SCA practice case · Video consultation
Professional: SCA practice case
A trainee colleague asks to talk about a child she saw
Video consultation
Child patient
Someone else speaking
Hard
Professional & ethical dilemmasChildren & young peopleUrgent & unscheduled care
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Leo Barnes · 3-year-old boy
Setting
Video consultation with a GP ST1 colleague who has asked to talk about a child she saw in surgery yesterday.
Past history
- Nil significant
- Immunisations up to date for age
Medication
- No regular medication
Allergies
No known drug allergies
Recent notes
Seen face to face yesterday at 16:20 by Dr Hannah Kowalski (GP ST1): 2 days of fever, temperature 38.9, heart rate 150, respiratory rate 32, oxygen saturation 97%, capillary refill not recorded; ’ears red, throat inflamed, chest clear, no rash’. Impression: viral upper respiratory infection; paracetamol and ibuprofen; ’safety-netting advice given’. Emergency department letter received 08:10 today: brought by ambulance at 02:40 after a 111 call; non-blanching rash on legs, cold peripheries, capillary refill 5 seconds; suspected meningococcal septicaemia; IV ceftriaxone and fluid boluses; transferred to paediatric intensive care; stable this morning.
Reason for contact
Video call requested at lunchtime by Dr Kowalski, GP ST1, after reading the hospital letter: ’Can we talk about Leo Barnes?’
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
This is a consultation with a colleague, and the first task is the person in front of you: a junior doctor in acute distress after a serious missed diagnosis. Support comes before analysis, and the analysis has to be honest. The learning points are real (an amber heart rate, no capillary refill, a mother’s concern and leg pain, verbal-only safety-netting) and so are the system ones (a late-running list and an unreachable duty doctor). The probity question about the notes needs a clear answer, candour needs coordinating, and she should not see feverish children alone this afternoon.
The guidance behind it
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