[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-317081-105":3,"doc-detail-317081-en":81,"detail-sidebar-cat-0-en-105":98},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","deteriorating-patient-3-notes-for-candidate","Deteriorating Patient 3 - Notes for Candidate","","Exam station notes for handling a deteriorating patient scenario, structured into two time blocks: 0–6 minutes for a full ABCDE assessment, including communicating observations, requesting appropriate investigations, and managing the patient through each assessment step; 6–10 minutes for performing a requested procedure and interpreting provided results. The examiner marksheet covers consent, airway, breathing, circulation, disability, exposure findings, and required clinical skills, plus investigation interpretation using the given lab values.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/deteriorating-patient-3-notes-for-candidate/317081/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/deteriorating-patient-3-notes-for-candidate/317081.png","ImageObject",300,407,{"name":42,"@type":43},"Himbo","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-26","2026-09-20",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What are the expected tasks in the first 0–6 minutes of this station?","Question",{"text":63,"@type":64},"Perform an ABCDE assessment and ask the nurse for observations and clinical signs at the appropriate stages. Manage the patient during the assessment and inform the nurse which investigations you want, briefly explaining why each is needed.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What should be done during the 6–10 minute section?",{"text":68,"@type":64},"Perform a procedure as requested by the examiner and interpret the results provided for you. No consent or communication with the mannequin is required.",{"name":70,"@type":61,"acceptedAnswer":71},"Which key patient findings and investigation requests are included in the examiner marksheet?",{"text":72,"@type":64},"Findings include post-fall presentation with severe lower abdominal and right leg pain, postural hypotension history, elevated HR with flushed warm skin, and right leg deformity consistent with a displaced NOF. Requested investigations include VBG, ECG, wide-bore cannulae, FBC, U&Es, LFTs, coag, CRP, G+S with crossmatch, urgent AP/lateral pelvis X-rays, and subsequent orthopaedic involvement and transfusion planning.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},317081,1790696485,{"code":4,"msg":82,"data":83},"success",{"doc_id":79,"user_id":84,"nickname":42,"user_avatar":85,"doc_module":4,"category_id":86,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":87,"file_id":88,"file_url":89,"file_type":90,"file_size":91,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":92,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":93,"faqs":94,"seo_title":95,"seo_description":12,"update_tm":96,"read_time":97},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697",7,"Deteriorating Patient 3 – Notes for Candidate Deteriorating patient – 10 minutes  \nYou will not be expected to handover the case during this station. The structure will be:  \n0 – 6 minutes:  \nPerform an ABCDE assessment, asking the nurse for any observations and clinical signs at the appropriate stages of your assessment.  \nManage the patient appropriately during the ABCDE assessment.  \nInform the nurse of the investigations you would like to perform and briefly explain why each is needed.  \n6 – 10 minutes:  \nPerform a procedure as requested by the examiner. (You will not be required to obtain consent or to communicate with the mannequin).  \nInterpret the results of the procedure (which will be provided for you).  \nDeteriorating Patient 3 – Examiner marksheet  \n\n| MARKING RUBRIC | ✓ |\n| --- | --- |\n| Opening:\u003Cbr>• Introduces themselves.\u003Cbr>• Confirms Patient demographics.\u003Cbr>• Explains and gains consent from patient about consultation. |  |\n| • AIRWAY\u003Cbr>Airway clear – Patient is Margeret Thomas, 78F who has presented post-fall, no head trauma. Severe pain near her lower abdomen and right leg.\u003Cbr>Known postural hypotension.\u003Cbr>NKDA |  |\n| • BREATHING RR – 19\u003Cbr>O2 – 96% on air Inspection – normal\u003Cbr>Chest wall movements equal and normal B/L\u003Cbr>Percussion – normal Auscultation – normal Central trachea and no cyanosis Requests VBG |  |\n| • CIRCULATION CRT > 2\u003Cbr>Skin is flushed, feels warm to touch\u003Cbr>HR – 154 BP – 98/66 HS I + II + 0\u003Cbr>Carotid and JVP normal Apex beat normal\u003Cbr>Requests ECG + 2x wide bore cannula + FBC, U&Es, LFTs, Coag, CRP, G+S + crossmatch Also asks for saline bolus – must switch this to O-ve blood as soon as \\#NOF is discovered. |  |\n| • DISABILITY\u003Cbr>Pupils equal and reactive B/L\u003Cbr>Arrived as AVPU – A, still A\u003Cbr>Cap glucose – normal\u003Cbr>Temperature – 36.9 |  |\n| • EXPOSURE No external bleeding\u003Cbr>Right leg is shortened, abducted and externally rotated.\u003Cbr>Requests urgent AP and lateral x-rays of the pelvis to visualise NOF.\u003Cbr>Begins O-ve blood transfusion\u003Cbr>Suggests to call orthopaedics on call to take for surgery and place an iliofascial block/suggests toadminister another sensible form of analgesia such as pentonox. |  |\n\n\n| • CLINICAL SKILL\u003Cbr>Please administer 10mg of morphine sulphate via IM injection, you do not need to obtain consent.– can either do this in the clinical skills lab or verbalise the steps\u003Cbr>5. Apply PPE |  |\n| --- | --- |\n| 6. Clean Tray + Trolley |  |\n| 7. Gather Correct size Needle (Blue/ Green), Sharps Bin |  |\n| 8. Check Medication against what has been prescribed, including Dose + Expiration date |  |\n| 9. Locate Acromion process and measure 3 finger breadths below |  |\n| 10. Using ANTT, open the Needle + Syringe and connect them together. Expose the needle |  |\n| 11. Pull down on patient's skin to apply Z-track technique |  |\n| 12. Insert the needle at 90º and gently aspirate to look for blood |  |\n| 13. Slowly administer medication at rate of 1ml over 10 seconds |  |\n| 14. Withdraw slowly and release Z-track pressure |  |\n| 15. Make needle safe on a hard surface and dispose in Sharps Bin |  |\n| 16. Thank patient and provide Aftercare (Pain, Fever, Infection signs, Drug side effects) |  |\n| • INVESTIGATION\u003Cbr>Please interpret the investigations in the context of this patient\u003Cbr>AP film of a right \\#NOF, displaced fracture, will need urgent orthopaedic input.\u003Cbr>FBC shows a normal Hb, despite haemorrhaging from the fracture, the Hb will remain normal as it is a marker of Hb concentration in the blood, and the remaining blood in her circulation has not been diluted. A low Hb would only emerge due to a chronic illness such as iron deficiency anaemia. |  |\n\nGlobal Impression: Patient Impression/comments:  \n• Excellent  \n• Good  \n• Pass  \n• Borderline  \n• Fail  \nDeteriorating Patient 3 – INVESTIGATIONS  \n\n| FBC-Hb (135 – 180 g/L) | 140 |\n| --- | --- |\n| MCV (82 – 100 fl) | 89 |\n| Platelets (150 – 400 * 10^9/L) | 160 |\n| WCC (4 – 11 * 10^9/L) | 5.2 |\n| Neutrophils (2 – 7 * 10^9/L","cbCailaa41qs6CGb","https://ap.wps.com/l/cbCailaa41qs6CGb","pdf",282455,"English","# Candidate Station Structure\n## ABCDE assessment (0-6 minutes)\n## Procedure and interpretation (6-10 minutes)\n# Examiner Marking Rubric\n## Opening and consent\n## AIRWAY, BREATHING, CIRCULATION, DISABILITY, EXPOSURE\n# Clinical Skill Checklist\n# Investigations and Interpretation\n## AP film and NOF management\n## FBC/CRP values","[{\"question\":\"What are the expected tasks in the first 0–6 minutes of this station?\",\"answer\":\"Perform an ABCDE assessment and ask the nurse for observations and clinical signs at the appropriate stages. Manage the patient during the assessment and inform the nurse which investigations you want, briefly explaining why each is needed.\"},{\"question\":\"What should be done during the 6–10 minute section?\",\"answer\":\"Perform a procedure as requested by the examiner and interpret the results provided for you. No consent or communication with the mannequin is required.\"},{\"question\":\"Which key patient findings and investigation requests are included in the examiner marksheet?\",\"answer\":\"Findings include post-fall presentation with severe lower abdominal and right leg pain, postural hypotension history, elevated HR with flushed warm skin, and right leg deformity consistent with a displaced NOF. Requested investigations include VBG, ECG, wide-bore cannulae, FBC, U\\u0026Es, LFTs, coag, CRP, G+S with crossmatch, urgent AP/lateral pelvis X-rays, and subsequent orthopaedic involvement and transfusion planning.\"}]","Deteriorating Patient 3 - Notes for Candidate | PDF",1789928524,10,{"code":4,"msg":82,"data":99},[100,104,108,112,117,122,125,130,134,137,140],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},"Exam",70,"exam",{"id":113,"doc_module":4,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},5,"Comic",60,"comic",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},6,"Technology",50,"technology",{"id":86,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":123,"slug":124},40,"healthcare",{"id":126,"doc_module":4,"doc_module_name":25,"category_name":127,"show_sort_weight":128,"slug":129},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":131,"show_sort_weight":132,"slug":133},"Religion & Spirituality",20,"religion-spirituality",{"id":132,"doc_module":4,"doc_module_name":25,"category_name":135,"show_sort_weight":132,"slug":136},"World Cup","world-cup",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":138,"show_sort_weight":97,"slug":139},"Lifestyle","lifestyle",{"id":141,"doc_module":4,"doc_module_name":25,"category_name":142,"show_sort_weight":113,"slug":143},19,"General","general"]