Technique & Tips

Question 1

EXAMINATION template:

Answer 1

Explain and consent
Hand hygeine
Offer symptomatic Txnfirst

__________

Obs
General- colour, distress, position etc
Top to toe systems review
vs
System of interest
- LOOK, FEEL, MOVE, FUNCTIONAL, SPECIAL TESTS

Question 2

INVESTIGATION template:

Answer 2

Bedside
- Mobile CXR)
- ECG
- FELS/ eFAST
- VBG
- BSL

Send from patient
- Bloods
–> BHCG, Group & Hold
- Urine
- Swabs

Send patient to
- Consider: ?remain in resus vs transfer for imaging

Question 3

MANAGEMENT template:

Answer 3

Resus
- (C)ABCDEfg
Symptomatic
- analgesia, antiemetic, splint
Definitive/ specific
- plaster, centesis, CRRT
Supportive
- *lines x4, NBM, maint fluids, VTEP, reg meds, etc.**
Referral
Disposition
- OT, imaging, ICU, retrieval
Consultantoid
- Doc, NOK, report, QI, debrief etc.

Question 4

APPROACH IN READING TIME:

Answer 4

Read tasks/ subquestions
Read stem

Read domains:
- WHICH
- WEIGHTING

Read tasks again in light of domain weighting

Decide how to portion up the 7 minutes

Anticipate direction of scenario

Question 5

MISC:

Answer 5

If involving a team, state WHAT FOR specifically

–> “I would call Obstetrics to facilitate urgent caesarean section”
–> “I would call anaesthetics for their expertise should a fibreoptic intubation/ emergency tracheostomy be required”
–> “I would seek Toxicology advice on when subsequent levels should be checked…”

Question 6

‘CONSULTANTOID’

Answer 6

Document

Debrief

Reporting
- Mandatory
- Notifiable PH
- Coroner
- Forensic

Quality
- Performance Mx
- Incident report
- Review current practice, processes and policy
- M&M
- Use at teaching/ SIM

Education
- Teaching
- M&M

Question 7

SUPPORTIVE CARE

Answer 7

Analgesia
Antiemetics

NBM
Fluids
+/- Nutrition

IDC
CVC/ art line

FASTHUGS
–> VTEP, head up, ulcer prophylaxis, glycaemic control

Vaccination

Question 8

DISCHARGE template:

Answer 8

Ensure safety
- Time of day, company, location, function
Instructions
- Written
Follow up
- Imaging, clinic
Red flags to represent

Question 9

‘RESUS’ template:

Answer 9

A
- Assess for ….
- Positioning, manoeuvres, adjuncts, intubation
—> My RSI modifications in this setting are…

B
- Assess…
- Position, analgesia
- Graded O2 delivery —> VV ECMO
- Chest drain
- ABG, CXR

C
- Assess….
- Dual IV access
- Bleed: Fluids, blood—> pressors. Haemostatic resus: direct, TXA, coags, pH, Ca, temp. Agent reversal
- Rhythm: DCR, optimise myocardium, meds. Pacing.
- Cardiogenic shock: inopressor, IABP, VA ECMO*

D
- GCS
- Glucose
- Agitation Max
- Seizure termination

(efg)