Case e6485

This is a sample eOral case. This sample is intended to show you the types of materials you might encounter during the case and how those materials will appear on the screen. Although laid out in narrative below, cases are seldom this linear, and materials will vary across cases. For a more realistic example of the flow of a case, refer to the video.

Sample Case Summary

This case involves a critically injured 6-year-old girl involved in a motor vehicle crash who presents with a head injury and transient hypotension. The case begins en route to the ED, with an EMS call stating that they are attempting to intubate the child. The child arrives with a right mainstem intubation, and becomes hypotensive and more tachycardic. You must organize the resuscitation team for arrival of the patient, pull back the endotracheal tube, treat shock, evaluate for the cause of shock, control the bleeding scalp wound, and communicate with the mother.

Candidate Screen

   

Notes

The examiner has a patient history and physical available to ensure all candidates receive the same information.

This information will be given to you verbally. Be sure to take notes of important information.

Screen for candidate attestation

The case begins with the attestation screen.

This screen asks you to verify three things:

  • Your name and candidate ID, and photo
  • That you have no conflict of interest with the examiner
  • That you agree to abide by your responsibilities under the Policy on Exam Irregularities

screenshot of examiner attestation

All candidates will receive the same set of introductory information.

In this case, there are two audio recordings. You will be able to adjust the volume of the recordings, and you may ask the examiner to replay them. Note, however, that replaying them will take time from your case. The patient’s vital signs are on the right, with the patient’s name just above the blood pressure. The vital signs may change as you manage the patient and an audible alert will be given to let you know the vital signs have changed

examiner view

As you begin to manage the patient, you will see the patient view begin to change.

The human graphic organizer (HuGO) can be accessed throughout the case by clicking on the “Patient View” at the top of the stimuli tray on the left.

In this case, the candidate has asked that the patient be undressed and an IV (red) with a 250 mL bolus of normal saline (blue) and a narcotic analgesic (blue) be delivered. Devices will appear in red; interventions in blue.

The most common requests will be illustrated. It will often be the case, however, that the examiner will verbally affirm that one of your requests has been done. A notepad is provided so you can keep track of your requests that might not appear on the screen. The examiner will also be taking notes on a notepad.

candidate view

If you ask for imaging studies, lab reports, or other tests, they will appear in the stimuli tray on the left. Click to access each stimulus.

For new stimuli, the background of each stimulus title will remain green until you open it. Note the opportunity, at the bottom of the screen, to adjust the size and contrast of the x-ray.

Please note that you may request a paper copy of an ECG from the examiner.

examiner view

candidate view

CT scans and ultrasound exams will appear as videos, note the control panel on the lower left of the screen that allows you to pause to see a single CT slice or ultrasound image and replay the video. You may need to hover the mouse over that area to see the control panel.

e6485 hematology candidate view

e6485 lactate candidate view

A zoom bar below the stimulus will allow you to enlarge it. All lab values are given in metric and S.I. units. Unlike the traditional cases, normal values appear on the right. Abnormal lab values are indicated with an asterisk.

examiner view

candidate view

Sometimes, the examiner may play a video or audio to assist in the play of the case. Many times, these cues will be given verbally by the examiner.

In this case, there is a verbal cue when the nurse states, “There is a lot of blood by her head, Doctor.”

The yellow triangle denotes a head wound that is visible when you enter the room.

examiner view

candidate view

The vital signs may change as you manage the patient and an audible alert will be given to let you know the vital signs have changed.

You may open a larger view of the rhythm strip by clicking on it. Click on the red “X” in the upper left-hand corner to return to the main screen.

candidate view

The examiner has several options for posting vital signs. Not every action by you, however, can be anticipated. In this case, the examiner will deliver the vital signs verbally and the vital signs will be blank.

examiner view