Explain a sudden cardiac arrest to an adolescent and his mother — OSCE

Candidate instructions

You are the paediatric registrar. You have ten minutes to speak with Liam, a fifteen-year-old boy, and his mother Mrs Chen. Yesterday, Liam collapsed during a school football match and was found to be in ventricular fibrillation. He was resuscitated by bystander CPR and two shocks from the automated external defibrillator at the sports ground. The echocardiogram this morning shows hypertrophic cardiomyopathy — the heart muscle is abnormally thickened, particularly in the wall between the two ventricles. The cardiology team is planning to implant a cardioverter defibrillator (ICD) within the next few days. Liam is frightened and quiet, and his mother is distressed and tearful. Liam's father died suddenly at thirty-eight. Explain what happened yesterday, what the diagnosis means, what the device does and why it is needed, what the implications are for his siblings and for sport, and agree a plan for the coming days. Answer their questions honestly and at a level Liam can engage with. ^[1]