Medicine · A-E assessment

Drowsy after a fall

Hard

8 min station · 2 min reading · Recommended for Notre Dame Year 4 students

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N D M Q

2 min reading · 8 min station · reminders at 1 min

Instructions

You are an intern on the medical ward. It is 3 am. The nurse asks you to see Rocco Battaglia, 79, admitted two days ago with pneumonia. She found him on the floor beside his bed at 1 am; nobody saw him fall. He has become harder to rouse over the last hour.

  1. Assess and manage the patient using an A to E approach

  2. Outline to the examiner:

    • Your most likely diagnosis
    • Next steps in management, including relevant investigations
  • A nurse is at the bedside and will carry out your instructions; describe procedures and painful stimuli rather than doing them
  • You do not need to take a full history
  • You do not need to summarise your findings

Observations at 3 am

RR 18, SpO2 95% on 2 L nasal prongs, HR 92, BP 172/94, T 37.3; weight on admission 80 kg

Practising alone? Ask the examinerFindings appear only when you ask for them

Investigations

Examination

After treatment

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