Station - Instructions for candidate
You are an intern working in the Emergency Department of a metropolitan general hospital in Perth.
Sanjay Singh, aged 2 years and 8 months, has been brought in by his mother, Priya, with a fever since last night and a rash that she noticed this morning. The triage nurse has placed him in a monitored cubicle and recorded his observations. His mother is with him and will give the history. The child is represented by the examiner's description; examination findings will be provided as you verbalise each step.
| Triage note | 2y 8m boy. Fever since last night, very sleepy this morning, vomited x2, spots on legs and tummy. Weight 14 kg. |
|---|---|
| Observations at triage | Temperature 39.4 degrees C, heart rate 168 /min, respiratory rate 40 /min, SpO2 96% on room air, blood pressure 78/45 mmHg |
Your tasks are to:
- Take a focused history from his mother.
- Perform a focused examination of the child, including his general appearance, hydration, skin, neck and neurological state. Verbalise each step to the examiner and the findings will be provided.
- Request any investigations you would order now. Results will be provided by the examiner if appropriately indicated.
- State your most likely diagnosis and the differential diagnoses to the examiner.
- Outline your immediate management plan to the examiner, including who you would call and what you would give.
- You do NOT need to summarise your history and examination findings to the examiner.
- You do not need to write a drug chart, but state drug, dose, route and rate where relevant.
- The examiner may hand you results at any point after you request them.
This is a 15-minute station, with 2 minutes of reading time.