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SECTION OF EDUCATION
OSCE MARK SCHEME
MODULE: CHILD AND FAMILY HEALTH WITH DERMATOLOGY
Station: DRABCDE Croup
Candidate Instructions: A 2 year old boy presents to A&E at night, struggling to
breath and with a worsening cough. Symptoms started approximately 48 hours ago,
and the patients’ condition has been gradually deteriorating. You have been asked
by the senior nurse to assess and treat this patient immediately.
Action
Latest Observations:
HR - 150bpm
BP – 120/80
RR – 23
Temperature - 37.5
O2 Sats - 95% on room air
Urine Output - Not known
Washes hands
Danger? – “Safe to approach”
Response? – The child is responsive but has a very hoarse voice and is
coughing
(Have to ask about both)
Call for senior HELP – Give mark if done at any point during this station
Airway
Look
Feel
Listen
Measure
Treat
Breathing
Look
Feel
Listen
Measure
P
BL
F
Mark
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Airway looks clear
(1 mark for offering to look in airway due to hoarse voice)
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 Cyanosis
 Chest wall recession
(Mention 1 for mark)
 Symmetrical chest movement
 Nothing on percussion
(Mention 1 for mark)
 Barking cough
 Stridor (high-pitched)
 Auscultation – generalised poor air entry
(1 mark for each symptom enquired about)
 O2 sats – 95% on air
 RR – 23
(Mention both for mark)
© UCLU Medical Society 2013
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uclumedicalsociety
SECTION OF EDUCATION
 Gives oxygen
 CXR to exclude foreign body
(Mention 1 for mark)
“Patient now very cyanosed and has severe stridor”
Circulation
Look
Pale and cyanosed
(Mention 1 for mark)
Feel
Warm to touch, pulse regular but rapid
Listen
Normal heart sounds
Measure
 HR - 150
 Cap Refill - < 2 seconds
 Temp – 37.5
 BP – 120/80
(Mention 2 for mark)
Treat
Monitor heart rate
Disability
A
V
Now falling in and out of consciousness, responding to voice
P
U
Exposure
BM -Normal
Treat
Treat
Must say either:
 Single dose – Oral dexamethasone (0.15mg/kg )
OR
 Nebulised budesonide (2mg)
(1mark)
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And
 Nebulised adrenaline
(1 mark)
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Management
 Call ITU
 Write in notes
 Monitor O2 and heart rate
(Mention 1 for mark)
Global
Score (for
borderline
candidates)
A – Clear Pass
B – Pass
C – Borderline
D – Fail
E – Clear fail
© UCLU Medical Society 2013