Emergency · Examination

Sharp chest pain and breathlessness after a long-haul flight - Emergency Department

MediumYear 5 · Curtin style · 10 min + 2 min reading · 4 tasks

2 min reading · 10 min station · reminders at 2 min

Station - Instructions for candidate

You are a final-year medical student on placement in the Emergency Department.

Majok Mading, a 32-year-old lawyer, has waited 40 minutes in an Emergency Department cubicle with a one-day history of sharp right-sided chest pain that is worse on breathing in, together with breathlessness. A brief background is on the chart in front of you. The patient is uncomfortable but settled, and is available for examination.

Triage background
Returned two days ago from a 14-hour flight. A close relative had a clotting problem in a leg vein in their thirties. No regular medicines. No known drug allergies.

Your tasks are to:

  1. Perform a focused examination.
  2. Request any relevant investigations and interpret the results provided.
  3. State your most likely diagnosis and differential diagnoses to the examiner.
  4. 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 take a full history, but you may ask the patient targeted questions as you examine.

This is a 10-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.

After treatment

Once you have acted, ask how the patient has responded.