Station - Instructions for candidate
You are an intern working in the Emergency Department of a metropolitan hospital in Perth that has a vascular surgery service. It is 10 am.
Thao Nguyen, 72, has been brought in by her husband with severe pain in her right leg that started suddenly this morning. She is on a trolley with the leg uncovered. The triage nurse has recorded observations and a bedside glucose.
| Triage note | 72 F. Sudden onset right leg pain at 6 am, foot pale and cold. Pain 9/10. Category 2. |
|---|---|
| Observations | HR 96 /min irregular, BP 156/88 mmHg, RR 18 /min, SpO2 97% on room air, T 36.6 degrees C, glucose 6.1 mmol/L |
Your tasks are to:
- Take a focused history.
- Perform a focused examination of the lower limb vascular and neurological systems, comparing both legs. Verbalise each step and the examiner will provide findings.
- Request the investigations you need now. The examiner will provide results where appropriate.
- State your most likely diagnosis and the differential diagnoses to the examiner.
- Outline your immediate management plan to the examiner, including who you will call, and explain the plan to Mrs Nguyen.
- You do NOT need to summarise your history and examination findings to the examiner.
- State drug, dose and route where relevant.
- A handheld Doppler is available on request.
This is a 15-minute station, with 2 minutes of reading time.