Chest pain scenario 1
candidate brief
Mr Hector has been brought in by ambulance following an episode of chest pain. Please take a history.
60% history taking, 20% communication 20% clinical reasoning
actor brief
Episode crushing central chest pain a few hours ago - lasted about an hour
Called ambulance -
examiner brief
- Washes hands, introduces self
- Confirms patient identity
- Checks patient comfort before starting
- Ensures patient is stable before starting history
- Gets event history
- Enquires about pain - character, duration, time course, radiation
- Enquires about important associated symptoms
- Past medical history
- Drug history and allergies
- Social history
- Smoking
- Alcohol
- Recreational drugs
- Sensitive to patient's defensiveness re drugs
- Elicits concerns and addresses these appropriately
- Invites questions
- Appropriate management plan
- ECG, Troponin
- Explains differentials
- Thanks patient
- Global mark examiner
- Global mark patient
to imitate the chest pain with cocaine scenario