A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. eds. Deciding on which symptoms to ask about depends on the presenting complaint and your level of experience. Intravenous thiamine (250 mg) as high potency intravenous Pabrinex if there is a history of alcohol abuse or impaired nutrition (Wernicke’s encephalopathy). WESTERLY — Two local residents are facing charges after the police said a traffic stop early Sunday morning led to the discovery of numerous narcotics, including Adderall, cocaine and crack If you cannot give enough information, then others who have seen the seizures happen should contribute what they know. First-line treatment for seizures involves the use of benzodiazepines such as: Second-line treatments for seizures may include: Other treatments to consider in the context of seizure include: It may be necessary to expose the patient during your assessment: remember to prioritise patient dignity and conservation of body heat. Clearly document your ABCDE assessment, including history, examination, observations, investigations, interventions, and the patient’s response. Explore what tasks the patient performs at work to identify high-risk activities (e.g. If foreign material is present, attempt removal using suction. There are just a few more things to do…. Facilitate the patient to expand on their presenting complaint if required: History taking typically involves a combination of open and closed questions. If an obstruction is visible within the airway, use a finger sweep or suction to remove it. prolonged standing), Structural cardiovascular disease (e.g. This will help ensure your consultation is more natural, patient-centred and not overly formulaic. VIENNA, 8 June 2018 – The OSCE Representative on Freedom of the Media, Harlem Désir, today expressed his concern about the seizure of a Dutch journalist’s records as part of an ongoing investigation into the leaking of classified information. febrile convulsion) however, this is rare in adults. The conference will provide an insight into international best practices in the management of seized assets. Review the clinical presentation of epilepsy and seizure disorder with this Osmosis video. With your index and other fingers placed behind the angle of the mandible, apply steady upwards and forward pressure to lift the mandible. Related documents. This guide provides a structured approach to taking a LOC history in an OSCE setting. A chest X-ray may be indicated if abnormalities are noted on auscultation (e.g. brain metastases, primary brain tumour, cerebral abscess). Closed questions can allow you to explore the symptoms mentioned by the patient in more detail to gain a better understanding of their presentation. In: LeBlond RF, Brown DD, Suneja M, Szot JF. We are your trusted source for NAC OSCE, USMLE CS, MCCQE II and your medical school OSCE exam study notes. Assess the patient’s pulse and blood pressure: Insert at least one wide-bore intravenous cannula (14G or 16G) and take blood tests as discussed below. Review the patient’s notes, charts and recent investigation results. Cyanosis can also occur in the context of a prolonged seizure, however tonic-clonic movements will typically precede the development of cyanosis. Does the patient need a referral to HDU/ICU? Deterioration should be recognised quickly and acted upon immediately. Some examples of symptoms you could screen for in each system include: Ask if the patient has any medical conditions: If the patient does have a medical condition, you should gather more details to assess how well controlled the disease is and what treatment(s) the patient is receiving. Sirven JI, Britton JW, Cascino GD, et al. The ABCDE approach can be used to perform a systematic assessment of a critically unwell patient. 1. This typically involves the use of a non-rebreathe mask with an oxygen flow rate of 15L. pulmonary embolism), Hypovolaemia (e.g. This allows you to check your understanding of the patient’s history and provides an opportunity for the patient to correct any inaccurate information. Neurological Seizure Partial • Simple partial: focal motor seizure, no LOC • Complex partial (e.g. If you'd like to support us and get something great in return, check out our PDF OSCE Checklist Booklet containing over 100 OSCE checklists in PDF format. hypoglycaemia, electrolyte abnormalities, drug or alcohol intoxication and adrenal insufficiency), Space-occupying lesions (e.g. Explore the patient’s general social context including: Understanding the patient’s daily activities allows you to consider the risk posed by further episodes of LOC. 3. Vasovagal syncope: triggers include emotional distress (e.g. The post-ictal period can last for several minutes to hours and is often not remembered by the patient. Make sure to re-assess the patient after any intervention. Carotid sinus hypersensitivity is another form of reflex syncope which can be triggered by sudden head-turning, wearing a tight collar and shaving. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Carotid sinus hypersensitivity: triggers include shaving, tight-fitting collars and sudden turning of the head. Common Neurology OSCEs . Reduced urine output (oliguria) is typically defined as less than 0.5ml/kg/hour in an adult. It involves working through the following steps: Each stage of the ABCDE approach involves clinical assessment, investigations and interventions. aortic stenosis, arrhythmia). See our blood glucose measurement, hypoglycaemia and diabetic ketoacidosis guides for more details. increased chest crackles) or if the patient isn’t responding adequately to repeated boluses (i.e. Patients experiencing a seizure will have a post-ictal period after the seizure in which they may be drowsy, confused and agitated. Administer oxygen to all critically unwell patients during your initial assessment. Well done, you’ve now stabilised the patient and they’re doing much better. oxygen saturations, blood pressure, pulse) It can be challenging to use the ICE structure in a way that sounds natural in your consultation, but we have provided several examples for each of the three areas below. 4. Explain that you’d like to take a history from the patient. Problems are addressed as they are identified and the patient is re-assessed regularly to monitor their response to treatment. Calculate the patient’s current fluid balance using their fluid balance chart (e.g. Ask how the patient is feeling as this may provide some useful information about their current symptoms. 4. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations.


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