Station 14 of 24 · Free

A patient collapses on the ward.

  • Basic life support
  • Care delivery
  • Medical ward, 16:20
  • Manikin

Station timer

Station timer: two minutes of reading, then eight to perform [S1], with a bell when two minutes are left [S1].

Candidate instructions

Setting: Medical ward, 16:20. Patient: Manikin.

You walk into a four-bed room and find Mr Peter Lowe, 64, slumped in his bed. He was admitted yesterday with chest pain. No one else is in the room.

An emergency call button is on the wall behind the bed. The resuscitation trolley with a defibrillator, set to automatic (AED) mode, is in the corridor.

In eight minutes:

  1. Respond as you would on the ward, following the Australian Resuscitation Council basic life support approach.
  2. Continue until help arrives and the examiner tells you to stop.

In the room: Resuscitation manikin on a hospital bed, emergency call button, gloves, pocket mask and bag-valve-mask, resuscitation trolley with defibrillator in AED mode and pads, backboard.

END OF CANDIDATE INSTRUCTIONS

Findings: what the patient or examiner tells you

Open these as you assess, one at a time, the way an examiner or patient would give them.

  • No response to your voice or a firm squeeze of the shoulders.
  • Not breathing normally: occasional gasps only.
  • A colleague arrives with the trolley about a minute after you call.

The checklist

Tick what you really did. 10 points, 3 safety-critical, each mapped to the NMBA standards [S4]. Our own practice checklist, not the NMBA marking scheme.

Did you do these?
  • Why it matters

    You cannot help anyone if you become a second casualty.

  • Why it matters

    Unresponsiveness is the first trigger for the rest of the sequence.

  • Why it matters

    Survival depends on early help and an early shock. Every minute counts.

  • Why it matters

    Gasping is common after a cardiac arrest and is often mistaken for breathing.

  • Why it matters

    Compressions move blood to the brain and heart. Delay costs brain cells.

  • Why it matters

    Shallow, slow or interrupted compressions move far less blood.

  • Why it matters

    Breaths add oxygen, but never at the cost of long pauses in compressions.

  • Why it matters

    An early shock is the treatment for the most common arrest rhythms.

  • Why it matters

    A clear handover stops the team repeating or missing steps.

  • Why it matters

    Compression quality falls quickly as rescuers tire.

Model walkthrough

Show it, minute by minute (try the station first)
  1. Reading

    Collapsed, alone, button behind the bed, defibrillator in the corridor. Run the sequence in your head: danger, response, send for help, airway, breathing, compressions, defibrillator.

  2. 0:00

    Danger: check the area, gloves on if they are right there. Response: loud voice, squeeze the shoulders.

    Say: Mr Lowe! Peter, can you hear me? Open your eyes!

  3. 0:15

    No response. Press the emergency button and shout.

    Say: I need help in room 3! Bring the resus trolley and defibrillator!

  4. 0:30

    Head tilt, chin lift. Look, listen and feel, briefly, so compressions are not delayed (many courses teach no more than 10 seconds): gasping only, so not normal breathing.

  5. 0:45

    Bed flat, backboard if at hand. Start compressions: centre of the chest, one third of the chest depth (more than 5 cm), 100 to 120 a minute. Count out loud.

  6. 1:45

    Colleague arrives with the trolley. Keep compressing while they place the pads. Follow the AED prompts.

    Say: Everyone clear! Oxygen away!

  7. 2:30

    After the shock (or no shock advised), straight back to compressions. Breaths 30 to 2 with the bag-valve-mask if two of you can do it well.

  8. 4:30

    Swap compressors at the rhythm check, at least every 2 minutes, with minimal pause.

  9. 6:00

    Bell. When the team arrives, hand over.

    Say: Peter Lowe, 64, admitted yesterday with chest pain. Found unresponsive and not breathing normally at 16:20. CPR started straight away, one shock at 16:22, CPR continuing.

  10. 7:00

    Keep going until told to stop. Later: document times and actions, and support the other patients in the room.

Common mistakes

  • Running to fetch the trolley before calling for help.

    Press the emergency button and shout first, then start compressions.

  • Taking gasping for breathing.

    Gasping is not normal breathing. Start compressions.

  • Stopping compressions to place the pads.

    Keep compressing while a second person places the pads.

  • Treating the manikin like a dummy.

    Talk to it and act as you would with a real patient.

From the official handbook

  • The handbook's reading list also includes the Australian Resuscitation Council, the Australian Medicines Handbook and Therapeutic Guidelines. [S1]
  • Examiners do not give prompts unless the candidate instructions say so. Some stations ask you to present your findings to the examiner. If the patient is a manikin, the examiner answers your questions for it, but you speak to the manikin. [S1]
  • Skills that may be tested include (the list is not exhaustive): observations and vital signs, calculating drug dosages, subcutaneous and intramuscular injection, aseptic non-touch technique (ANTT), in-hospital resuscitation, safe disposal of sharps, medication administration, wound care, hand hygiene, communication and consent, infection control, patient identification, intravenous therapy and risk management. [S1]
  • The candidate instructions end with the line END OF CANDIDATE INSTRUCTIONS, and you must stay seated for the whole two minutes of reading time, even if you have finished reading. [S1]
  • When reading time ends, the candidate instructions are taken away: at one exam centre they disappear from the screen, at the other you return the instruction card before you enter the room. [S1]
  • It is a regulatory exam, not an educational one. Examiners do not coach, prompt or give feedback, and when station time is up you move on even if you have not finished. [S1]
  • Try to complete every task in the candidate instructions, including writing the documentation. You get a new piece of notepaper at each station, and you hand all your notes to the examiner when time is up. [S1]