Trauma OSCE

Question 1

What is the first thing you MUST do in this osce?

Answer 1

Ask if the scene is safe

Question 2

Once the scene is safe, what is the assessment that you will do?

Answer 2

End of bed assessment

Question 3

What are we looking and asking for in the end of bed assessment?

Answer 3

GeneralAppearance - Position, colour (pale, clammy)

Question 4

After the end of bed assessment, what do we do?

Answer 4

Introduce ourselves to the patient, if they are awake ask for consent, if not explain that you will be acting under the doctrine of neccessity. NEED TO EXPLAIN WISH TO TREAT PATIENT.

Question 5

After gaining consent what is the next step.

Answer 5

Verbalising and doing the primary survey, AVPU and their general appearance

Question 6

What is the prmary survey when dealing with a trauma patient?

Answer 6

CABCDE - Catastrophic haemorrage, Airway (consider C spine - is a jaw thrust better?), Breathing (have a quickfeel, look and listen, equal air entry both sides?), Circulation (pulse, capillary refill , GATE, temp of skin), Disability (Pupils - PEARLS), expose and examine (look to see if any other injuries).

Question 7

When completing the primary survey, when youve assessed breathing what must you do?

Answer 7

Put the patient on 100% oxygen with a non rebreather mask - VERBALISE THIS

Question 8

Once the primary survey is completed what must we do?

Answer 8

Verbalise if the patient is primary survey positive/ negative and if they are time critical.

Question 9

What must you remember to get in good time?

Answer 9

BACK UP - VERBALISE

Question 10

What do you do after you have done the primary survey and immobalised the patient correctly.

Answer 10

Begin the secondary survey - VERBALISE THIS

Question 11

What is the history structure that you use in the secondary survey?

Answer 11

SAMPLE

Question 12

What does SAMPLE mean?

Answer 12

Symptoms, allergies, medication, past medical history, last meal, events leading up to

Question 13

What are we evaluating each region of the body for?

Answer 13

DCAPBTLS - Deformities, contusions, abrasions, penetrasions/ punctures, burns, tenderness, lacerations, swelling - VERBALISE THIS AT EACLH REGION

Question 14

When checking the head, where are we checking?

Answer 14

Feel all over the head including the hair

Question 15

What are the red flags when checking the head in the secondary survey?

Answer 15

Boggy masses, battle signs, racoon eyes, alteretd pupil response

Question 16

After the head, where are we checking next in the secondary survey?

Answer 16

The neck - VERBALISE

Question 17

What are we checking the neck for?

Answer 17

VERBALISE - central trachea, feel for c-spine, tenderness, bony abnormalities, crepitius of the larynx, hoarseness.

Question 18

If there is pain in the neck or a fall from height what are we going to do when assessing the neck at the secondary survey?

Answer 18

Measure and apply a collar - VERBALISE

Question 19

After assessing the neck, what region do we assess next in the secondary survey?

Answer 19

The chest - VERBALISE

Question 20

What do we have to do when assessing the chest in the secondary survey?

Answer 20

Complete a full ascultation of the chest, do not forget the back if you can, is there equal chest expansion - IPPA - Are the chest sounds absent, unequal or diminished?. Also check for any DCAPBTLS

Question 21

What are we checking after the chest in the secondary survey?

Answer 21

The abdomen - VERBALISE

Question 22

When further checking the abdomen what do we do?

Answer 22

Visual checks - bruising?, scars?bumps?bleeding?. - DCAPBTLS
Palpate all regions, stop when you reach pain.

Question 23

After the abdomen where do we assess next in the secondary survey?

Answer 23

The pelvis

Question 24

What are we looking for when checking the pelivs?

Answer 24

DCAPBTLS -Pain, disformiy - apply pelvic binder in good time - VERBALISE

Question 25

What is the last area that is checked in the secondary survey?

Answer 25

The back and limbs

Question 26

What is the appropriate immobalisation for back and limb injury

Answer 26

Splint and dress appropriately

Question 27

What is TXA?

Answer 27

Drug that can help the blooding process - reduces blood loss.

Question 28

What pain relief can we give patients?

Answer 28

Paracetamol, entonox, ibuprofen, ketamine, morphine - CHECK JRCALC BEFORE GIVING DRUG

Question 29

What do we have to do before adminstering a drug?

Answer 29

Use ADETOUR to make sure it is safe - VERBALISE

Question 30

What does ADETOUR stand for

Answer 30

Allergies, drug, Expiary, Time, Options for administration, Units, Recorda and document.

Question 31

Throughout the scenario what is it important to keep checking and reassessing?

Answer 31

Vitals/ observations

Question 32

After the patient is ready to go to hospital, what must you do?

Answer 32

Handover using atmist or SBAR - VERBALISE

Question 33

What does ATMIST stand for?

Answer 33

Age, Time, Mechanism, Injiuries, signs and symptoms, treatment

Question 34

What does SBAR stand for?

Answer 34

Situation, Background, Assessment, Reccomendation

Question 35

What are the options for transport?

Answer 35

Local trauma centre (local ED), Major trauma centre (possibly coventry)

Question 36

What should you do if you are unsure where the patient should go?

Answer 36

Use the trauma pathway - JRCALC or in the trauma bag