[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical skills](https://durgical.com/en/clinical-skills/) › [OSCE stations](https://durgical.com/en/clinical-skills/areas/stations/) › The emergency (ABCDE) station

# The emergency (ABCDE) station

- OSCE station

An OSCE station with an acutely ill or injured simulated patient, where you assess and treat in ABCDE order, call for help early and reassess.

Updated Nov 13, 2026

## Key points

- Safety, response, help: check the scene, check whether the patient responds, and call for help in the first seconds.
- ABCDE in order, treating each problem before moving on, and reassessing from A after every intervention.
- In major trauma, stop catastrophic external bleeding first and protect the cervical spine while managing the airway.
- Cardiac arrest: compressions at 100–120 per minute, about 5–6 cm deep, minimal pauses, early shock for VF or pulseless VT.
- Never forget the glucose, and finish with a structured handover (ISBAR) and a senior plan.

On this page

- The basics Key points
- What it is
- What is assessed
- How to do it (and why)
- ABCDE at a glance
- Mistakes that cost marks
- Self-check list
- Memory aid
- Elsewhere in DurgiPedia

- Study Test yourself

- Connections Connections

## What it is

The emergency station uses a manikin or a standardised patient, a monitor and often a nurse or assistant who gives observations and carries out instructions only when asked. Typical scenarios are anaphylaxis, sepsis, a severe asthma attack, hypoglycaemia, major trauma and cardiac arrest. The approach is always the same: check that the scene is safe, check whether the patient responds, call for help early and ask for monitoring. Then work through Airway, Breathing, Circulation, Disability and Exposure in order, treating each problem as soon as it is found before moving on, and reassess from the airway after every intervention and whenever the patient changes. In major trauma the primary survey starts with control of catastrophic external bleeding, and the airway is managed with cervical spine protection; the head-to-toe secondary survey waits until the patient is stable. If there is no pulse, cardiac arrest care takes over: high-quality chest compressions with minimal pauses, early defibrillation for ventricular fibrillation or pulseless ventricular tachycardia, adrenaline and amiodarone given by protocol, and a search for reversible causes (the Hs and Ts). Examiners mark the sequence, the safety of each intervention, teamwork (clear roles, closed-loop instructions, thinking aloud) and the final escalation and structured handover. A single critical omission, such as never calling for help or leaving an obstructed airway, can fail the station.

## What is assessed

- Recognising a critically ill patient within seconds and calling for help early.
- A systematic ABCDE assessment with treatment at each step.
- Safe, correct interventions: positioning, airway manoeuvres, oxygen, IV access, fluids and medicines [per protocol], monitoring.
- Reassessment after each intervention and whenever the patient changes.
- Team leadership: clear roles, closed-loop instructions and thinking aloud.
- Escalation and disposition: senior doctor, intensive care, theatre.
- A structured handover at the end of the station.

## How to do it (and why)

- Check danger, put on gloves and ask «Can you hear me?» — then call for help and ask for saturation, blood pressure and ECG monitoring.
- A: look, listen, feel; head tilt–chin lift (jaw thrust in trauma), suction, adjuncts — a blocked airway kills first.
- B: rate, effort, saturation, trachea, expansion, percussion, auscultation; give oxygen — find tension pneumothorax, asthma, oedema.
- C: colour, capillary refill, pulse, blood pressure; two large cannulas, bloods, fluids [per protocol] — shock and bleeding are treated here.
- D: AVPU or Glasgow scale, pupils and capillary glucose — hypoglycaemia is quick to find and quick to reverse.
- E: expose fully for rash, bleeding and wounds, measure temperature, then cover — a rash or a hidden wound changes the plan.
- Reassess from A after every intervention: «Saturation has improved, I will go back to A» — deterioration needs a new look.
- If there is no pulse: start CPR, attach the defibrillator, shock VF or pulseless VT, rhythm check every 2 minutes — time is everything.
- Give closed-loop instructions: «Please start the fluid bolus and tell me when it is running» — nothing is lost between people.
- Hand over with ISBAR and name the plan and the team — the receiving team needs the picture and what is still pending.

## ABCDE at a glance

| Step | Look for | Do |
| --- | --- | --- |
| A, airway | Is the patient talking? Stridor, gurgling, see-saw breathing | Head tilt–chin lift or jaw thrust, suction, simple adjuncts, call the airway team |
| B, breathing | Rate, saturation, effort, trachea, symmetry, breath sounds | Sit up, oxygen, treat bronchospasm, decompress a tension pneumothorax |
| C, circulation | Pulse, blood pressure, capillary refill, skin, bleeding, urine output | Control bleeding, IV access and bloods, fluids [per protocol], ECG |
| D, disability | AVPU or Glasgow scale, pupils, glucose, seizures | Treat hypoglycaemia; protect the airway if consciousness is reduced |
| E, exposure | Rash, wounds, bleeding, temperature, calves, back | Expose, then cover and keep the patient warm |

## Mistakes that cost marks

- Not calling for help, or calling only at the end of the station.
- Moving on to B or C while the airway is still compromised.
- Finding a problem and not treating it, for example reading a low saturation aloud and giving no oxygen.
- Never reassessing after an intervention or when the monitor changes.
- Forgetting the glucose, the temperature or the patient's back.
- In cardiac arrest: long pauses in compressions, shallow or slow compressions, late defibrillation.
- In trauma: missing catastrophic bleeding or not protecting the cervical spine.
- Working in silence: the examiner can only mark what is said or done.

## Self-check list

- Did I check safety and response and call for help in the first seconds?
- Did I ask for monitoring and observations early?
- Did I go A, B, C, D, E in order and treat each problem as I found it?
- In trauma, did I control catastrophic bleeding and protect the cervical spine?
- Did I check the glucose?
- Did I reassess after every intervention?
- In cardiac arrest, were compressions continuous and the shock early?
- Did I give closed-loop instructions and think aloud?
- Did I escalate to the right team and hand over with ISBAR?

## Memory aid

DEFG: Don't Ever Forget Glucose.

## Test yourself

Think of the answer, then tap the question to see it.

## During the ABCDE assessment the patient is wheezing and the saturation is low. What do you do before moving on to C?

Treat it at B: sit the patient up, give oxygen, start a bronchodilator per protocol and call for help, then reassess. ABCDE means treating each problem as you find it.

## In a major-trauma scenario with heavy bleeding from a thigh wound, what comes before the airway?

Control of the catastrophic external bleeding, with direct pressure or a tourniquet; then the airway with cervical spine protection. Uncontrolled bleeding can kill faster than an airway problem.

## What are the targets for high-quality chest compressions in an adult cardiac arrest?

100–120 per minute, about 5–6 cm deep, full recoil, minimal interruptions and a compressor change about every 2 minutes; 30 compressions to 2 breaths without an advanced airway.

## Why is the glucose checked at D in every emergency station?

Hypoglycaemia causes reduced consciousness, seizures and strange behaviour, is easy to test at the bedside and is quickly reversible; missing it is a classic critical error.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/clinical-skills/the-emergency-station/)

## Elsewhere in DurgiPedia

- [The ABCDE of pigmented lesions](https://durgical.com/en/clinical-exam/the-abcde-of-pigmented-lesions/)
- [Level of consciousness and the Glasgow Coma Scale](https://durgical.com/en/clinical-exam/level-of-consciousness-and-the-glasgow-coma-scale/)
- [Shock: the clinical signs and the types](https://durgical.com/en/clinical-exam/shock-the-clinical-signs-and-the-types/)
- [Bronchial obstruction syndrome](https://durgical.com/en/clinical-exam/bronchial-obstruction-syndrome/)
- [Recognising deterioration and calling the rapid response team](https://durgical.com/en/nursing/recognising-deterioration-and-calling-the-rapid-response-team/)
- [Handoff and SBAR communication](https://durgical.com/en/nursing/handoff-and-sbar-communication/)

## Connections

## Related 8

- [How the ECOE works and how it is marked](https://durgical.com/en/clinical-skills/how-the-ecoe-works-and-how-it-is-marked/)
- [The handover station (ISBAR)](https://durgical.com/en/clinical-skills/the-handover-station/)
- [The physical-examination station: what examiners look for](https://durgical.com/en/clinical-skills/the-physical-examination-station-what-examiners-look-for/)
- [Opening the airway: head tilt, jaw thrust and simple adjuncts](https://durgical.com/en/clinical-skills/opening-the-airway-head-tilt-jaw-thrust-and-simple-adjuncts/)
- [Bag-mask ventilation](https://durgical.com/en/clinical-skills/bag-mask-ventilation/)
- [Defibrillation and synchronised cardioversion](https://durgical.com/en/clinical-skills/defibrillation-and-synchronised-cardioversion/)
- [Intraosseous access in an emergency](https://durgical.com/en/clinical-skills/intraosseous-access-in-an-emergency/)
- [Chest drain insertion and care](https://durgical.com/en/clinical-skills/chest-drain-insertion-and-care/)

## Related conditions 8

- [Cardiac arrest (VF, pulseless VT, asystole, PEA)](https://durgical.com/en/conditions/cardiac-arrest/)
- [Anaphylaxis](https://durgical.com/en/conditions/anaphylaxis/)
- [Sepsis and septic shock](https://durgical.com/en/conditions/sepsis-and-septic-shock/)
- [Hypovolaemic shock](https://durgical.com/en/conditions/hypovolaemic-shock/)
- [Pneumothorax](https://durgical.com/en/conditions/pneumothorax/)
- [Asthma](https://durgical.com/en/conditions/asthma/)
- [Hypoglycaemia (including insulin-induced)](https://durgical.com/en/conditions/hypoglycaemia/)
- [Traumatic brain injury](https://durgical.com/en/conditions/traumatic-brain-injury/)

## In Pharmacology 3

- [Epinephrine](https://durgical.com/en/pharmacology/epinephrine/)
- [Amiodarone](https://durgical.com/en/pharmacology/amiodarone/)
- [Oxygen](https://durgical.com/en/pharmacology/oxygen/)

[← All clinical skills](https://durgical.com/en/clinical-skills/)

Educational content; it does not replace supervised hands-on training, your institution's protocols or a prescriber's order. A procedure is learnt with a teacher and done only once you are trained to do it.

Sources: [Trauma Assessment](https://www.ncbi.nlm.nih.gov/books/NBK555913/) (StatPearls (NCBI Bookshelf), 2026); [Advanced Cardiac Life Support (ACLS)](https://www.ncbi.nlm.nih.gov/books/NBK613285/) (StatPearls (NCBI Bookshelf), 2025).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/clinical-skills/the-emergency-station/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-skills/the-emergency-station/