Collapse in the waiting room
AMC Clinical practice station

The task

You are a doctor in a suburban general practice. Mrs Eileen Fraser, aged 71, fainted in the waiting room about five minutes ago and has now woken on a trolley in the treatment room. The practice nurse, Hamid, is with you. The emergency department registrar can be reached by telephone once you decide to call. Assess and stabilise her, decide what to do next, and give a telephone handover as you would to the receiving doctor. Observations and examination findings will be given on request.

What this station tests

• Call 000 early for an unstable patient in primary care; stabilise while waiting.
• Interpret observations together: slow pulse with low blood pressure after collapse needs emergency care.
• Stop drugs that slow the heart rate and avoid delaying transfer for tests.
• ISBAR handover has five parts; close the loop by repeating the plan back.
• Give the team specific tasks and ask for repeat observations with times.

Sources for the clinical content

• Australian Resuscitation Council and NZ Resuscitation Council: Guideline 11.9, managing acute dysrhythmias
• Triple Zero Australia: when to call 000
• ACSQHC: Communicating for Safety Standard

An original practice scenario with invented patients. Not an exam question.

Practise next

• Fever and abdominal pain after bowel surgery
• Fall at home with a knock to the head in an older man