Telephone escalation of a falling neurological score
RN OSCE practice station

The task

Helen Grant is under ED observation after a fall with a head strike. The neurological chart shows a new change. Escalate using ISBAR and record the confirmed response. Do not delay urgent support to complete the form. The patient is a manikin; address the patient and the examiner voices their answers and supplies findings. Dr Taylor Singh is reachable by phone. RN Alex Morgan is available.

What this station tests

• A falling GCS with new focal findings requires emergency review.
• Anticoagulant name and last dose belong in a head-injury escalation.
• Request urgent CT and confirm the anticoagulant hold with the prescriber; never invent scan results or reversal orders.

Sources for the clinical content

• Healthdirect: Head injuries
• ACSQHC: Recognising and Responding to Acute Deterioration Standard
• ACSQHC: Communicating for Safety Standard

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

Practise next

• Telephone escalation for worsening infection
• Calling from a clinic about sudden breathlessness
• RN handover after a minor head injury
• Shift handover for a resident with acute confusion
• Calling for a child with increasing oxygen needs