Station - Instructions for candidate
You are a final-year medical student on placement in the Emergency Department.
Nyibol/Majok Mading, a 32-year-old lawyer, has waited 40 minutes in an Emergency Department cubicle with a one-day history of sharp right-sided chest pain that is worse on breathing in, together with breathlessness. Triage observations and a brief background are on the chart in front of you. The patient is uncomfortable but settled, and is available for examination.
| Triage observations | HR 118 regular, BP 112/70 mmHg, RR 26, SpO2 91% on room air, temperature 37.1 C, pain score 5/10 |
|---|---|
| Triage background | Returned two days ago from a 14-hour flight. A close relative had a clotting problem in a leg vein in their thirties. No regular medicines. No known drug allergies. |
Your tasks are to:
- Perform a focused examination of the cardiorespiratory system and both legs. Describe to the examiner what you would like to look for or examine and the relevant findings will be provided to you.
- Request any relevant investigations. Results will be provided by the examiner if appropriately indicated.
- State your most likely diagnosis and two to four differentials to the examiner, with brief justification for each.
- Outline your initial management to the examiner, including drug, dose and route for the key treatment, the escalation and referral you would arrange, and the safety-netting.
- You do not need to take a history; the triage observations and background above are all you are given.
- Please verbalise your examination to the examiner; findings will be provided as you work through it.
- You do NOT need to summarise your findings to the examiner before giving your diagnosis and management.
This is a 10-minute station, with 2 minutes of reading time.