Itching after an intravenous antibiotic
AMC Clinical practice station
Ethics, consent & capacity · 2 min to read · 8 min to perform
Mr Peter Nguyen, aged 67, is being treated for cellulitis of his left leg.
Peter NguyenDoctor, I'm all itchy. The nurse says you want to talk to me.
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Open the full station (charts, voice, result letter) →The task
You are a junior doctor on a medical ward. Mr Peter Nguyen, aged 67, is being treated for cellulitis of his left leg. Forty minutes ago a nurse gave him a dose of intravenous flucloxacillin, a penicillin. His chart shows a penicillin allergy recorded on admission that was missed at prescribing. The infusion was stopped as soon as the error was noticed. He is now itchy. Your registrar has asked you to assess him and speak to him about what happened. The nurse, Dana, is at the bedside. Examination findings will be given on request.
What this station tests
- Assess for anaphylaxis and treat first; open disclosure follows promptly once the patient is safe.
- Disclose the error plainly, apologise sincerely and avoid blame or speculation.
- Explain what is being done now, what happens next and how the event will be reviewed.
- Say when you do not know, and promise a follow-up that you will keep.
- Document facts, update the allergy record and report the incident through the local system.
Sources for the clinical content
- Australian Commission on Safety and Quality in Health Care: Open disclosure
- ASCIA: Guidelines for acute management of anaphylaxis
- ACSQHC: Medication Safety Standard
- Medical Board of Australia: Good medical practice, a code of conduct for doctors in Australia
An original practice scenario with invented patients. Not an exam question.