Summary
Summary Anaesthetics OSCE guides
- Module
- Anaesthetics OSCE guides
- Institution
- University Of Leeds (UoL)
a summary of possible OSCE stations guide for anaesthetics module
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Anaesthetics OSCE guides-1. Acute airway management:
Introduction
check GCS score/AVPU -if equal or less than 8, intubation is needed, call anaesthetist for
help
Airway-look chest rises, look for obvious obstruction in the mouth
Listen-abnormal breath sounds
Feel- air through nose
Head tilt chin lift or jaw thrust-reassess the airway
Put in air adjunct
If still doesn’t work, call for help
Ventilate patient with mask and bag
2. C spine injury:
ABCDE assessment-use prioritising sequence to assess people with trauma, for example
<C>ABCDE
catastrophic haemorrhage
airway with in-line spinal immobilisation (see airway management)
breathing
circulation
disability (neurological)
exposure and environment.
At all stages of the assessment:
protect the person's cervical spine with manual in-line spinal immobilisation, particularly
during any airway intervention, and avoid moving the remainder of the spine
or
maintain full in-line spinal immobilisation
initial factors to take into consideration:
has any significant distracting injuries
is under the influence of drugs or alcohol
is confused or uncooperative
has a reduced level of consciousness
has any spinal pain
has any hand or foot weakness (motor assessment)
has altered or absent sensation in the hands or feet (sensory assessment)
has priapism (unconscious or exposed male)
has a history of past spinal problems, including previous spinal surgery or conditions that
predispose to instability of the spine.
assessment for the cervical spine
Canadian c spine rule
High risk-
65 and above
, Dangerous mechanism
Paraesthesia in the upper and lower limbs
Low risk-
involved in a simple rear-end motor vehicle collision
comfortable in a sitting position
ambulatory at any time since the injury
no midline cervical spine tenderness
delayed onset of neck pain
no risk
have one of the above low-risk factors and
are able to actively rotate their neck 45 degrees to the left and right.
Assessing for thoracic or lumbosacral spine injury in hospital
age 65 years or older and reported pain in the thoracic or lumbosacral spine
dangerous mechanism of injury (fall from a height of greater than 3 metres, axial load to the
head or base of the spine – for example, falls landing on feet or buttocks, high-speed motor
vehicle collision, rollover motor accident, lap belt restraint only, ejection from a motor
vehicle, accident involving motorised recreational vehicles, bicycle collision, horse riding
accidents)
pre-existing spinal pathology, or known or at risk of osteoporosis – for example steroid use
suspected spinal fracture in another region of the spine
abnormal neurological symptoms (paraesthesia or weakness or numbness)
on examination:
abnormal neurological signs (motor or sensory deficit)
new deformity or bony midline tenderness (on palpation)
bony midline tenderness (on percussion)
midline or spinal pain (on coughing)
on mobilisation (sit, stand, step, assess walking): pain or abnormal neurological symptoms
(stop if this occurs).
When to carry out full in-line spinal immobilisation in hospital
a high-risk factor for cervical spine injury is indicated and identified by the Canadian C spine
rule or
a low-risk factor for cervical spine injury is indicated and identified by the Canadian C-spine
rule and the person is unable to actively rotate their neck 45 degrees left and right
if indicated by one or more factors for suspected thoracic or lumbosacral spine injury
Do not carry out or maintain full in-line spinal immobilisation or request imaging for people
if:
they have low-risk factors for cervical spine injury as indicated by the Canadian C-spine
rule, are pain free and are able to actively rotate their neck 45 degrees left and right
they do not have any of the factors
how to carry out in line spine immobilisation
Fit an appropriately sized semi-rigid collar unless contraindicated by:
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