Psych CASC / OSCE · Emergency psychiatry
Explaining ABD care and contested labels — CASC communication station
MRCPsych/FRANZCP-style station: explain ABD framing, medical priorities, sedation and monitoring, restraint safety, avoid contested ExDS as diagnosis, and outline next steps without inventing legal section codes.
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Station brief
Format. Communication and clinical reasoning station, approximately 7–10 minutes after reading time. You are the psychiatry registrar in ED after the acute episode has been controlled. [2]
Candidate instructions. Explain what happened using acute behavioural disturbance language; address the sister's concern about the term excited delirium without being dismissive; describe medical priorities (temperature, monitoring, why medication was used, goal of calm not unconsciousness); explain restraint minimisation and safety; outline investigations and next steps; discuss capacity and legal principles without inventing statute section numbers. [1][3]
References3ShowHide
- [1]Stolbach AI, Dargan PI, Greller HA, et al. ACMT Position Statement: End the Use of the Term "Excited Delirium" J Med Toxicol, 2023.PMID 37349654
- [2]McGuinness T, Lipsedge M 'Excited Delirium', acute behavioural disturbance, death and diagnosis Psychol Med, 2022.PMID 35546291
- [3]Patel MX, Sethi FN, Barnes TR, et al. Joint BAP NAPICU evidence-based consensus guidelines for the clinical management of acute disturbance: De-escalation and rapid tranquillisation J Psychopharmacol, 2018.PMID 29882463