- 17 year old pedestrian admitted 48 hrs ago following an MVA. Deeply unconscious at the scene, difficulty in securing the airway due to blood in the airway. Candidates were asked to assess neurological state and outline plan of management.
Other issues – comment on CT head, management of ICP, family discussions
Areas of weakness identified by examiners:
- Poor systematic examination of the relevant neurology.
- Application of pain to a paralysed fully sedated patient.
- CT scans: difficulty with simple diagnosis including distinguishing between an extradural and subdural
- Inability to summarise the neurology and formulate a management plan including a realistic view of the prognosis for discussion with the family.