OSCE- CARDIAC ARREST STATION

Cardiac Arrest OSCE Station (Verbal/Role-Play)

Station Title: Management of an Adult Patient in Cardiac Arrest

Time: 10 minutes

Objectives:

  • Assess the student’s knowledge of Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) protocols.
  • Evaluate the student’s decision-making skills during cardiac arrest.
  • Assess the student’s ability to communicate effectively and lead a team.

Station Overview

Scenario for Students:

You are called to respond to a 55-year-old male patient who has collapsed in the hospital. The patient is unresponsive and not breathing. You are asked to explain and describe the actions you would take to manage this case.

  • You will be verbally walked through the scenario by the examiner.
  • The examiner will act as your assistant/team member, and you will lead the resuscitation verbally.

Instructions for Students:

You must describe each step you would take to manage the patient, including initial assessment, CPR, and defibrillation. Communicate your actions clearly and guide the examiner as your assistant. Answer any follow-up questions from the examiner regarding the clinical reasoning behind your decisions.

Instructions for Examiner:

  • Role: Act as an assistant or team member following the student’s instructions.
  • Assess: Listen carefully and score the student based on their ability to recall protocols, provide correct instructions, and explain their clinical reasoning.
  • Questions: Ask follow-up questions to test the student’s depth of understanding (e.g., “Why is it important to minimize interruptions during compressions?”).

Assessment Criteria and Marking (Out of 10 Marks)

Section Task Max Marks
1. Initial Assessment (2 Marks)
  • Describes checking for scene safety and patient responsiveness.
  • Calls for help and asks for an AED.
  • Assesses breathing and pulse correctly.
 2
2. High-Quality CPR (3 Marks)
  • Describes initiating chest compressions.
  • Provides correct hand placement, compression depth (5-6 cm), and rate (100-120/min).
  • Explains minimizing interruptions in CPR.
 3
3. Defibrillation (2 Marks)
  • Verbalizes using the AED or defibrillator appropriately.
  • Describes checking rhythm and delivering shock when indicated.
 2
4. Airway and Breathing (2 Marks)
  • Describes correct airway management (e.g., jaw thrust or head tilt-chin lift).
  • Describes proper ventilation (e.g., bag-mask ventilation, 30:2 ratio if no advanced airway).
 2
5. Communication & Leadership (1 Mark) Effectively communicates steps and delegates tasks to the “assistant.” 1
Total 10 Marks

Sample Questions for the Examiner

  • During Initial Assessment: “What would you do if the patient is not breathing but has a pulse?”
  • During CPR: “Why is minimizing interruptions during compressions critical?”
  • Airway Management: “How would you manage the airway if the patient has a suspected spinal injury?”
  • After Defibrillation: “If the patient regains a pulse, what would be your next steps?”

No-Manikin Approach: Role-Play

In this setup, the examiner will simulate the patient’s clinical condition and guide the student through the scenario. For example:

  • The examiner may say: “The patient is unresponsive, has no pulse, and is not breathing.”
  • The student will then describe their steps, guiding the examiner (playing a team member or assistant) to perform tasks such as getting the AED, starting chest compressions, or ventilating the patient.

Room Setup

  • Simple setup with a chair or table to simulate the scene.
  • Examiner seated nearby to act as the assistant/team member.
  • Verbal cues provided by the examiner for any feedback or information the student would need (such as the AED analysis or rhythm status).

Final Notes

  • Focus on Verbal Communication: Since no manikin is available, students should explain their actions clearly and in detail.
  • Emphasize Decision-Making: Ensure students can justify their decisions based on ACLS protocols.
  • Adaptability: The role-play can be modified based on the level of the student (e.g., focusing more on BLS for junior students or incorporating advanced airway techniques for senior students).
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