations at 84 percent and put him on 15 L/min of oxygen by mask; he has become drowsy on the way in. He is on a monitored bed and is rousable to voice.

Your tasks are to:

  1. Take a focused history.
  2. Perform a focused examination.
  3. Request any relevant investigations and interpret the results provided.
  4. Summarise your findings to the examiner with your most likely diagnosis and differential diagnoses.
  5. Outline your initial management plan to the examiner.
  • Please verbalise your examination to the examiner; findings will be provided on request.
  • You do not need to write prescriptions or medication orders.

This is a 15-minute station, with 2 minutes of reading time.

Ask the examiner

Say what you would examine or request, the way you would in the station. Nothing is named until you ask for it.

Whatever the examiner recognises is revealed below. Or pick a numbered item to reveal it blind.

Investigations

Ask for a category the way you would in the station: “Can I have the obs and a set of bloods?”

Examination

Say what you would examine and how; the examiner reports what you would find.