INTRODUCTIONS
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Trunk → Branches → Twigs → Leaves
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The 8 ACEM OSCE Domains
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Health Advocacy Domain
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The 7 ACEM OSCE Stations "Types"
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SCBD Structures
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SCBD Example 1 (Upper GI Bleed)
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SCBD Example 2 (Cocaine Overdose)
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Communication Stations
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The Importance of the Differential Diagnosis
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Teaching Stations
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Do Not Use These Notes For Patient Care
Learnings from 5 years of ACEM Fellowship OSCE Examiner Reports
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ACEM exam reports - how to use this section
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Golden Rules from 5 years of OSCE exam reports
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SCBD Station Reports
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History-Taking Station Reports
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Communication Station Reports
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Teaching/Procedures Station Reports
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JMO Clinical Discussions (non-teaching) Reports
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Physical Examination Station Reports
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Department Management / Admin Station Reports
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Health Advocacy Stations
SCENARIOS - BASED ON COMMON FAILURE MODES IN REAL EXAMS
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01 Fall from a ladder
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02 The unwell infant
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03 Bilateral leg weakness
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5 Chest discomfort in a young athlete
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04 The recurrent headache
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06 Pelvic injury preparation
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07 A junior doctor meeting
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08 Busy evening shift
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09 Painless jaundice and weight loss
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10 A family meeting
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11 The patient who wants to leave
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12 A registrar asks to speak with you
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13 Chronic back pain
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14 A forearm injury
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15 A scald in a toddler
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16 Advice on an intoxicated patient
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17 Urethral discharge and dysuria
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18 An acute deterioration in a frail patient
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19 A disposition decision overnight
COMMUNICATION STATIONS
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Useful phrases
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Adverse outcome/event
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Impaired colleague
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Breaking Bad News
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Non-Accidental Injury (NAI)
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Domestic Violence
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End of Life discussions
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First seizure
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Trainee discloses error
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Workplace bullying - confederate on receiving end
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Sexual Assault
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Chronic pain
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Discharge Against Medical Advice
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Hot Debrief (after a resus)
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Disagreement with another team
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Vaccine / Treatment Refusal
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Blood Transfusion Refusal
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Antibiotics for URTI / Acute otitis media
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Patient who recurrently represents
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Safe Discharge Planning
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Ceilings of Care Discussions (with family member)
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Miscarriage
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Elder Abuse
ADMIN / DEPARTMENT MANAGEMENT
SCBD
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Useful Headline Statements
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Pre-arrival Preparation
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Patient transfer
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Any major bleeding
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STEMI
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Massive Transfusion
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CPR
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Return of Spontaneous Circulation (ROSC)
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Intubation
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Intubation - pre-arrival
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Airway plan & CICO
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Airway modifiers
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Ventilation
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Post-intubation hypoxia
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Post-intubation hypotension
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Laryngospasm
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Non-Invasive Ventilation (NIV)
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Procedural sedation
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Trauma
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Traumatic cardiac arrest
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Head injury
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Penetrating neck trauma
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Pneumothorax
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Subarachnoid Haemorrhage (SAH)
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Decompensated liver failure
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Asthma (life-threatening)
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Tracheostomy emergency
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Epistaxis
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Post-tonsillectomy bleed
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Neonatal resus (birth)
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Paediatric airway
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Restraint (physical + chemical)
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Sick neonate
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Seizures
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Pregnancy Emergencies
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Pre-eclampsia
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Bleed during thrombolysis
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Pulmonary Embolism
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Arrhythmia
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Guillain-Barré syndrome (or other paralysis)
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Blood transfusion reaction
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Diabetic Ketoacidosis (DKA)
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Hyperosmolar Hyperglycaemic State (HHS)
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Alcoholic Ketoacidosis
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Imaging - "Discuss" pros/cons
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Sickle cell emergencies
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LQT syndrome
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Thyroid storm
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Extubation in ED
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Anticoagulant reversal
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Cooling / Warming
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Drowning
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Burns
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Hanging
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Elderly trauma
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Stroke
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Confusion in Liver Disease
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Toxicology Assessment
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Toxicology Management
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Toxicology: Shock
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Toxicology: Differentials
HISTORY TAKING
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Overall Structure for Any History Station
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Syncope
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Refugee History
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Mental State Examination
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Suicide Risk Assessment
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Mania
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Toxicology Risk Assessment
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Needlestick
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Headache
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Headache (Paediatric)
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C-spine injury
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Lower Back Pain
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Chest Pain
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Troubled Teenager
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Eating Disorder
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Pregnancy
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Thyroid
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Asthma
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Fever in Returned Traveller
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Foreign Body Ingestion
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Sexual History
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Unprotected Sexual Intercourse (UPSI)
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Recreational Drug use
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New Atrial Fibrillation (AF)
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Pre-eclampsia History
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Snake Bite
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Alcohol Withdrawal
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Pulmonary Embolism
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TIA / Stroke History
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Eye History
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Inflammatory Bowel Disease
DIFFERENTIAL DIAGNOSES
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Chest Pain
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Shortness of Breath
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Syncope
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Seizure
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Altered Mental State
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Weakness
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Headache
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Abdominal pain (adult)
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Abdominal pain (child)
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Unsteadiness
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Sudden Vision Loss
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Red Eye
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Leg Swelling
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Petechiae
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Per-Vaginal (PV) bleeding
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Upper GI Bleed
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Lower GI Bleed
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Paediatric Limp
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Crying / Unsettled Baby
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Lower Back Pain
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Jaundice (adult)
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Painful Joint
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Hyperkalaemia
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Paediatric Neck Lump
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Stridor
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Scrotal swelling
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Vomitting
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Cerebellar
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Cardiac Failure
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Spinal Neurology
PAEDIATRIC STATIONS
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Sick Neonate
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Paeds hydration assessment
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Febrile Child
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Kawasaki
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Febrile Convulsions
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Brief Resolved Unexplained Event (BRUE)
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Bronchiolitis
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Asthma - safe discharge discussions
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Anaphylaxis & Epipen discussion
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Paediatric Seizure
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Paediatric Head Injury
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Concussion
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C-spine assessment
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Neonatal Jaundice
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Paediatric Elbow X-Ray
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Choking
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Supraventricular Tachycardia (SVT)
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Tricky Paeds Platelets
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Unsettled / Crying Baby (Counselling)
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Persistent Cough
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Iron Deficiency Anaemia
TEACHING STATIONS
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General Structure - any teaching station
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Hyponatraemia
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ECG interpretation
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ST Elevation (ECG)
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QRS Prolongation (ECG)
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Blood Gas Interpretation
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Toxicology VBG
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Body Fluids Analysis
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Diplopia
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CT Brain Interpretation
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C-Spine X-Ray Interpretation
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Scaphoid #
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Ultrasound-Guided Need Procedure
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Point of Care Ultrasound Imaging (POCUS)
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PE in Pregnancy - Approach
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SVT with Aberrancy vs Ventricular Tachycardia (VT)
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ECG - Arrhythmia Differential
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Acute Kidney Injury (AKI) - an approach
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Renal Colic - approach
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Orbital Blow-Out Fracture
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Compartment Syndrome
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Hyperemesis Gravidarum
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Autonomic Dysreflexia
EXAMINATIONS
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General Structure for any Examination Station
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Thyroid
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Neck Mass
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Breast
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Vertigo
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Unsteady Gait
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Cerebellar Exam
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Trauma - Primary Survey
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Trauma - Secondary Survey
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Facial Injury
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Gunshot Wound
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Lower Limb Neuro
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Sensory Change (Numbness) approach
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Mononeuropathies
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Cranial Nerve Exam
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Facial Weakness
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Acute Stroke Examination
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Eye Exam
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Ear Exam
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Abdominal Exam
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General MSK Exam
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Summary MSK Special Tests
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Shoulder
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Elbow
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Hand & Wrist
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Spine
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Hip
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Knee
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Foot & Ankle
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Difficult Airway Assessment
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Cardiac Failure (CCF) Exam
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Respiratory Exam
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Scrotal Exam
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Pregnant Abdomen
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Gynaecological Exam
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Hernia
COURSE FEEDBACK
