No Scenario Questions Focus on

1. 80 year old female fell down a flight of Initial management. Trauma Call
stairs. Collared and boarded and brought CT shows right side Extra-dural haemorrhage A B C D E Approach
to ED. Patient on Warfarin for AF. with 2 cm midline shift. Trauma Series CT Scan

Blood tests and group and save

INR
Reverse Warfarin : Vit-K and Beriplex
Neuro-Surgical referral
Baseline functional status
2. 7 months old child brought to ED with pain Initial management Ensure child’s ABCEDs stable
over right thigh. X-Ray shows fracture shaft Next steps in management Pain relief: NSAIDs, Intra-nasal Diamorphine
of femur. IV Access
Trauma referral
Traction to align fracture
Suspicion of NAI
Skeletal survey
Involve senior paediatric team - Discuss

3. 92 year old male from Nursing home. Initial steps Management of Septic Shock
Breathless and coughing : 4 days Next steps ITU Opinion and Medical admission
BP 80/50, Fever 40’C, SpO2 : 88 % on room Consider DNAR
air. Past Hx: COPD, NIDDM, IHD, CVA ;Bed Discuss with family
bound, Hoisted.
4. 47 years male, Nausea and belching. Chest Management Questions on Acute MI management
pain and SOB on exertion. ECG shows new
LBBB. History of IDDM, HTN, Asthma
5. You are the Middle Grade staring your Questions on: It’s a busy shift and unlikely to be managed in
night shift at 10pm. You have another - Who you will involve conventional way. Acknowledge that you need
Middle Grade starting with you. 2 SHOs on - How will you distribute your staff help.
shift on this night shift. 3 Patients in Resus. - Strategy to handle the situation - Talk to Nurse in-charge and bed
50 patients waiting to be seen in the manager to get situation on beds.
department with 3 hour wait: Out of - Inform on duty Consultant about the
which, 30 are in Minors+Paeds and the situation and if not on site, request to
remaining 20 in Majors. 1 Trauma alert come for help.
patient expected in the next 8 minutes. - Request the other Middle grade to
How will you manage the shop floor. start in Minors+ Paeds to clear the
patients… Better to allot a senior to
Paeds and Minors as quick decisions
can be taken and better disposition
rates.
- The 2 SHOs can start in Majors. Ask
them to get back to you after seeing
patients to formulate management
plans early. They can approach you in
Resus if necessary.
- You keep an overview of the entire
shop-floor in the absence of
Consultant.
- Attend? Lead the Trauma patient who
will come to the department shortly.
Delegate roles to Trauma team
members.
- Few patients can be quickly assessed
and referred directly to Medical /
Surgical Teams. Request the Medical,
Surgical and Ortho teams to help with
few patients in the department.

Above are suggested responses. You can come

out with your own strategies of management.
6. Regarding quality indicators for A&E Time to Initial Assessment (ambulance arrivals) : 15 Minutes
Time to Treatment : 1 Hour
Total time in A&E : 4 Hours
Left without being seen : 5 %
Unplanned Re-attendance Rate : 5 %
Friends and Family: 97 %
7. Questions on Major Incident Response METHANE Handover
Confirm : Major Incident Stand-by / Major Incident Declared
Call 2222 and inform switchboard : Switchboard to cascade the info to all concerned
Inform Nurse Co-ordinator
Inform Duty Consultant
Inform Security – Hospital Lock-Down
Senior Nurse to go to Minors and request patients to go to GP / other A&Es as Major Incident
situation and they may not be seen for a very long time
Resus Nurse to co-ordinate with ITU and theatre recovery to clear Resus Patients.
Majors patients to be moved to Medical Wards / CDU
Get Major Incident Kit and distribute Action Cards
Set up Triage Desk and Triage Category Cards and Major incident documentations
Ensure decontamination unit set up if METHANE information suggests its necessary.
Direct Nurses and Doctors who arrive for help from various specialties to various sections of
A&Es pre-designated areas: Category 1, 2 , 3 areas.
You continue the role of Silver commander till ED consultant arrives.
Hand over the role to Consultant and assume role of Middle Grade once ED Consultant arrives
and you have briefed him/her of the situation.

I recommend you read in detail about Major incident management as its currently a very hot
topic in view of recent incidents.
8. Questions on how your will supervise - Take history from junior
juniors: - Ask relevant additional questions
- Review and examine results of lab and radiology investigations
- Review radiology images yourself
- Review patient yourself if needed
 - Give management plan
- Suggest any modifications to treatment
- Take it as an opportunity to teach juniors in the given time frame.

9. Other favourite topics:

- AAA
- Aortic Dissection
- Mesenteric ischaemia
- Ruptured Ectopic
- Hypoglycaemia
- Opiate overdose
- Hyperkalaemia
- Pulmonary oedema secondary
to CCF
- Torsion testis

10. Other general questions:

1. Tell me about yourself
2. Tell me why you want to join our hospital
3. Tell me about your future plans / Career goals
4. About your Life Support Certifications
5. Child Protection Certifications
6. What are your strengths?
7. What are your weaknesses?
8. Any questions to the interviewing panel?
9. When can you start to work?
10. Any special requests?

11. General tips:

- Dress smart
- Be confident
- Go through your CV prior to the interview
- Be ready for the interview at least 15-20 minutes prior to agreed time
 - Do not make up answers – If unsure admit you do not know or ask for senior opinion
- Do not talk about salary
- Ask questions about rota structure, leaves, staffing at night
- Ask questions about support towards educational activities / regarding teaching.
- Ask about accommodation arrangements if applicable

12. All the best for your interview.