Eclamptic seizure scenario

candidate brief

actor brief

examiner brief

pregnant patient initially hypertensive 30/40
then starts seizing
objective - recognise eclampsia, open ddx, give Mg

Initial obs:
SpO2 96% on air, RR 16
HR 70, BP 149/90
GCS 15/15

Halfway through assessment (at minute 2-3), patient starts seizing
Seizures will continue if Mg is not given

  • Washes hands, introduces self
  • Confirms patient identity
  • Identifies team competencies
  • Takes brief history
  • Past medical history
  • Drug history, allergies
  • Responds appropriately to change in clinical status
  • Airway assessment
  • Breathing assessment
    • spO2, RR
    • inspects, palpates, auscultates chest
  • Circulation
    • IV access
  • Disability
    • GCS, blood glucose
    • MgSO4
  • Exposure
    • Consideration for urinanalysis
  • Establishes appropriate escalation to specialty - obstetrics, neonates, ICU/anaesthetics
  • Requests appropriate investigations
    • Bloods including FBC/U+E/Ca/Phos/Mg/LFT
    • Consideration for CT head
  • Plans for ... critical care, intubation, emergency c-section...
  • Leads team well
  • Global mark from examiner

#gynae-obstetrics

Revision: pre-eclampsia