SimMan Scenario, Step by Step Demonstration | PLAB 2, UKMLA | SimMan Case

foreign [Music] so first uh read the scenario brief thoroughly read the scenario rehearse of what you're going to do when you enter the room okay so that you will have an idea of what you're going to perform uh when you enter the room after reading the scenario look for clues in the room like insulin syringes inhalers and adrenal syringes Etc when you enter the room first introduce yourself to the patient and say you'll be taking all universal precautions talk to the patient or talk to the Sim man treat him as a real patient and ask for the main presenting complaint if the patient is hemodynamically stable then expand on the complaint if the patient is unstable then you can proceed straight to a to e assessment explain the patient you would like to examine and obtain consent start at approach in all the scenarios and treat and reassess in every situations once you've done an intervention reassess to make sure that your intervention is working before moving on to the next step explain the plan of action at the end of the scenario now moving on to Airway a so first when you enter the room after you take universal precautions you introduce yourself to the patients hello John you all right is the patient is talking back it means the average patent if the area is not patent do you hear any additional sounds is there any lip swelling is there any tongue swelling uh can you hear any gurgling sounds or snoring noises are you able to hear any Strider or horses of voice you connect the fish with the cardiac Monitor and if the patient is hypoxic you ask for 15 liters of oxygen via non-rebreathing mask be aware of COPD patients where you have to titrate oxygen to maintain a sales of 88 to 92 percent if there are lots of secretions then you use the suction and position the patient appropriately that's your a moving on to B breathing wise first you look at the patient looking for adequate chest stress on both sides and then feeling for adequate chest stories making sure the turkey is in midline is it okay midline yes trickiest in midline percussion focusing on both his resonant resonant resonant president compare it with either sites now going for auscultations listening for add entry Iron Tree Iron Tree Elementary our entry are entry I would also examine the back of the patient finish your B by listening to the heart sound is it muffled or is it okay any additional heart sounds occur and then you ask for Respiratory saturations if you have not picked up your low SATs in a you can do it in B and if it's hypoxic you can connect to oxygen investigations wise you can ask for blood gases a b g or vbg depending upon the situation ask for chest x-ray and if the patient is easy then you give some nebulizers moving on to C first feeling for it feel the periphery is it warm or cold if it's cold then it means the patient might be in shock again look for the pulses you will also have the heart rate on the monitor but feel for the pulses to assess the volume the character and if it's steady abdomen look again is it distended or not palpate field for any obvious tenderness guarding or HDT and oscal tape for bowel sounds if it's present or absent get both on the present in C you ask for two large board IV access for all unstable patients you send Bloods for basic investigations like full blood count unes CRP lfts coagulation screening if the patient is septic when you ask for our blood cultures if the patient is bleeding then you ask a group and save and cross match four units you also asked for ECGs and cardiac patients and treatment wise you can give some antibiotics for infection by sepsis blood transfusion in cases of patients who are bleeding IV fluids for hypotensive patients and in sepsis and you can also consider txa for all bleeding patients moving on to the disability is a patient alert either you can use the fpus code or you can use a GCS whichever you're comfortable with and then check for pupils sorry John I'm going to sign some light into your eyes okay comment on the size of the people that's equal or unequal and if it's reacting to light or not and then you look for any focal neurology at the same time if you're suspecting managers you can also check for some neck rigidity or stiffness remember in the investigations wise you can ask for glucose and elevation is hypoglycemic then considered 20 textures as the first option coming on the exposure uh when you're examining the patient say that you would like to have a chapter to completely expose the patient examine look for any rash any genitals look for any cough tenderness any pedial edema any trauma on the Torso or limbs or any blood on the floor and then you also ask for temperature that's a quick whisk through of ate assessment in medical patients this is the same approach for all medical patients okay just make sure that you do the 80 approach so that you'll be able to pick up what is what are the issues and treat them accordingly laughs [Music]

Channel: Dr. Aman Arora - Arora Medical Education

Views: 11,770

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Id: cnF6jSSuLGg

Length: 5min 37sec (337 seconds)

Published: Tue Aug 08 2023