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Primary OSCE 72

Created: 29/11/2013
1. Simulator manikin
Demonstrate peripheral pulse examination plus blood pressure (BP) measurement and assessment of jugular venous pressure on a simulated manikin.

2. Resuscitation
Demonstrate resuscitation in pulseless ventricular tachcardia.

3. Scans
You are shown an ultrasound (US) scan image of the internal jugular vein and carotid artery and are asked questions about US frequency, anatomy and the means of confirming insertion in a vein compared with an artery.

4. Clinical anaesthesia
Discuss the management of a bradycardic patient postoperatively.

5. History taking
Take a history from a 35-year-old female presenting for laparoscopic sterilisation. She has a history of recreational drug and alcohol use.

6. Scans
You are shown a chest X-ray showing upper lobe consolidation, in a patient with an acute abdomen. Discuss.

7. Simulator manikin
Assess the cardiovascular system; measure the pulse and BP, and auscultate.

8. Clinical Anaesthesia
You are asked to interpret an ECG showing aortic stenosis with left ventricular hypertrophy. What problems might arise with spinal anaesthesia?

9. Examination/skills
Discuss laryngeal mask insertion, methods of sterilisation, the number of uses, and the appropriate size for a 2-year-old child.

10. Anatomy
You are shown a transverse section of the neck at C6 and are asked about it.

11. History taking
Take a history from a 22-year-old male presenting for wisdom tooth extraction. His sister has a history of suxamethonium muscle pain. The patient has had a previous nasal fracture from playing rugby. He has no means of being collected after the procedure.

12. Clinical measurement/physics
 - Discuss the use of hot water baths and other means of humidifying and the problems that arise without humidification.
 - Discuss the CO2 electrode

13. Anatomy
Sacrum: identify the sacral hiatus.
- Discuss the embryology of the sacrum
- Explain how to perform a caudal block.
- What is the maximum dose of bupivacaine for a child?

14. Anatomy/nerve blocks
Describe the general anatomy of the ribs, and the features of the first rib
- On a simulated patient, show the position for intercostal block and discuss the potential problems associated with it.
- Show the positions for needle decompression of tension pneumothorax and implantable cardioverter defibrillator insertion

15. Communication skills
Explain to a patient with a flu-like illness and fever presenting for arthroscopy that the operation has to be cancelled owing to the risk of joint infection.

16. Scans
You are asked to interpret a reconstructed facial computed tomography (CT) scan showing numerous fractures.

17. Equipment
You are asked about chest drains.

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