Teaching a junior doctor to take blood cultures
PLAB 2 practice station
Teaching · 1 min to read · 8 min to perform
Mr Desmond Walsh, aged 77, has a temperature of 38.9 °C and needs blood cultures before antibiotics.
Desmond WalshGo on then, doctor. I do not mind helping the young doctor learn, as long as it does not hurt too much.
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You are a doctor on a medical ward. Mr Desmond Walsh, aged 77, has a temperature of 38.9 °C and needs blood cultures before antibiotics. Dr Aroha Ngata, a foundation doctor in her first week, has never taken blood cultures and has asked you to show her. Mr Walsh is awake and has agreed to you both being at the bedside. Teach Dr Ngata how to take blood cultures safely, as you would with a junior colleague, speaking aloud to her and to Mr Walsh. You do not need to complete the procedure. The examiner will not take part in the conversation.
What this station tests
- Find out what the learner already knows before you teach.
- Demonstrate, then supervise, then give specific feedback; ask the learner to teach it back.
- Aseptic non-touch technique, chlorhexidine in alcohol that is allowed to dry, a fresh venepuncture site, and bottle tops disinfected, reduce contamination.
- Take blood cultures before antibiotics but never delay antibiotics in sepsis.
- Protect the patient: consent, comfort and dignity apply during teaching.
Sources for the clinical content
- NICE NG253: Suspected sepsis in people aged 16 or over: recognition, assessment and early management
- GMC Good medical practice: teaching, training, supporting and assessing
- NHS National Services Scotland: review of how to prevent blood culture contamination
An original practice scenario with invented patients. Not an exam question.