Monday 10 October 2011

Tutorial 10th. October 2011.

Website.
Podcast.
Tonight we started with a viva in which you had to talk about writing a critical incident report.
The scenario is below.
Then we went on to a critical appraisal of the RCOG's patient information leaflet on herpes in pregnancy.
http://www.rcog.org.uk/genital-herpes-pregnancy-information-for-you.
I have written some thoughts on both.

Spend 15 minutes on each, writing an outline of what you are going to say.
Send them to me and I'll let you have my thoughts on the appropriate techniques.
The critical incident instructions are:
Adverse incident report.

Candidate’s instructions.
Mrs Penelope Jane Brown sustained a 4th. degree tear after the delivery of her second baby.
Dr. James Peter White conducted the delivery and was asked to write a statement for the Risk Management Team (RMT), to whom the incident has been reported as an adverse clinical incident.
You have been asked to look at Dr. White’s report to identify issues that the RMT need to explore further. You have 15 minutes to read Dr. White’s report, after which you will have a viva with the examiner. The examiner will not lead the discussion and will simply listen to what you have to say.

Dr. White’s Statement.
I am Dr. J. White. I have been SpR in obstetrics and gynaecology at the Royal Infirmary for over a year.
On the 27th. September I was bleeped by a midwife on the labour ward and asked to see a Mrs. Brown who needed to be delivered as there had been delay in the second stage and she was becoming exhausted.
On arrival on the labour ward I felt that Mrs. Brown was not trying very hard to deliver the baby naturally and that the midwives were not making much effort to encourage her. I advised that they should get her pushing properly and that I would go for a coffee and return in half an hour.
I returned in 50 minutes, having had a phone call from my wife about arrangements for our forthcoming holiday. The situation was unchanged and I was not impressed with either the woman’s endeavours or the midwives’ encouragement of her.
Examination showed the head to be midcavity. I felt that it could get it out using forceps. The midwives told me that her bladder was empty. I applied the forceps with ease. The baby delivered in good condition. I then noted that she had a 4th. degree tear. I repaired this in the usual way.
I went on holiday the next day for two weeks and did not see this woman again.

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