Content for Histories, Examinations and Extras

[peterwoodward-court]

Hi all - here are some stations to fill in the content:

Histories:

• Headache
  --
  --
  --
  --
  v
• Vomiting
• Shortness of Breath
• Visual loss
• Cough
• Chest Pain
• Abdominal Pain
• Dysuria
• Weakness

Examinations:

• Cardiovascular
  -- Washes hands
  -- Introduction
  -- Gains consent
  -- General inspection
  -- Checks peripheral pulses
  -- Checks blood pressure
  -- Inspects JVP
  -- Palpates carotids
  -- Localises apex beat
  -- Auscultates valve areas with correct positioning
  -- Listens to lung bases
  -- Checks for ankle oedema
  -- Thanks patient & summarises findings
  -- Washes hands
• Respiratory
• Abdominal
• Cranial nerves
• Thyroid
• Upper Limb neurological
• Lower Limb neurological
• Shoulder
• Hip
• Knee
• Ankle

Extras:

• ABCDE
  -- Checks it is safe to approach the patient
  -- Asks for baseline observations- If done, asks for help if appropriate
  -- Shakes pt's shoulders and speaks loudly in both ears
  -- Airway: Looks for Obvious respiratory distress
  -- Airway: Visualises the oral area to check for obvious obstruction
  -- Airway: Listens for stridor, gurgling and snoring (must state all 3) + wheeze
  -- Airway: Measures RR and sats
  -- Airway: Treats if appropriate: Sit patient up, ‘consider airway adjunct’
  -- Breathing: Looks for: Pursed lips & nasal flaring
  -- Breathing: Looks for: Tracheal deviation
  -- Breathing: Looks for: Symmetrical chest expansion
  -- Breathing: Looks for: Accessory muscle use
  -- Breathing: Feels for: Tracheal centrality
  -- Breathing: Feels for: Symmetrical expansion
  -- Breathing: Percussion of the chest
  -- Breathing: Listens to the front and back of the chest
  -- Breathing: Checks for sacral oedema after listening to the back
  -- Breathing: Measures: Oxygen saturations
  -- Breathing: Measures: Respiratory rate
  -- Breathing: Treats: ABG as appropriate
  -- Breathing: Treats: High flow (15L) oxygen via a non-rebreathe mask
  -- Breathing: Treats: Analgesia (morphine + lax + anti-emetic) as appropriate
  -- Reassess - candidate reviews airway
  -- Circulation: looks for: Cyanosis
  -- Circulation: looks for: Trauma/bleeding
  -- Circulation: looks for: Visible JVP
  -- Circulation: feels for: Warm/well perfused peripheries
  -- Circulation: feels for: Radial pulse
  -- Circulation: feels for: Carotid pulse
  -- Circulation: feels for: Heaves/thrills
  -- Circulation: feels for: Apex beat
  -- Circulation: Listens for: Heart sounds
  -- Circulation: Measures: Capillary refill
  -- Circulation: Measures: Blood Pressure
  -- Circulation: Measures: Heart Rate
  -- Circulation: Measures: Urine Output
  -- Circulation: Measures: Temperature
  -- Circulation: Treats: ECG as appropriate
  -- Circulation: Treats: 2x wide bore cannulae
  -- Circulation: Treats: Fluid challenge
  -- Circulation: Treats: Bloods (U&E, FBC, cross match)
  -- Reassess airway and breathing
  -- Disability: AVPU
  -- Disability: Blood glucose
  -- Everything Else: Top-to-toe assessment (e.g. checks rashes)
  -- Everything Else: Checks allergy
  -- Everything Else: SBAR handover
  -- Other: Calls for help at an appropriate time and calls 2222

• Inhaler technique

• Prescribing IV fluids

• Smoking Cessation

[sima-qian]

Thanks @peterwoodward-court, that's great :)

Can I clarify whether you expect there to be cases within Examination stations or Extra stations, in the way that History stations have specific cases? We've just started to implement the database (it went well 👍), so it's important to know in order for us to plan the database schema appropriately.

Additionally, would you consider the items listed under ABCDE to be mark scheme elements?

It would also be nice to have perhaps one or two cases and related mark schemes for each History station, just so there aren't a lot of blank pages hanging around the app.

[peterwoodward-court]

@sima-qian Thanks for the info! I have just realised I submitted this incorrectly...hence the '--' repeated and the 'v' under headache! I'll sort it tomorrow! Sorry - I will pad it out with more cases and mark schemes (they were meant to be there!)

Yes everything under ABCDE are elements of the mark scheme (long one!)

Thanks for all your hard work!