Station - Instructions for candidate
You are an intern working in the paediatric area of a metropolitan Emergency Department in Perth. It is 11 pm; the paediatric registrar is available by phone and will attend when called.
Noah Callaghan, six weeks old, is in a cot in the paediatric bay with his mum, who is worried about him. Triage observations are on your sheet.
| Triage note | 6-week-old male, 4.5 kg. Fever at home 38.6 (axillary) this afternoon; mother gave paracetamol 70 mg orally at 9 pm. Feeding poorly and sleepy for 12 hours. No rash. Triage category 2. |
|---|---|
| Observations at triage (11 pm) | HR 178 /min, RR 48 /min, SpO2 98% on room air, T 37.9 degrees C (38.4 on arrival at 10.40 pm), capillary refill 3 seconds, weight 4.5 kg, blood glucose 4.8 mmol/L |
Your tasks are to:
- Take a focused history from the mother, including the relevant birth, feeding, growth, development and immunisation background.
- Perform a focused examination of the infant: general appearance, fontanelle, skin, chest, abdomen and hydration. Describe to the examiner what you are looking for; the findings will be provided.
- Request the investigations you consider necessary; the examiner will provide results where appropriate. State your assessment and the differential diagnoses to the examiner.
- Outline your initial management plan, including any drug with its dose, route and frequency, and explain the plan to the mother.
- You do NOT need to summarise your findings to the examiner.
- The infant is represented by a mannequin; the mother is played by a simulated patient.
- State drug, dose (per kilogram and total, with the maximum), route and frequency for anything you prescribe.
This is a 15-minute station, with 2 minutes of reading time.