Term
| **INTRODUCTION & IDENTITY CHECK** **Q1:** How do you introduce yourself and start the consultation? |
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Definition
| **A:** *"Hello, my name is Dr [Your Name], one of the doctors working in the Emergency Department today. Could I confirm your full name and age, please? I can see you’ve come in today with some tummy discomfort — is that right? I'll do everything I can to help. Is it alright if we have a quick chat?" |
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Term
| * **Q2:** What 3 key pieces of information must you confirm? |
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Definition
| **A:** Full name, age, and presenting complaint (e.g., abdominal discomfort). |
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Term
| --- #### **FOCUSED HISTORY** **Q3:** How do you explore the pain? |
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Definition
| **A:** Use **SOCRATES**: - *"Could you tell me more about this pain — when did it start? Site, character, radiation, timing, exacerbating/relieving factors, severity?" |
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Term
| * **Q4:** What urinary symptoms must you ask about? |
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Definition
| **A:** *"Have you had difficulty passing urine today? When was your last void? Any urgency, burning, or dribbling? Any lower abdominal swelling/discomfort?"* |
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Term
| **Q5:** Key systemic symptoms? |
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Definition
| **A:** *"Any nausea, vomiting, fever, back pain, confusion, or lightheadedness?" |
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Term
| * **Q6:** Relevant medical history? |
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Definition
| **A:** *"Any kidney issues or recent urinary tract procedures?" |
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Term
| * **Q7:** Critical safety checks? |
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Definition
| **A:** - *"Are you on blood thinners (warfarin/aspirin)?"* - *"Any allergies, especially to latex/lidocaine?"* - *"History of bleeding disorders?" |
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Term
| **Q9:** What do you verbalise for focused examination? |
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Definition
| **A:** *"I’ll check your vital signs (BP, HR, SpO₂, temperature) and gently examine your abdomen for swelling/tenderness. |
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Term
| "* **Q10:** How do you deliver the provisional diagnosis? |
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Definition
| **A:** *"Based on your history and exam, I believe you have acute urinary retention. We need to relieve pressure with a urinary catheter."* --- #### **CONSENT (PPECC)** |
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Term
| **Q11:** How do you explain the procedure? |
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Definition
| **A:** *"I’ll place a soft, sterile tube (catheter) into your bladder via the urethra to drain urine. You may feel pressure, but I’ll use numbing gel. You’ll lie flat with knees bent, exposed waist-down with drapes for privacy. A female chaperone will be present. Are you happy to proceed?"* --- #### **PREPARATION (PREP)** |
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Term
| **Q12:** What equipment do you verbalise? |
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Definition
| **A:** *"I’m preparing: Female Foley catheter (12–14Fr), lidocaine 1% gel, 10mL syringe with sterile water, antiseptic/saline, sterile forceps, 3 gauze swabs, 2 kidney trays, sterile gloves, urine bag, Tegaderm, drapes, waste bags. |
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Term
| "* **Q13:** What 3 safety checks do you perform? |
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Definition
| **A:** Balloon integrity, expiry date, no latex/lidocaine allergies. --- #### **PROCEDURE (PERFORM)** |
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Term
| **Q14:** How do you position the patient? |
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Definition
| **A:** *"Please lie flat with knees bent and hips relaxed. I’ll expose you from waist to mid-thigh with drapes for dignity." |
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Term
| * **Q15:** Describe the cleaning technique. |
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Definition
| **A:** 1. *Don sterile gloves.* 2. *Part labia with non-dominant hand (now non-sterile).* 3. *With forceps (dominant hand):* - *Soak gauze in antiseptic.* - *Clean labia → urethra front-to-back with 3 separate gauze pieces.* - *Dispose in kidney tray. |
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Term
| * **Q16:** How do you apply anaesthetic gel? |
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Definition
| **A:** *"I’m inserting numbing gel now."* → *Instil full syringe into urethra. Wait 3–5 minutes.* **Anchor phrase:** *"Always wait — don’t rush past the gel step. |
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Term
| "* **Q17:** Describe catheter insertion. |
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Definition
| **A:** - *Partially expose catheter without touching tip.* - *Gently insert until urine flows → advance to Y-junction.* - *Inflate balloon with 10mL sterile water slowly.* - *Gently withdraw until resistance. |
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Term
| * **Q18:** Post-insertion steps? **A:** - |
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Definition
| *Attach drainage bag below bladder level.* - *Secure catheter with Tegaderm.* - *Dispose gloves/waste.* --- #### |
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Term
| **POST-PROCEDURE (PAUSE)** **Q19:** What 3 checks do you perform? |
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Definition
| **A:** 1. Urine draining freely. 2. Patient comfortable. 3. Check BP (risk of hypotension if large volume drained). --- |
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Term
| #### **REASSURANCE & SAFETY NETTING** **Q20:** How do you reassure and safety-net? |
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Definition
| **A:** *"You’ve done really well. If you have discomfort, bleeding, or no drainage, tell staff immediately. We’ll monitor your urine output and vitals. |
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Term
| "* **Q21:** What investigations/medications might be needed? |
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Definition
| **A:** - **Tests:** FBC, U&Es, urine MC&S, ultrasound. - **Meds:** IV paracetamol (analgesia), IV fluids (if dehydrated), antibiotics (if infection). --- #### **DOCUMENTATION & WRAP-UP** . |
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Term
| **Q22:** What do you document? |
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Definition
| **A:** *Date/time, catheter size, balloon volume, urine colour/volume, post-procedure vitals. |
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Term
| * **Q23:** Closing statement? |
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Definition
| **A:** *"Mrs X, we’ve drained your urine successfully. I’ll check your blood tests and monitor you. Alert us if you feel unwell."* --- |
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Term
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Definition
** - **SOCRATES:** Pain assessment.
- **PPECC:** Procedure, Pain, Exposure, Chaperone, Consent. -
PREP: Preparation → **Position, **Ready equipment, **Expiry/allergy checks, **Privacy.
- PAUSE: Post-procedure checks → **Patient comfort, Assess drainage, U/Es (bloods), **Safety-net, **Examine vitals. >
**Pro Tip:** Practice verbalising each step while mimicking actions (e.g., "I'm cleaning front-to-back with gauze") to build muscle memory for OSCE |
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Term
| * **Q8:** Contraindications to catheterisation? |
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Definition
| "Ever had trauma, bleeding, or discharge from vagina/urethra? Known urethral narrowing/strictures?" |
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