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Go from there. Yeah, it's recording. Ok. It's recording now. Ok. So I'm just gonna share my screen. Can you see that as the whole screen now? Saba? Uh Yeah. Ok. Right. Uh Let's get started, I guess. Uh So hello everyone. Uh my name's Poppy Valerie and I'm 1/4 year student currently at Imperial. I'm not sure how much experience you have all had with this topic. So I'm just gonna run through the basics tonight to make sure everyone's on the same page by the end. Um Hopefully this shouldn't take too much time. I doubt we'll need the full hour. Uh I've, I confess this is quite based towards imperial guidelines. Um because that's, that's the only thing I know really? So I would definitely advise that you check your individual universities, um sort of what they want from you as well. But hopefully this will just give a basic overview. So today we're gonna be looking at wound care and suturing together as these two topics often come hand in hand. Uh in the Os. I think it's very unlikely you'll be asked to do both in the same station just for time reasons. Really. But in practical terms, you'd obviously be expected to perform these skills together because you can't really do one without the other suturing in particular is a very common station in the Os. So I definitely recommend you learn how to do this competently. I was asked to do it in my oy last year, all the older years I know have also been asked to do suturing. So for imperial students watching, I'd say to consult in send as that's quite helpful. And for other students, I imagine your faculty will also have similar guidance for exactly what your uni wants for the mark scheme. But there's also lots of great videos and resources online. So the geeky magic ones are always good. And thankfully for both of these skills, there are many marks that you can scoop up just by learning a script and some questions to ask the patient before and after. So even if you're not the most confident with the technique itself, there's still an opportunity to do well in these stations. And the way to do many of these practical stationss is to break it down into before during, after which we'll do tonight. So before we get started, there are some general tips for every practical OSK station. So make sure you clean everything and clean it really extravagantly. So the examiner can see likewise check everything's in date and tell the examiner that it is in date. Lots of the OSK can become a bit of a pantomime. To be honest, it's, um, it's a lot about acting. If you can do something nicely and confidently, then that does go a long way in the eyes of the examiner. And there might even come a point where they stop looking for any errors that you make also for this station and others do learn how to use the sterile fields on the sterile gloves as it actually does take quite a lot of work to learn how to do it competently. And you don't want to be fumbling in the exam either for time reasons. And also you don't want to look unprofessional and like you've never done it before. So for this tutorial, I thought we'd utilize a case to add some context. You're in A&E and you're asked to see a patient who's fallen off his motorbike. Thankfully, there was no major trauma here. He swerved to avoid the cat when pulling out the drive and ended up on the ground. Unfortunately, you can't do anything for his pride, but you can do something about the laceration that he's sustained on his forearm. Now, you've got him settled in a cubicle and you're going to clean the wound and dress it. And no worries guys. The cat was also alright. So first things first, any idea for what equipment we would need? I prepared this as a question, but unfortunately, I can't see the chat in this um way of presenting the slides, er, do feel free to put your ideas in the chat just to give yourself some validation when you get the right answer on the next slide. So, as we'll see, there are many items that you will likely need and what you're given will probably vary from campus to campus. But some basics that you will probably need are as follows. So you'll need correct PPE for this station. Definitely a plastic apron. You're less likely to need non sterile gloves in the osk setting. But um in real life, you probably would some places might give you a trolley to set everything out on others. We will have. You just use the table, always make sure you've got some handy clinal with you. If you're using a blue tray at all and also to clean the trolley. If you're using that, you'll also need some dressings. Just a, a simple one is ok for this station. It's more about the principle. The dressing pack is your key item here. So this is a bundle with a handy tray for the antiseptic and cotton wool gauzes might have some forceps in there. All the things that you'll need for the station, you will also definitely need a pair of sterile gloves. You might want to take some small syringes to irrigate the wound if there's any debris. And as mentioned, they might provide you some forceps, but I don't think you'd probably be expected to use those on the models that they have. Lastly, you'll need a cleaning agent such as sterile saline or the pink chlorhexidine. And remember all of this will be laid out in front of you. So there's quite a bit of intuition. You don't have to just remember it all off the top of your head. Also make sure that you check the date on everything and make sure that you announce that to the examiners. So they know what you're doing as well. Here's just an idea of what a dressing pack might have in it. They do vary. Some places have a little ruler to measure the wound as well. Um But as you can see, there's lots of gauze, there might be cotton wool, there's a tray in the top left for the antiseptic and the bin bag in the middle. This one has some gloves included in it, but you might need to put them in separately as well. You can actually use the BM bag in the middle or the gauze as a sort of makeshift glove to sort out everything that you need because when you open the bundle, it'll all be mixed up. So to help you lay out your items, you can put your hand inside the sterile bin bag and then use it just to organize all the items in the sterile field. And then when you're done, you can stick the bin bag. It's got like a sticky layer on the back, you can just stick it onto the table or if you use a piece of gauze, if there isn't a bin bag, then that's also how you can lay everything out, but just make sure you then get rid of that gauze, don't use it or put it back into the sterile field afterwards. So, the beauty of this station and the suturing station is that you can actually gain a lot of marks before you even lay a hand on the patient. It's all just about saying the right things and about the same is true across the whole sy really. And it is sort of before, during, after where you pick up marks, not just the technique itself, if you, if you do suturing for instance, absolutely flawlessly, but you don't have any patient manner, then you won't get the top marks. Uh I'd really recommend you have a script ready for sort of introducing yourself to the patient and just learn it by heart. So you're confident on the day. Uh There's some good mnemonics out there that sort of help you remember all the different things to say. I think wiper is quite a popular one. So, apologies in advance for the heavy text on this slide, but I thought I would just write it all down and then you guys can refer back to it on the recording. So first you need to introduce yourself to the patient, give them your name and your role and you can wash your hands while talking to save time and then you can confirm the patient's name and date of birth. Then next, you need to explain what you'll do and get consent, which is the most crucial part. You don't need to absolutely bamboozle the patient with loads of information, but you do need to give them enough info. So they know roughly what's going to come next. But for legal informed consent and also for the patient's own benefit, um This might help a particularly anxious patient if they know what you're going to do, and it just shows that you've got good patient manner. So before you start, you need to ask some more questions um to check that it's safe to continue. So again, there's lots of good marks to be gained here. You might not need all of these for time's sake, but here's just a possible list. So check if the patient's got any prior experience of having wound care before, ask the basics as to how they got the wound. Did they see if anything went in it? Um The patient will sort of keep it brief because they're actors in the oy and they'll be aware that you're under time pressure if you have time and it's pertinent for the method of injury, you might want to ask if they've had a tetanus shot in the last 10 years. And if they haven't say that you'll get a member of the team to go and give them one shortly. Then there are some standard questions that you should ask from practical stations such as do they have any allergies for this one? In particular allergies to latex or cleaning solutions? Ask them if they're on any blood thinners or medications like steroids. Ask if they're in any pain right now in the osk, uh, pretend member of the team will have given them local anesthetic already. And then lastly check if the patient has any questions. And again, in the osk, they probably won't because they're aware that you're under time pressure. So now you have all your equipment gathered and you've sorted out things for the patient, it's time to get set up. So your cleanliness and your aseptic technique is very important here. First, you need to ensure the patient is comfortable and has the wound exposed because you don't want to get everything set up and have your sterile gloves on. Only to realize that the patient's got a jacket on and you need to, you can't access the wound. So just in practical terms, make sure that that's all ready and then clean your hands again before handling your equipment. You can never do it too many times. Clean the trolley or the table with wipes and on your apron and gloves. Uh If you have time, you can make a bit of a show of inspecting the wound for any debris