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Date Completed: 05/04/2023
Page 1 of 15
- Procedural Skills (SLO6)
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Chest Drain Insertion: Seldinger Technique
A 40 year old, lifelong smoker, presents to ED with sudden onset breathlessness. On examination, he has reduced chest expansion and decrease
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Central Venous Cannulation
Whilst on your ITU rotation, you are asked to perform central venous cannulation on a patient with shock. Which of the following is an advan
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Intraosseous Access
You are completing your Advanced Life Support (ALS) refresher course. You are currently discussing intraosseous access. Regarding intraosseo
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Intraosseous Access
A 10 year old boy is brought into ED following a collapse. He has no signs of life and paramedics have started CPR. They have not yet manage
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Arterial Blood Gas Analysis
A 71 year old patient presents to ED following a collapse. Her arterial blood gas results are: pH = 6.9 PaO2 = 11.0 kPa PaCO2 = 6
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Airway Assessment
You have been asked to come in early to assist in the anaesthetic pre-operative assessment of patients who are due to undergo elective ortho
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Reduction of Fracture and Dislocation
You are giving a teaching session for junior colleagues based in the Emergency Department. You are discussing reduction of fracture and disl
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Chest Drain Insertion: Open Thoracostomy
You receive a pre-alert from the ambulance service regarding a 17 year old male who has received multiple stab wounds to the chest. The para
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Procedural Sedation: Drugs
You are preparing to perform procedural sedation on a patient who requires a closed reduction of an ankle fracture. You have decided to use
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Bier’s Block
A 72 year old woman presents to the Emergency Department after injuring her wrist following a slip on ice. She has a dinner fork deformity o
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Focused Assessment with Sonography for Trauma (FAST)
You are participating in a simulation session for Focused Assessment with Sonography for Trauma (FAST). You are currently discussing Echocar
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Airway Assessment
You are working in the anaesthetics department on your ACCS rotation being supervised during a routine surgical list. This is your view at d
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Central Venous Pressure Waveform
You are assessing the central venous pressure waveform on a patient in ITU who was admitted with sepsis. Regarding the central venous pressu
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Lumbar Puncture
A patient presents to ED with a fever, headache, neck stiffness and photophobia. Meningitis is suspected and a lumbar puncture is performed.
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Lumbar Puncture
A patient presents to ED with a headache, neck stiffness and photophobia. You suspect meningitis. Lumbar puncture is performed and you are r
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Procedural Sedation: Drugs
You are preparing to perform procedural sedation on a patient who requires a closed reduction of an ankle fracture. You have decided to use
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Paediatric Ketamine Sedation
You have been asked to assist in performing a ketamine sedation for a child who requires suturing to a large laceration on her right thigh.
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Surgical Cricothyroidotomy
A 21 year old woman is brought to ED following a severe allergic reaction. Whilst in ED her lips and tongue continue to swell despite approp
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Arterial Blood Gas Analysis
A 28 year old patient presents to ED following a collapse. His arterial blood gas results are: pH = 7.25 PaO2 = 11.1 kPa PaCO2 =
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Central Venous Pressure Waveform
You are discussing the central venous pressure waveform in a teaching session for medical students. What does the y descent represent on the
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Surgical Cricothyroidotomy
You have been asked to teach a group of medical students about airway rescue manoeuvres. You are currently discussing cricothyroidotomy. Whi
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Waveform Capnography
A 40 year old man is brought into ED with severe pneumonia in type I respiratory failure. A decision is quickly made for escalation to criti
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Nasogastric Tube Placement
You are asked to insert a nasogastric tube for feeding. The chest x-ray to confirm nasogastric tube placement is shown. What is the most app
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Central Venous Cannulation
Whilst on your ITU rotation, you are asked to perform central venous cannulation on a patient with sepsis. Which of the following is an adva
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Airway Assessment
As part of your anaesthetic rotation you are working on a routine surgical list. The airway assessment has been done earlier that day by the
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Waveform Capnography
A 51 year old man is brought into ED following a choking episode in a restaurant which led to cardiac arrest. The paramedics led resuscita
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Intraosseous Access
A pre-alert call arrives for a 21 year old male patient involved in a road traffic collision with extensive blood loss. The paramedics have
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Fascia Iliaca Block
A 74 year old woman presents to ED following a fall. She complains of pain in her right hip and her right leg is shortened and externally ro
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Central Venous Pressure Waveform
You are discussing the central venous pressure waveform in a teaching session for medical students. What does the x descent represent on the
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Airway Assessment
A 60 year old overweight man, with known sleep apnoea, is brought into ED with respiratory distress. You are planning for intubation and p
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Procedural Sedation: Drugs
You are discussing procedural sedation in an Emergency Department peer to peer teaching session. Which of the following best describes the m
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Emergency Airway Management
A 51 year old man presents to ED following a road traffic collision with significant facial trauma. On examination you note gurgling and 'se
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Lumbar Puncture
A 21 year old student is sent in to ED by his GP with suspected meningitis. You are about to perform a lumbar puncture. Which of the followi
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Large Joint Aspiration
A 29 year old man presents to ED with a red hot painful left knee. Joint aspiration is performed and the results are: Colour: cloudy ye
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Abdominal Aorta Ultrasound
You are observing a consultant performing an abdominal aorta ultrasound in an older man who presented to ED with new onset back pain. Which
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Focused Assessment with Sonography for Trauma (FAST)
You are participating in a simulation session for Focused Assessment with Sonography for Trauma (FAST). Which of the following is NOT a stan
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Waveform Capnography
You are leading a teaching session for your colleagues on waveform capnography. What does the letter 'D' denote?
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Arterial Blood Gas Analysis
A 61 year old patient presents to ED complaining of breathlessness. His arterial blood gas results are: pH = 7.37 PaO2 9 kPa PaCO
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Intraosseous Access
A 3 year old girl is brought into ED by her parents with a fever and non-blanching rash. On assessment she is poorly responsive with signs o
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Focused Assessment with Sonography for Trauma (FAST)
You are participating in a simulation session for Focused Assessment with Sonography for Trauma (FAST). Which of the following is NOT an adv
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Arterial Cannulation
You have been asked to perform arterial cannulation on a patient who is being transferred to ITU. Regarding arterial cannulation, which of t
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Non-Invasive Ventilation
A 64 year old man presents to ED with a 3 day history of worsening breathlessness. He has a past medical history of COPD. His observations a
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Bier's Block
A 76 year old woman presents to the Emergency Department after falling at home. She has sustained a dorsally angulated fracture of her domin
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Waveform Capnography
A 23 year old woman is brought to ED after falling down an escalator in a shopping centre. She has been intubated by a pre-hospital critical
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Airway Assessment
You are leading a teaching session for junior ED colleagues and discussing airway assessment in the ED. Which of the following is a distance
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Airway Assessment
A 19 year old man presents to ED with a dislocated shoulder after falling at a rugby match. Attempted reductions with entonox are unsuccessf
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Rapid Sequence Induction: Drugs
You are being observed performing a rapid sequence induction on a patient who was brought in unconscious following an alleged assault. You a
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Needle Cricothyroidotomy
You are participating in a airway simulation station. You have failed to intubate the patient and now are unable to ventilate the patient us
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Digital Nerve Block
A 29 year old farmer presents with a crush injury to his left index finger. In order to fully assess the wound, you are planning to perform
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Lumbar Puncture
A 49 year old woman presents to ED complaining of a sudden onset posterior headache and photophobia. Initial CT head was reported as normal.
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Arterial Blood Gas Analysis
You are asked to review an arterial blood gas (ABG) that has been performed by a junior colleague. The ABG shows a normal anion gap metaboli
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Arterial Pressure Waveform
Whilst on your ITU rotation a nurse asks for your assistance with assessing the arterial pressure waveform. You determine the trace is overd
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Lumbar Puncture
A 72 year old patient presents to ED with a fever, headache and neck stiffness. You suspect meningitis. A lumbar puncture is performed and t
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Ultrasound Guided Vascular Access
You are running a skills based teaching session for medical students and focusing on difficult peripheral venous access. Which of the follow
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Waveform Capnography
You are leading a teaching session for your colleagues on waveform capnography. Which of the following denotes the end-tidal carbon dioxide
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Arterial Blood Gas Analysis
A 35 year old man is brought to the Emergency Department after being found collapsed at home by his girlfriend. Calculate his anion gap usin
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Procedural Sedation: Drugs
You are preparing to perform procedural sedation on a patient who requires a closed reduction of an ankle fracture. You have decided to use
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Fascia Iliaca Block
You are giving a teaching session to junior colleagues regarding regional anaesthesia in the ED. You are discussing fascia iliaca blocks. Re
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Abdominal Aorta Ultrasound
A colleague asks you to perform a bedside ultrasound to exclude abdominal aortic aneurysm (AAA) as a differential diagnosis in a gentleman p
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Chest Drain Insertion: Seldinger Technique
A 40 year old man presents to ED with sudden onset chest pain and breathlessness. X-ray shows a large left sided pneumothorax. A seldinger c
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Lumbar Puncture
A 42 year old man presents to ED complaining of a headache and a fever. A lumbar puncture is performed and the results show: WCC 460 ce
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Chest Drain Insertion: Open Thoracostomy
You are leading a teaching session on chest drain insertion and discussing the recommended site of insertion. Which of the following landmar
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Fascia Iliaca Block
A 74 year old woman presents to ED following a fall. She complains of pain in her right hip and her right leg is shortened and externally ro
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Procedural Sedation: Procedure
You are preparing to perform a procedural sedation for a reduction of an ankle fracture-dislocation. Regarding procedural sedation, which of
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Lumbar Puncture
You are asked to review a 32 year old man in ED who has presented with a fever of 38.2°C and a headache. His flatmate brought him to ED as
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Arterial Blood Gas Analysis
A 55 year old, lifelong smoker, presents to ED with breathlessness. His observations are: BP 135/86, HR 105 bpm, RR 24, SpO2 82% OA. His ABG
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DC Cardioversion
A 89 year old patient presents to ED feeling unwell with palpitations. He is pale and sweaty and his blood pressure is 80/60 mmHg. His ECG s
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Procedural Sedation: Drugs
You are discussing procedural sedation in an Emergency Department peer to peer teaching session. Which of the following best describes the m
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Central Venous Pressure Waveform
You are discussing the central venous pressure waveform in a teaching session for medical students. What does the v wave represent on the wa
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Pleural Aspiration
A 21 year old patient presents to ED with a primary spontaneous pneumothorax. You are asked by your consultant to perform a pleural aspirati
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Pleural Aspiration
A 26 year old man presents to ED with a pain in the right side of his chest which came on very suddenly. He has no previous medical history.
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Arterial Blood Gas Sampling
A 59 year old patient presents to ED complaining of chest pain and breathlessness. You are supervising a medical student performing an arter
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Waveform Capnography
A 35 year old woman is brought into ED after being found unresponsive at home. Her GCS is 6 on arrival. An end-tidal nasal cannula shows the
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Large Joint Aspiration
A 69 year old woman presents to ED with a red hot painful left knee. Joint aspiration is performed and the results are: Colour: clear y
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Bier's Block
A 76 year old woman presents to the Emergency Department after falling at home. She has sustained a dorsally angulated fracture of her domin
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Resuscitative Thoracotomy
You are participating in a trauma simulation in which the patient requires resuscitative thoracotomy. Which of the following muscles is divi
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Lateral Canthotomy
A 27 year old man presents to the Emergency Department after being hit in the right eye by a squash ball. His visual acuity is greatly reduc
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Chest Drain Insertion: Open Thoracostomy
You are asked to perform an open thoracostomy and chest drain insertion on a trauma patient with a large pneumothorax. You are identifying t
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Lumbar Puncture
An 18 year old female is brought to ED with a fever, headache and neck stiffness. Meningitis is suspected and your consultant asks you to pe
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Focused Assessment with Sonography for Trauma (FAST)
A 28 year old man is brought into ED following a road traffic collision in which he was knocked off his motorcycle by a van. He has intraven
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Bier’s Block
An 82 year old woman presents to the Emergency Department after injuring her wrist following a fall in a supermarket. She has a dinner fork
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Emergency Airway Management
You are completing your refresher Advanced Life Support (ALS) Course and discussing emergency airway management. Regarding emergency airway
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Procedural Sedation: Procedure
A 29 year old man presents to ED following a rugby injury in which he sustained an anterior shoulder dislocation. You are performing shoulde
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Chest Drain Insertion: Seldinger Technique
A 65 year old patient, who has smoked all his life, presents to ED complaining of a sudden pain in his right chest and shortness of breath.
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Airway Assessment
You are working on your anaesthetics rotation and have been asked to perform an airway assessment on a patient due to undergo elective chole
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Temporary Cardiac Pacing
A 67 year old woman is brought into the Emergency Department by her husband. She has been complaining of increasing breathlessness and chest
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Central Venous Pressure Waveform
You are discussing the central venous pressure waveform in a teaching session for medical students. What does the c wave represent on the wa
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Non-Invasive Ventilation
A 65 year old woman with known COPD presents to ED with worsening breathlessness and wheeze. Her observations on admission are: BP 135/87, H
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Bier's Block
A 76 year old woman presents to the Emergency Department after falling at home. She has sustained a dorsally angulated fracture of her domin
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Arterial Blood Gas Analysis
A 65 year old is brought into the Emergency Department after being found unresponsive on a park bench. An arterial blood gas is performed an
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Focused Assessment with Sonography for Trauma (FAST)
You are being observed performing a Focused Assessment with Sonography for Trauma (FAST) on a patient who was brought to ED following a road
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Focused Assessment with Sonography for Trauma (FAST)
You are participating in a simulation session for Focused Assessment with Sonography for Trauma (FAST). An image of the abdomen is shown. Wh
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Chest Drain Insertion: Seldinger Technique
A 21 year old man presents with sudden onset chest pain and shortness of breath. Chest x-ray demonstrates a large left sided pneumothorax. A
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Rapid Sequence Induction: Drugs
A 39 year old man is brought to ED by ambulance with reduced GCS. He was found at home surrounded by multiple empty pill packets. His GCS is
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Central Venous Pressure Waveform
You are discussing the central venous pressure waveform in a teaching session for medical students. What does the a wave represent on the wa
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Needle Pericardiocentesis
Multiple casualties have been brought to your ED following a high speed multi-vehicle collision on a nearby motorway. You are caring for a p
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Perimortem Caesarean Delivery
A 24 year old woman, at 30 weeks gestation, presents unresponsive with cardiopulmonary resuscitation (CPR) in progress after a high speed mo
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Bier's Block
A 76 year old woman presents to the Emergency Department after falling at home. She has sustained a dorsally angulated fracture of her domin
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Airway Assessment
You are participating in a teaching session at the start of your anaesthetic rotation and discussing the view at direct laryngoscopy. Which
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Waveform Capnography
A 25 year old male is brought into ED overnight with a GCS of 5 following a suspected mixed overdose. You perform an RSI and subsequently re
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DC Cardioversion
A 74 year old patient presents to ED feeling unwell with palpitations. She is pale and sweaty and her blood pressure is 80/60 mmHg. Her ECG
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Arterial Pressure Waveform
You are discussing the arterial pressure waveform in an ITU teaching session. Regarding arterial pressure waveform, which of the following s
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Nasogastric Tube Placement
You are asked to insert a nasogastric tube for feeding. The chest x-ray to confirm nasogastric tube placement is shown. What is the most app
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Chest Drain Insertion: Open Thoracostomy
You are asked to perform an open thoracostomy and chest drain insertion on a trauma patient with a large pneumothorax. You are identifying t
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Lumbar Puncture
A woman presents to ED complaining of a sudden onset posterior headache and photophobia. You have been asked to perform a lumbar puncture 12
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Fascia Iliaca Block
You are giving a teaching session to junior colleagues regarding regional anaesthesia in the ED. You are discussing fascia iliaca blocks. Wh
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Large Joint Aspiration
A 55 year old woman presents to ED with a red hot painful right knee. Joint aspiration is performed and the results are: Colour: cloudy
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Central Venous Cannulation
A 26 year old woman is brought into the Emergency Department after returning from holiday. She is short of breath and chest x-ray shows uppe
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Focused Assessment with Sonography for Trauma (FAST)
A 22 year old motorcyclist is brought into ED following a road traffic collision. On initial assessment during the primary survey, the patie
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Arterial Cannulation
You are giving a teaching session to a group of junior colleagues about arterial cannulation. Which of the following is NOT an indication fo
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Arterial Blood Gas Analysis
You are giving a teaching session on arterial blood gas analysis to a group of medical students. Regarding arterial blood gas analysis, whic
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Arterial Blood Gas Sampling
A 76 year old man presents to ED complaining of chest pain. Whilst seeing the triage nurse, the patient collapses and CPR is started. The te
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Nasogastric Tube Placement
You are asked to insert a nasogastric tube for feeding. The chest x-ray to confirm nasogastric tube placement is shown. What is the most app
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Pleural Aspiration
A 19 year old tall thin male presents to ED complaining of shortness of breath. He has reduced air entry and hyperresonance on the left side
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Rapid Sequence Induction: Drugs
A 26 year old man is brought into ED following a road traffic collision. You are preparing to perform an RSI with suxamethonium. Suxamethoni
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Arterial Pressure Waveform
Whilst on your ITU rotation, you are on a ward round when your consultant asks about the arterial waveform displayed on the patient's monito
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Paediatric Ketamine Sedation
You have been asked to assist in performing a ketamine sedation for a child who requires suturing to a large laceration on her right thigh.
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Focused Assessment with Sonography for Trauma (FAST)
A 26 year old woman is brought to ED following a road traffic accident. Focussed assessment for sonography in trauma (FAST) on the supine pa
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DC Cardioversion
A 32 year old woman presents to ED complaining of chest pain and palpitations. Her ECG shows a narrow-complex tachycardia with a rate of 150
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Arterial Blood Gas Analysis
An 18 year old female student, who is known to have type 1 diabetes mellitus presents to ED with polyuria, polydipsia, nausea and abdominal
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Non-Invasive Ventilation
A 60 year old patient, with known COPD, presents to ED with an acute exacerbation. After initial therapy with controlled oxygen and bronchod
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Waveform Capnography
A 21 year old man with known epilepsy is brought into ED in status epilepticus. Initial treatment is unsuccessful and a decision is made to
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Needle Pericardiocentesis
A 21 year old man is brought to ED having been involved in a road traffic accident. He is hypotensive with muffled heart sounds and distende
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Procedural Sedation: Procedure
A 45 year old roofer presents to ED with a painful left shoulder after falling from his ladder. X-ray demonstrates an anterior shoulder disl
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Arterial Blood Gas Analysis
You are asked to review an arterial blood gas (ABG) that has been performed by a junior colleague. The ABG shows an raised anion gap metabol
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Needle Thoracocentesis
A 21 year old is brought into ED with a stab wound. During the primary survey, your consultant diagnoses a tension pneumothorax and advises
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Arterial Blood Gas Analysis
A 21 year old patient presents to ED complaining of chest pain and breathlessness. Her arterial blood gas results are: pH = 7.49 PaO
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Large Joint Aspiration
A 41 year old man presents to ED with a red hot painful right knee. Joint aspiration is performed and the results are: Colour: cloudy y
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Abdominal Aorta Ultrasound
A 79 year old man is brought to ED following a syncopal episode at home. He is complaining of new onset abdominal pain. He has a past medica
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Procedural Sedation: Drugs
You are preparing to perform procedural sedation on a patient who requires a reduction of an anterior shoulder dislocation. Which of the fol
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Abdominal Aorta Ultrasound
A 72 year old man presents to ED complaining of abdominal pain radiating to his back which came on about 4 hours ago. You ask your consultan
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Focused Assessment with Sonography for Trauma (FAST)
You are participating in a simulation session for Focused Assessment with Sonography for Trauma (FAST). Which of the following is NOT true o
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Waveform Capnography
A 24 year old is brought to ED by the police after causing a disturbance in the local high street. She has been involved in a violent alterc
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Central Venous Cannulation
A 50 year old man is brought to ED with haemorrhagic shock following a major road traffic collision. You are inserting a subclavian central
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Bier's Block
You have been asked to perform a Bier's block on a patient with a Colles fracture. Regarding Bier's block, which of the following statements
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Procedural Sedation: Drugs
You are discussing procedural sedation in an Emergency Department peer to peer teaching session. Which of the following best describes the m
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Intraosseous Access
A 31 year old, known IV drug user, is brought to ED in cardiac arrest. The paramedics have been unable to establish intravenous access due t
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Needle Cricothyroidotomy
You have been asked to teach a group of medical students about airway rescue manoeuvres. You are currently discussing cricothyroidotomy. Whi
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Chest Drain Insertion: Open Thoracostomy
A 23 year old cyclist is brought into the Emergency Department following a collision with a car. The patient is poorly responsive, tachycard
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Nasogastric Tube Placement
You are asked to insert a nasogastric tube for feeding. The chest x-ray to confirm nasogastric tube placement is shown. What is the most app
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Waveform Capnography
A 64 year old patient who presented with chest pain and shortness of breath collapses whilst having his chest x-ray. CPR is commenced and th
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