Station - Instructions for candidate
You are an intern working in the Emergency Department of Broome Hospital.
Shirley/Jarrah Collard, aged 9, has been brought in by their mother, Lena, from a community two hours away with a week of fevers and a painful, swollen left ankle. The right knee was sore and swollen earlier in the week but has improved. The triage nurse has recorded observations and weight. The child is on the bed; Lena will give the history, and the child will answer simple questions. An Aboriginal Health Worker is available if you would like them present.
| Observations at triage | Temperature 38.6 degrees C, heart rate 118 /min, respiratory rate 24 /min, SpO2 98% on room air, blood pressure 100/62 mmHg, weight 28 kg |
|---|---|
| Triage note | 9y. Fevers 1 week. Sore swollen L ankle, not weight-bearing. R knee sore earlier in the week. From community. Category 3. |
Your tasks are to:
- Take a focused history from the mother, including the relevant paediatric background.
- Perform a focused examination of the child's joints, heart and skin. 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 initial management plan to the examiner, and explain the essentials to the mother.
- You do NOT need to summarise your history and examination findings to the examiner.
- State drug, dose and route where relevant; you do not need to write a drug chart.
- 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.