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Quick Scroll OSCE -Buster: List: Paediatrics : OSCE Stations -Contribute 07.07.05 (3 years ago) #1

Paediatrics

1. Talk to the mother about her 2 sons who have etichy skin. Take a history. They do not have fever or signs of infection. Father and another brother also developed it.
2. Counsel the mother of this diabetic child who had a hypoglycaemia episode
3. Child with overdose of paracetamol with no complications. Explain to father why there is no need for further management
4. Counsel the father of a child who was found to be having celiac disease. Answer his questions
5. Irritable hip – counsel the parents (handouts already given)
6. Lethargy, polydipsia, polyuria in a 4yr old. Talk to the mother. Explain to her the diagnosis of diabetes and counsel her
7. Child with splenic injury and fracture femur following RTA. Talk to the mother
8. Non accidental injury - 1yr old with feet scalds
9. 9 month old child has come to the causality after sustaining a head injury. Talk to the mother. Take a history and counsel her
10. Mother is concerned that her 2 year old son is still not walking. Talk to the mother
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Quick Scroll Child with splenic injury and FRACTURE femur following RTA. 07.11.05 (3 years ago) #2

Talk to the mother


Hello, Im dr.deepsea,one of the doctors around.

Im sorry that your son had an accident. We examined him and did some investigations. We found out that your son has afracture in his thigh and also he has splenic rupture. Spleen is an organ in the tummy that deals with immunity. It is a serious condition and requires urgent operation. Otherwise, there will massive internal bleeding and it can be dangerous to his life. He may also require blood transfusion and we have already arranged for it. We also need to fix the fracture in his thigh.

Do you have any questions?

We are doing everything to stabilise him, but we need to open his tummy to see the condition of spleen.For that we will have to put him to sleep. If it is badly damaged im afraid we have to remove it to save his life. If so, he will have to take an antibiotic called penicillin for the rest of his life, because his immunity will be low once spleen is removed. He will also need to take jabs against 2 bugs.

He will have to be in hospital for sometime depending on his recovery and needs close monitoring.
Do you have any questions?

If you understood and agreed to what we have said , we want you to sign this form.
Plase donot worry. We are doing our best and lets hope that he will be fine soon.

Thank You.

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Quick Scroll 08.27.07 (1 year ago) #3

This is basically a breaking bad news station.
Don not assume that the parent knows what has happened to the child. Break the news early but do it in a stepwise fashion so that the parent doesn't ract adversely to you or go into shock.
Again, yu have to develop rapport with the patient otherwsie the station might go pear shaped., you'll spend the rest of the five minutes comforting the parent rather than being able to give the relevant information. Because everything else in the above note is absolutely perfect except....howwould you feel if the doctor came up to you and say that you're child has a broken leg and ruptured spleen when you were just called from work to the hospital because something had happened to the child because you don't know what's happened at all!!!!!
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