1. Stress Based Scenarios!

2. “He’s never going to lie still for a CT”
54yr male, “had a few”, BIBA, semiconscious, head-brace and collar, flailing around.
“Can you come to A+E he needs a CT head”.
GCS – E4, M4, V4 – 12/15
Ask for help

3. Plan? Attend A+E O2, ABC Attempt to get history Examine
Friend
Paramedics
Examine
Sedation vs GA?
Ask for help

4. Management RSI GA – C-spine? ODP Thio, sux, ETT
Transfer to CT – what drugs?
CT scan problems?
Ask for help

5. Results CT normal – plan? CT shows some sub-dural blood – plan?
CT shows large intracranial bleed – plan?
Ask for help

6. Variations Seizures. Post-ictal. Overdose. Old person ?stroke.
Ask for help

7. Routine Appendix 23yr male – likely appendix. Management plan.
Ask for help

8. RSI
Before any of this?

9. Failed intubation

10. Can’t intubate can’t ventilate
Who goes for help?

11. Quick review for laparotomy.
74yrs old female, abdominal distension, NBM, U+Es worsening, oliguric.
Hypertensive, Type II diabetic.
“Dances twice a week”
Quick anaesthetic review.
Ask for help

12. Pain “Epidural not working” “PCA not working”
“Oramorph is not strong enough”
Ask for help

13. Cardioversion 58yr old. Palpitations. AF 130-170
Can you come to A+E so we can do a quick cardioversion?
Plan?
Ask for help

15. Ambulance transfer
“Sorry but there’s no-one else”
Ask for help

16. The End
Ask for help