Wet dressing and dizziness after a knee replacement
RCSI OSCE practice station
Handover and escalation · 1 min to read · 10 min to perform
Take and record observations.
Mr Pádraig KellyI don't feel right, nurse. My leg is very wet and I'm a bit dizzy.
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Open the full station (charts, voice, result letter) →The task
You are the nurse on a surgical ward. Mr Pádraig Kelly, aged 58, had a total knee replacement this morning and returned to the ward four hours ago. You have been called because his dressing looks wet. A healthcare assistant is available. Introduce yourself, confirm his identity and assess him. Take and record observations. Decide what is wrong and what immediate actions to take. Then telephone the registrar using ISBAR and record your handover in the form provided.
What this station tests
- Rising pulse, falling blood pressure and a wet dressing mean bleeding until proven otherwise.
- Do not remove a saturated dressing; reinforce it.
- Escalate shock early using ISBAR with numbers.
- Hold anticoagulant doses until prescribed otherwise.
- Document actions, times and who was told.
Sources for the clinical content
- National Clinical Guideline No. 1: INEWS V2 summary, including the scoring key
- HSE: ISBAR communication tool
- NMBI: Code of Professional Conduct and Ethics
- RCSI: overseas aptitude test preparation (public topic list)
An original practice scenario with invented patients. Not an exam question.