Location: You are an FY1 and have been paged by the ward sister to review a patient
Patient: 45 year old patient, has acutely become short of breath
– Take a focused history from the patient
– Perform a full ACDE assessment, a nurse will be available to help you with investigations or management that you require.
– After 6 minuets you will be asked a series of questions by the examiner.
– Answer any questions that the patient may have
Note to actor: Try to restrain yourself from volunteering too much information – you may do so when prompted (that is, by a specific question, not a general one). If a student is on the wrong line of clinical reasoning do not fuel this line of thinking, state no to the question as being ambiguous may prompt further questioning and does not allow the student to be appropriately tested. The aim of the exercise is to take a focused history; short answers are required.
This is an ABCDE assessment.
You are a 45 year old male who has presented to accident and emergency with shortness of breath and are now finding it difficult to talk in complete sentences. You are known to have asthma and it is well controlled with a blue and brown inhaler but you do not know the names of these. This started a couple of hours ago, you realised you were using your blue inhaler a lot, when your wife came home from getting the shopping she called an ambulance.
If asked you have not recently been unwell. You have never had to come to hospital with your asthma and have never been admitted to intensive care unit.
PMH = asthma
Drugs = blue inhaler, brown inhaler. No allergies
Social history = smoker, non-drinker
You are unable to provide anymore information than this.