OSCE SKILLS QUESTIONS AND ANSWERS LATEST UPDATE
A+ GRADED
Sites for IO insertion
1. Anterior tibia (two fingers down, 1 inner medial across
2. humeral head
Describe IO insertion
1. Prepare equipment:
Location sites of needle decompression
1. 2nd ICS, midclavicular line, closest to third rib because contains nerve bundle closer
to 2nd rib
2. 4th-5th ICS, midaxillary line
Signs of when to needle decompress
Increase JVP
Unilateral chest rise and fall
Absent chest sounds on affect side
Respiratory distress
Hypotension
Resistance with IPPV
Tracheal deviation/tugging
Describe needle decompression procedure
What to do it deterioration of patient occurs following insertion of needle
decompression
- Advance a tiny volume of NaCl into the cannula, hoping it dislodges blockage.
If this doesn't work, insert another needle decompression.
Haemorrhage control measures
- Elevation of limb
- Dressing with pressure
- Wound packing
- Tourniquet
Indications of tourniquet
- External, life-threatening haemorrhage
- Amputation of limb
- Mass casualty with less resources available
Problems and complications with tourniquets
- Painful
- Decrease perfusion, decreased O2 = ischaemia and necrosis if left on for too long
- Compartment syndrome due to compression of tissue
- Rhabdo
How to assess and apply arterial tourniquet (for OSCE setting)
A+ GRADED
Sites for IO insertion
1. Anterior tibia (two fingers down, 1 inner medial across
2. humeral head
Describe IO insertion
1. Prepare equipment:
Location sites of needle decompression
1. 2nd ICS, midclavicular line, closest to third rib because contains nerve bundle closer
to 2nd rib
2. 4th-5th ICS, midaxillary line
Signs of when to needle decompress
Increase JVP
Unilateral chest rise and fall
Absent chest sounds on affect side
Respiratory distress
Hypotension
Resistance with IPPV
Tracheal deviation/tugging
Describe needle decompression procedure
What to do it deterioration of patient occurs following insertion of needle
decompression
- Advance a tiny volume of NaCl into the cannula, hoping it dislodges blockage.
If this doesn't work, insert another needle decompression.
Haemorrhage control measures
- Elevation of limb
- Dressing with pressure
- Wound packing
- Tourniquet
Indications of tourniquet
- External, life-threatening haemorrhage
- Amputation of limb
- Mass casualty with less resources available
Problems and complications with tourniquets
- Painful
- Decrease perfusion, decreased O2 = ischaemia and necrosis if left on for too long
- Compartment syndrome due to compression of tissue
- Rhabdo
How to assess and apply arterial tourniquet (for OSCE setting)
