OSCE questions Flashcards
What is an ECG
Electrocardiogram. Shows electrical activity through the heart and rate.
Why is correct lead placement important?
To avoid diagnostic errors and misinterpretation
What are chest lead landmarks
V1 - 4th intercostal right of sternum
V2 - 4th intercostal left of sternum
V3 - Between V2 and V4
V4 - 5th intercostal left mid clavicular line
V5 - Between V4 and V6
V6 - 5th intercostal left mid axillary line
When is ECG indicated
Chest pain
Sycope
Unexplained falls
What is a normal heart rate
60 - 100 bpm
>60 bradycardia
<100 tachycardia
What is blood pressure
Pressure in blood vessels in mmHg
What is systolic/ diastolic
Systolic is pressure when heart beats (bigger number)
Diastolic is pressure between beats (smaller number
What factors can affect blood pressure
Cardiac output
Volume of blood
Stress
Caffeine
Medication
What is normal blood pressure
Systolic 90-120
Borderline hypertensive 120-140
What are indications for measuring blood pressure
Chest pain
Unexplained falls
syncope
What are contra indications for measuring blood pressure
Patient refusal
IV line in arm
Recent open wounds on arm
Other procedures required as priority
Advantages/ disadvantages of automatic blood pressure
Easier
Cuff placement is less important
Less accurate as estimates systolic/ diastolic based on mean arterial pressure
Advantages/ disadvantages of manual blood pressure
More accurate
Noise/ movement can interfere
User error
When is ECG contra indicated
Allergy to adhesive
Patient refusal
Other procedures needed as priority
What does peak flow measure
The amount of air that can be forcefully exhaled measured in L/min
What can impact peak flow
Conditions affecting lung capacity e.g. pneumonia/ copd/ asthma
Age
Gender
Indications for peak flow
Chronic conditions (asthma) to measure severity of exacerbation and improvement
Contra indications for peak flow
Severe exacerbation of breathlessness
Patient refusal
Not indicated
What can peak flow identify
Severity of asthma attack
Lung function
If treatment is having an impact
What do you do if you get a needle stick injury
Bleed it, wash it, cover it, report it
What factors affect needle size selection
SC/IM injection
Fat/muscle
Size / age
Complication of injections
Abscess
Anaphylaxis/ allergy
Bleeding/ pain
Factors affecting drug absorption
Exercise
Blood flow to area
Temperature
Contra indications for site selection
Burns
Inflammation
Oedema
Medicine legislation allowing paramedics access and administration of medication
Human medicines regulations schedules 17 and 19
Patient Group Directives
Purpose of primary survey
Establish if patient is time critical
How long does a primary survey take
60-90 seconds
Who requires primary survey
Every patient
What to do if there is a concern during primary survey
Correct if possible before moving on
What is the purpose of safety netting
Instructions for the patient on if the conditions worstens or impacts their activities of daily living.
Management of the condition for exacerbations
When should you safety net
Every patient especially if you are leaving them at home
How would you alter safety netting in those with cognitive impairment
Simple words
Ensure understanding by asking them to reword and repeat
Write things down for them to refer to
Types of communication we can use for taking history
Verbal
Written
Body language
Signing
What are barriers to communication and solutions
Cognitive - writing, simple language
Language - translate/ languageline
Hearing - writing
Why is accurate documentation important
Legal document of the care received
Recorded events for continuation of care
