Category: Abcde assessment osce

A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes.

A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations.

Anaphylaxis | Acute Management | ABCDE

A comprehensive collection of medical revision notes that cover a broad range of clinical topics. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management.

A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Diabetic Ketoacidosis or DKA is a life-threatening condition that you need to be able to recognise and manage in the acute setting. This guide has been created to assist students in preparing for emergency simulation sessions as part of their training. It is not intended to be relied upon for patient care. DKA can present in a variety of different ways.

However, diagnosing the condition requires the following 3 key features:. DKA usually occurs as a result of either absolute insulin deficiency or complete insulin insensitivity. Therefore the two patient groups who suffer from DKA are:.

In DKA the body will produce an increase in counter-regularly hormones such as glucose, cortisol, growth hormones and catecholamines.

Blood will become more acidic due to a rise in acid ketones. Therefore symptoms of DKA will include:. Osmotic diuresis due to the hyperglycaemia in DKA will also lead to fluid depletion and electrolyte disturbance.

Therefore, patients will appear clinically dry and will have clinical findings to support this:. Diabetes UK developed thorough guidelines together with the Joint British Diabetes Societies Inpatient Care Group for the management of diabetic ketoacidosis in adults available online here. Perform a quick general inspection of the patient to get a sense of how unwell they are:.

If the patient is unconscious or unresponsive and not breathing start the basic life support BLS algorithm as per resuscitation guidelines. Call for help! If you think your patient has a compromised airway you need help ASAP. Put out a crash call immediately as you require urgent anaesthetic input to secure the airway. You can perform some simple airway manoeuvers in the meantime.

Perform a head tiltchin lift manoeuvre. If noisy breathing persists, try a jaw thrust. If this is still not enough to open up the airway you can consider the use of an airway adjunct:. If you were aware that your patient was at risk of DKA then it would be appropriate to measure their capillary blood glucose as soon as possible.

If you have an extra person, you could ask them to do a finger-prick test whilst the Airway, Breathing and Circulation are being assessed. However, it is vital to secure their airway and assess their breathing as problems with airway, breathing and circulation will kill the patient more rapidly than hyperglycaemia will. This allows continual reassessment of the response to treatment and early recognition of deterioration.

Well done!

abcde assessment osce

There are just a few more things to do….A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes.

A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving.

A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. A comprehensive collection of medical revision notes that cover a broad range of clinical topics. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. A collection of free medical student quizzes to put your medical and surgical knowledge to the test!

All three can result from a ruptured or eroded coronary artery plaque. You can think of them as lying along a disease spectrum with unstable angina as a milder form of the disease and STEMI as the most severe. Myocardial infarction MI can be classified as either type 1 or type 2. ACS is life-threatening and must be recognised and treated in a timely manner.

Remember: time is myocardium! This guide has been created to assist students in preparing for emergency simulation sessions as part of their training. It is not intended to be relied upon for patient care. The list of differentials for chest pain is long. However, a focused history covering cardiac risk factors can help you to determine which patients are more likely to be suffering from ACS.

When a patient presents with chest pain, it is impossible to arrive at a diagnosis without further examination and investigation.

Diabetic Ketoacidosis (DKA) | Acute Management | ABCDE

A comprehensive history of the chest pain using a SOCRATES method see our chest pain history taking guide can help to narrow the differential diagnosis considerably.

However, you will still require further investigations such as ECG and serum troponin levels to be confident of the diagnosis. Silent MIs do not present with these classical symptoms. Females, the elderly and diabetics are at increased risk of suffering ACS with minimal symptoms. Often the only symptom may be shortness of breath. Importantly, ACS can occur in the absence of any physical signs.

Perform a quick general inspection of the patient to get a sense of how unwell they are:. If the patient is unconscious or unresponsive and not breathing start the basic life support BLS algorithm as per resuscitation guidelines.

Call for help! If you think your patient has a compromised airway you need help! Put out a crash call immediately as you require urgent anaesthetic input to secure the airway. You can perform some simple airway manoeuvers in the meantime. If this is still not enough to open up the airway you can consider the use of an airway adjunct:. You want to get an ECG as soon as possible so you can know what you are dealing with:. You must speak to the cardiology team ASAP. We have already covered oxygen in breathing.

This allows continual reassessment of the response to treatment and early recognition of deterioration. Well done! You have successfully implemented the immediate treatment for your patient. There are just a few more things to do…. If possible, it is important to revisit history taking to clarify risk factors for ACS and other relevant medical information.A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes.

A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving.

A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. A comprehensive collection of medical revision notes that cover a broad range of clinical topics.

A collection of anatomy notes covering the key anatomy concepts that medical students need to learn.

abcde assessment osce

Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! The ABCDE approach is used for performing an initial systematic assessment of any critically unwell or deteriorating patient, and intervening as necessary. This method involves ordered examination, investigation and interventionfocusing on each major body system in turn.

Any problems are addressed as they are identified with the patient being regularly re-assessed. The aim of the ABCDE approach is to improve the clinical outcome of the unwell patientwith or without a definitive diagnosis. The below guide is a general overview that can be used for any unwell patient in a simulation setting ; it may seem intimidating at first, but remember your patient is unlikely to need all of the investigations or interventions mentioned!

This guide has been created to assist students in preparing for emergency simulation sessions as part of their training, it is not intended to be relied upon for patient care. Perform a quick general inspection of the patient to get a sense of how unwell they are:. If the patient is unconscious or unresponsive, start the basic life support BLS algorithm as per resuscitation guidelines. You may need the crash team.

Acute Coronary Syndrome (ACS) | Acute Management | ABCDE

In the meantime, you can perform some basic airway manoeuvres to help maintain the airway. See anaphylaxis case. Any patient who is short of breath should be sat up in the bed if possible to aid inspiration. Extremes of heart rate or blood pressure with any worrying features such as shock, new heart failure, syncope or myocardial ischaemia suggest the patient may be peri-arrest. Seek immediate senior help and alert the crash team as appropriate.

You have enough information to identify SIRS at this point. Perform the sepsis 6 immediately in suspected sepsis. Collect blood cultures and bloods as you cannulate. See blood cultures guide. See blood bottles guide. Stop and seek help if the patient has a negative response e. Acute deterioration in consciousness level may be due to a number of causes including:.

Alert a senior immediately if you have any concerns about the consciousness level of a patient. A GCS of 8 or below warrants urgent expert help from an anaesthetist. A crash team may be needed. Concerns about consciousness level always warrant senior input. Re-assess and maintain the airway. Well done! Just a few more things to do…. Take a more detailed history of what has happened and how the patient has been. Check out our history taking guides here.A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes.

A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. A comprehensive collection of medical revision notes that cover a broad range of clinical topics.

A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management.

A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Check out the examination of a skin lesion dermatological exam mark scheme here. Configuration refers to the shape or outline of skin lesions. The pattern of multiple lesions or shape of an individual lesion can assist in diagnosis.

Don gloves if the skin lesion is felt to be infective or is likely to expose you to bodily fluids e. Crust — if present, are you able to remove crust and see what is underneath? Assess the nails, hands and elbows for signs associated with dermatological disease. Read more about nail changes, with included images here. British Association of Dermatologists. Handbook for Medical Students and Junior Doctors. Published Dermnet New Zealand.

Dermatology terminology. Available [ HERE ]. Clinical Examination. Anatomy of the Uterus. Prescribing in Primary Care.

Interpreting a Coagulation Screen. Atrioventricular Block. A collection of surgery revision notes covering key surgical topics. Hilum of the Lung. Spinal Cord Summary. A man with blood in his urine. A man with testicular pain. Medical Student Finals Questions. ABG Quiz.The approach is widely accepted by experts in emergency medicine and likely improves outcomes by helping health care professionals focusing on the most life-threatening clinical problems.

In an acute setting, high-quality ABCDE skills among all treating team members can save valuable time and improve team performance. The approach is applicable in all clinical emergencies. It can be used in the street without any equipment Figure 1 or, in a more advanced form, upon arrival of emergency medical services, in emergency rooms, in general wards of hospitals, or in intensive care units. The evidence supporting the systematic ABCDE approach to critically ill or injured patients is expert consensus.

The approach is widely accepted and used by emergency technicians, critical care specialists, and traumatologists. In analogy, algorithms for resuscitation are applied to improve the speed and quality of treatment. The authors believe that a generally accepted algorithm for the ABCDE approach taught to health care professionals may improve treatment of the critically ill and injured, whereas differences in the interpretation of the algorithm may lead to confusion. Training health care professionals for recognition and management of critically ill patients increases confidence and reduces concerns about being responsible for the severely ill.

The clinical signs of critical conditions are similar regardless of the underlying cause. This makes exact knowledge of the underlying cause unnecessary when performing the initial assessment and treatment. It is a valuable tool for identifying or ruling out critical conditions in daily practice. Cardiac arrest is often preceded by adverse clinical signs and these can be recognized and treated with the ABCDE approach to potentially prevent cardiac arrest. When confronted with a collapsed patient, first ensure the safety of yourself, bystanders, and the victim.

Then check for cardiac arrest unresponsive, abnormal or absent breathing, and, if trained, pulse-check lack of carotid artery pulse. If the victim is in cardiac arrest, call for help and start cardiopulmonary resuscitation according to guidelines. All health care professionals can encounter critically ill or injured persons, either at work or in private life, and may therefore benefit from knowing the ABCDE approach.

The lay public expects health care professionals to act when confronted with illness or injury, whether it occurs in the street with no equipment at hand or in the hospital. Assessment and treatment can be initiated without equipment and more advanced interventions can be applied on arrival of emergency medical services, in a clinic, or at the hospital. Medical emergencies, including pediatric emergencies, occur in the general practitioners office more often than expected.

With the ABCDE approach, the initial assessment and treatment are performed simultaneously and continuously. Even when a critical condition is evident, the cause may be elusive; in such situations, life-saving treatment must be instituted before a definitive diagnosis has been obtained. Early recognition and effective initial treatment prevents deterioration and buys time for a definitive diagnosis to be made.

Causally focused treatment can then be instituted. First, life-threatening airway problems are assessed and treated; second, life-threatening breathing problems are assessed and treated; and so on. Using this structured approach, the aim is to quickly identify life-threatening problems and institute treatment to correct them.

OSCE implementation

Often, assistance will be required from emergency medical services, a specialist, or a hospital response team eg, medical emergency team or cardiac arrest team. Responders should call for help as soon as possible and exploit the resources of all persons present to increase the speed of both assessment and treatment. Improved outcome is most often based on a team effort.A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes.

A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. A comprehensive collection of medical revision notes that cover a broad range of clinical topics.

abcde assessment osce

A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Anaphylaxis is a life-threatening condition that you need to be able to recognise and manage in an acute setting.

This guide gives an overview of the recognition and immediate management of anaphylaxis using an ABCDE approach. This guide has been created to assist students in preparing for emergency simulation sessions as part of their training, it is not intended to be relied upon for patient care. Anaphylaxis can present in a wide variety of ways, making early diagnosis sometimes difficult.

The resuscitation council UK have devised the following set of criteria that if met suggest anaphylaxis is likely:. The exposure to a known allergen also helps support the diagnosis of anaphylaxis. Perform a quick general inspection of the patient to get a sense of how unwell they are:. If the patient is unconscious or unresponsive, start the basic life support BLS algorithm as per resuscitation guidelines.

If anaphylaxis is suspected, the immediate removal of potential anaphylactoid triggers such as IV antibiotics should be performed. In addition, you should ask another member of staff to source adrenaline to allow this to be administered quickly once you have confirmed the diagnosis. If any of the above features are present you should immediately put out a crash call as you require urgent anaesthetic input to secure the airway. In the meantime, you can perform some basic airway manoeuvres to help maintain the airway.

An arterial blood gas may be useful in quantifying the degree of hypoxia, however, it should not delay emergency management of anaphylaxis. A portable chest x-ray may be useful in ruling out other respiratory diagnoses if shortness of breath is the primary issue e. Chest x-ray should not delay emergency management of anaphylaxis and should only be performed if the diagnosis is in doubt.

In practice, high flow oxygen should be administered as soon as it is available whilst you continue your assessment. Give nebulised bronchodilators if there is suspicion of bronchospasm e.

Gain IV access — large bore cannulas required for rapid fluid resuscitation. If the patient remains hypotensive, they will need admission to critical care for inotropic support. If the patient has a cardiac arrest, commence CPR as per advanced life support guidelines. A falling level of consciousnesses is a sign of serious deterioration and will require critical care input for further support e.

This allows continual reassessment of the response to treatment and early recognition of deterioration. If anaphylaxis is suspected then critical care should be contacted immediately as their support will be needed. Well done!

abcde assessment osce

Just a few more things to do…. Take a more detailed history of what has happened and how the patient has been. Check out our history taking guides here.

ABCDE Approach to Emergency Management

Double check the medications you have just prescribed, and any routine medications the patient is taking. Write down any pertinent details from your history-taking. See documentation guide.A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes.

A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations.

A comprehensive collection of medical revision notes that cover a broad range of clinical topics. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. A collection of free medical student quizzes to put your medical and surgical knowledge to the test!

This guide has been created to assist students in preparing for emergency simulation sessions as part of their training, it is not intended to be relied upon for patient care. Perform a quick general inspection of the patient to get a sense of how unwell they are:. You may need the crash team.

In the meantime, you can perform some basic airway manoeuvres to help maintain the airway. Pulse — assess rate and rhythm e. Gain IV access — large bore cannula — for administration of anticonvulsant medication.

Abnormalities in the above values would indicate the need for urgent critical care input. A portable chest x-ray should be performed if there are concerns about aspiration pneumonia, however, this is unlikely to change management in the hyperacute context and therefore should not delay other management steps.

This allows continual reassessment of the response to treatment and early recognition of deterioration. Well done! Just a few more things to do…. Take a more detailed history of what has happened and how the patient has been. Check out our history taking guides here. Double check the medications you have just prescribed, and any routine medications the patient is taking. Write down any pertinent details from your history-taking.

See documentation guide. The next team of doctors on shift should be made aware of any patient in their department who has become acutely unwell. Treating ongoing generalised tonic-clonic seizures convulsive status epilepticus in hospital. Epilepsies: diagnosis and management. Clinical Examination. Anatomy of the Uterus. Prescribing in Primary Care. Interpreting a Coagulation Screen. Atrioventricular Block. A collection of surgery revision notes covering key surgical topics.

Hilum of the Lung. Spinal Cord Summary. A man with blood in his urine. A man with testicular pain. Medical Student Finals Questions.

ABG Quiz. Thyroid Pathology Quiz.


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