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Primary OSCE 33

Created: 9/1/2007
1. Equipment
Describe the advantages and disadvantages associated with the following laryngoscope blades: disposable, fibreoptic, Magill’s blade and straight blade.
- Describe three uses of Magill’s forceps.

2. Intubation
- What are the adverse cardiovascular effects of intubation?
- How would you change the tracheostomy tube in an intensive care unit patient who is on a ventilator?
- What precautions should be taken before proceeding?
- Describe the late complications of tracheostomy.
- What should be the pressure in the tracheostomy tube cuff?
- How much of the dead space of the upper airways is lost after tracheostomy?
- You are shown an X-ray showing contrast of a pharyngeal pouch and are asked to describe the findings.

3. Resuscitation
Describe the protocol for managing ventricular fibrillation.

4. History taking
You are presented with a patient who is on the list for elective carotid endarterectomy. Describe your management of this patient.

5. History taking
A patient is due to undergo a hysterectomy for fibroids. Describe your management of this patient.

6. Communication
A patient is on the day-case list for painful inguinal hernia repair. The operation has been cancelled by the surgeon because of an emergency case, and you have been asked to break the news to him.

7. Data interpretation
You are asked to interpret a chart showing heart rate, oxygen saturations and respiratory rate.

8. Data interpretation
You are asked to interpret data (oxygen saturation, respiratory patterns) from an obese male patient who has undergone abdominal surgery.
- Will the patient benefit from oxygen postoperatively?
- What might have caused his respiratory patterns?
- How would you manage this respiratory pattern?

9. Anatomy
Describe the structure of the orbit.
– How would you administer a peri-orbital block?

10. Anatomy
Describe how you would carry out the following:
- Femoral nerve block.
- 3 in 1 block.
- Block of the dermatomes of the lower limb.
- Lumbar plexus block.

11. Skills
Describe the procedure for carrying out a subarachnoid block.
- How should the patient be positioned?
- What needles would you use?

12. Electrical safety
You are asked questions on diathermy devices and pacemakers, and asked to interpret some diathermy circuits showing a floating circuit.

13. Equipment
You are shown an oesophageal temperature probe and asked questions about temperature and thermistors, and given some graphs to interpret.

14. Equipment
You are shown a precordial stethoscope.
- What are its uses?
- How would you identify and treat an air embolism?

15. Examination
Carry out an examination of cranial nerves III to XII.

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