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O2
Adrenaline 1:1000 IM
Fluids
Chlorpheniramine
Hydrocortisone
Salbutamol

Answer - Oxygen & fluids yes if the person leading has given the instruction, drugs no.

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Please ensure tracker is updated, this is checked weekly.

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ANSWER - Yes one room per week; however, if you check the night before and there is space then you can book.

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Lecturers will be moved around; 6 different scenarios per room.

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iGel is preferred over stepwise approach. However, this is dependant on organisation as iGels are more timely.

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iGel is preferred over stepwise approach. However, this is dependant on organisation as iGels are more timely.

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Could we have traumatic cardiac arrest in which osce
ANSWER - No

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Can we choose between corpus’s and lifepak
ANSWER - Yes.

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When will we find out our groups

ANSWER - not too early to prevent stress - will be given next Wednesday. Can talk to Sharyn next Wednesday and Friday if any complications.

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Do our trucks carry LUCAS devices or are they only available if we request a RAT car?

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Do our trucks carry LUCAS devices or are they only available if we request a RAT car?

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ANSWER - if you request any additional resources then it shows you are considering it for transport.

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Are we expected to intubate even if our service doesn’t allow paramedics to do it anymore?
ANSWER - no.

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What are the COPD oxygen guidelines for peri arrest/ sepsis / life threatening illnesses?

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What are the COPD oxygen guidelines for peri arrest/ sepsis / life threatening illnesses?

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ANSWER - high flow oxygen, don't tirate.

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Do we use GTN in inferior MIs? Different groups been told not to and other groups not been informed?

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Do we use GTN in inferior MIs? Different groups been told not to and other groups not been informed?

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ANSWER - Later blackboard feedback. Rationalise

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When treating life threatening asthma do you still follow the I only said I had asthma algorithm, or do you go straight to adrenaline say?
ANSWER - adrenaline is last in algorhythm.

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Easter placement dates conflicting eachother been sent two timetables that dont match

Ambulance placements will go ahead from the 8th March continuous (EMAS and YAS) including optional easter holiday.
Hospital (group B) - from the 15th March and can still go ahead with ambulance placement on Easter holiday. We will be emailed soon.

YAS students must YAS email placement team if they wish to go on easter holiday ambulance placement.

*missing hospital placements can be done in contingency weeks / uni works.

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Unable to use the trauma kit amongst the groups. Feel it is unfair some students having them for 2 weeks already.
ANSWER - advice has been given.

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Witnessed, monitored shockable cardiac arrests

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Witnessed, monitored shockable cardiac arrests

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In our OSCEs, if the patient is initially conscious but subsequently deteriorate into VF, do we recheck ABC prior to delivering the 3 stacked shocks?
ANSWER - No, deliver stacked shocks only if pads are on.

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For cocaine toxicity in an arrest do we give diazepam 10mg wait 10 minutes and give another dose 10mg- MX20mg or is that just if they are alive/ROSC ?

ANSWER - No diazepam in an arrest

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Is the OSCE on special circumstances and normal ALS scenarios or could we get Burns and HHOTT ALS?
ANSWER - Wouldn't be give HOTT or burns.

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Are we expected to intubate in our OSCE,

ANSWER - Recognise intubation need; request backup to perform. If confident then do it, not dependant on YAS or EMAS.

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Can we have a list of accepted things to ask in osces eg. Cap refill etc as advice is different from each staff member we ask ! Thanks
ANSWER - anything which will affect patient's life will result in a fail, i.e. not asking for allergies in conscious patient before administering drugs. Cap refill would not harm life so wouldn't make you fail.
Lists should be avoided.

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We are told to always do 30:2 and practice that in sessions however on JRCALC it says if an advanced airway is in place then continuous compressions should be used. Which is correct for osces and if continuous compressions is it a breath every 6 secs

ANSWER - it is advisable to pause when ventilating to ensure airway focus and to avoid leakage.

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Can you give drugs such as hydrocortisone to treat asthma or anaphylaxis during cardiac arrest or should they only be given when the patient is alive?
ANSWER - Only when conscious.

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How do you give nebulised drugs if the patient is in the supine position?

ANSWER - you can't, could use positional methods instead.

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Are we allowed to ask our crew to keep an eye on times, eg  for two minutes?
ANSWER - Yes. Initial direction from lead.

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Would we be expected to terminate resuscitation efforts in an OSCE - if the scenario fitted?
ANSWER - Yes.

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So if we get a pt with special circumstances- I.e. asthma or anaphylaxis will we be expected to remember the full regime of treatment to give - i.e salbutamol (own and neb), O2, Atrovent, hydrocortisone, Adrenaline? (Asthma)?
ANSWER - yes,

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In regards to bee stings, the JRCALC says to remove from environment causing allergy? Does this mean we have to remove the sting before starting treatment ?
ANSWER - could potentially remove if it is visible as it needs to be removed; however, wouldn't be a priority in arrest. Could stop them from going in to arrest however.

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Will we get feedback on our OSCEs as well as a mark of Pass/Fail.
ANSWER - 3 weeks for pass/fail ; feedback will be given.

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How do the OSCE get marked and is it just a Pass/Fail or is there a %
ANSWER - pass and fail

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For the marking- is it a bit like a driving test - you have so many minors before you fail or is it just a blanket pass/fail even if you make a really minor mistake?
Answer - You will refer if you make a critical error eg something dangerous or would be of detriment to your patient. A few minor errors may be Vivaed by the tutor or given in feedback.

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If we forget to put the metronome on- do we fail the osce?
ANSWER - No but compressions should be expected at a good rate.

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If needed in the OSCE can we use our JRCALC when administering drugs if we have a mind blank of the dosages ( I’ve had different answers on this)

ANSWER - medical yes, mid arrest no,

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So the scenarios we’ve been practicing have had pt’s with different levels of consciousness then eventually go into cardiac arrest - is this the setup for the osces or will the pt be in cardiac arrest already and we just treat it as a cardiac arrest from the beginning?

ANSWER - could be either.

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Are we just verbalising what drug we are giving, when and how we are giving it, how much and pretend to draw up or are we physically drawing up the drug?
ANSWER - verbalise

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So when we give meds - either before pt goes into cardiac arrest or during cardiac arrest, do we have to state the dosage of the meds we are giving as well as the name of the med? I.e the Anaphylaxis scenario, we’d potentially give Adrenaline IM if we have chance before the pt goes into cardiac arrest.

ANSWER - Yes, advisable to check drug doses via JRCALC unless life threatening and delays must not occur.

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Will the OSCE just be special circumstances or is it a mix of both special circs and normal ALS?

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Will the OSCE just be special circumstances or is it a mix of both special circs and normal ALS?

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ANSWER - a mixture

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On the corpuls, if we press AED (when patients in CA) it brings up the page that shows a countdown and how many times we’ve shocked etc- are we allowed to use that during the OSCE?

ANSWER - No AED mode in OSCEs :)

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Will we be actually expected to draw up a drug required or just verbalise drawing up a drug ?
ANSWER - Verbalisation.

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If someone else in your osce (the eca or student) does something wrong and you don't pick up on it, would that be a fail?
ANSWER - depends to what degree, direction should be from lead only. Lead should check important factors as they are directing the team.

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ANSWER - when identified or when possible, give during hypovol arrest; or when unknown cause. Always justify.

ROSC - clinical justification in sense of patient perfusion, repeat obs to maintain bloody pressure.

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If we fail our OSCE is it just one more attempt we get or do we have an IMR as well?
ANSWER - feedback within 3 weeks; IMR date (w/c 12th April) on module guidance on BB. If IMR is failed then it goes to exam board.

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Within our practise bubbles, will we be able to choose who we do our osce with?

ANSWER - groups have been revised to ensure OSCE groups will have someone (at least one person) you are familiar with. Being unfamiliar with people is more like real life - you need to be able to demonstrate leadership.

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Are we using Narcan in a cardiac arrest every minute as JRCALC advises? as every tutor suggests it will have no effect in cardiac arrest although guidelines say we must use it every minute for overdose?

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Are we using Narcan in a cardiac arrest every minute as JRCALC advises? as every tutor suggests it will have no effect in cardiac arrest although guidelines say we must use it every minute for overdose?

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ANSWER - yes use every minute as Narcan can pass blood brain barrier (not cellular level) so can metabolise during arrest. However, glucose has to pass cell barrier so cannot metabolise during arrest. Overall, yes give narcan in arrest every minute, don't give glucose.

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Do we have to insert an iGel in our OSCE if required or can our crew mate do it as long as we check it is correctly in place and secured afterwards?

ANSWER - Direction to do it must come from lead, however lead must check patency. Any crew member can insert iGels.

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During OSCES, will we be allowed to ask for capnography is mmHg (EMAS) or kPA (YAS) or will it just be said in one measurement?

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During OSCES, will we be allowed to ask for capnography is mmHg (EMAS) or kPA (YAS) or will it just be said in one measurement?

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ANSWER - which ever one you want.

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Are we following YAS and EMAS guidelines for OSCES? Because there is some disagreement to whether YAS students can intubate in OSCES? As well the use of other drugs outside of regions such as clopidogerel etc? 

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Are we following YAS and EMAS guidelines for OSCES? Because there is some disagreement to whether YAS students can intubate in OSCES? As well the use of other drugs outside of regions such as clopidogerel etc? 

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ANSWER - Use drugs within the region.

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Will we be showing how to extricate the patient to the back of the ambulance for ALS or just saying we are on the back?

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Will we be showing how to extricate the patient to the back of the ambulance for ALS or just saying we are on the back?

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ANSWER - No just verbalise it.

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In regards to suctioning a patient, we will have to show we know how to suction or just say 'suction patient'?

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In regards to suctioning a patient, we will have to show we know how to suction or just say 'suction patient'?

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ANSWER - suction machine in OSCE so verbalistion.

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Can we pre-prep our bags? Such as ready making the airway tree and preparing it?

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Can we pre-prep our bags? Such as ready making the airway tree and preparing it?

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ANSWER - Yes.

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Will it always be a student paramedic and ECA crew?

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Will it always be a student paramedic and ECA crew?

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ANSWER - all team members will be able to perform ILS including iGel insertion.

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Are we in the same OSCE groups for the exam than our practice bubbles?

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Are we in the same OSCE groups for the exam than our practice bubbles?

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ANSWER - groups to be given next Wednesday.