Instructions
You are an intern in the emergency department. Callum Rafferty, 34, has just been brought in by paramedics, still fitting after collapsing at the gym at 0950; it is now 1020 and a nurse is with you.
Assess and manage the patient using an A to E approach
Outline to the examiner:
- Next steps in management, including relevant investigations
- A nurse will carry out your instructions; describe procedures rather than doing them
- You do not need to take a full history
- You do not need to summarise your findings
Paramedic handover
Collapsed on a rowing machine at 0950; jerking of all four limbs since, timed by gym staff. Midazolam 10 mg IM at 1003, no change. No IV access. Oxygen came off in the move to the trolley. Estimated weight 85 kg.
On arrival (1018)
HR 128, BP 162/94 mmHg, RR 28, SpO2 88% on room air, T 37.4 degrees C