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Psych CASC / OSCEEmergency psychiatry

Psych CASC / OSCE · Emergency psychiatry

Explaining NMS and emergency plan to family — CASC communication station

MRCPsych/FRANZCP-style station: explain NMS in plain language, acknowledge medication association without abandoning hope, outline stop-and-support care, and discuss later careful rechallenge principles.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 35-year-old man with schizophrenia developed fever, rigidity, and confusion after antipsychotic escalation. He is being transferred to HDU. His sister arrives distressed, asking whether you have 'poisoned him with psychiatric drugs' and whether he will ever be able to take medication again.

Station brief

Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar. The patient is being stabilised medically; you meet the sister. [2]

Candidate instructions. Explain what neuroleptic malignant syndrome is, link it to dopamine-blocking medicines without minimising seriousness, describe what the team is doing now (stopping those medicines, cooling, fluids, monitoring), and answer questions about whether medication can ever be restarted. Avoid jargon dumps and avoid inventing legal section numbers. [1][3]

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References3ShowHide
  1. [1]Gurrera RJ, Caroff SN, Cohen A, et al. An international consensus study of neuroleptic malignant syndrome diagnostic criteria using the Delphi method J Clin Psychiatry, 2011.PMID 21733489
  2. [2]Pileggi DJ, Cook AM Neuroleptic Malignant Syndrome Ann Pharmacother, 2016.PMID 27423483
  3. [3]Rosebush PI, Stewart TD, Gelenberg AJ Twenty neuroleptic rechallenges after neuroleptic malignant syndrome in 15 patients J Clin Psychiatry, 1989.PMID 2569457
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