NMC OSCE A to E Assessment Template

Before you start

Safe scene and privacy, clean hands, introduce yourself, check ID (name, and date of birth or hospital number) and allergies verbally, on the wristband and the documentation, then gain consent.

Look and listen. Can the patient talk to you in full sentences?
Say it: "You are talking to me in full sentences, so your airway is clear, with no obstruction."

Count the respiratory rate for one full minute. Say the rate and whether it is high or low.
Comment on rhythm (is it regular?) and depth (shallow or normal?).
Measure oxygen saturation with the pulse oximeter and state the reading.
Listen for breath sounds such as rattle, wheeze or stridor, and ask about any recent cough.
Check the chest rises equally on both sides and say so.
Look for signs of respiratory distress. Accessory muscle use, sweating, cyanosis, paradoxical breathing.

Take the pulse for one full minute. State the rate, whether it is regular, and whether it is strong or weak.
Measure blood pressure and give the exact reading.
Check capillary refill. Press the nail for 5 seconds; colour should return within 2 seconds.
Comment on skin colour and perfusion (for example, no pallor, well perfused). Staying silent here is a critical fail.

Assess the level of consciousness using ACVPU (alert, confusion, voice, pain, unresponsive) and say the result. In the exam it is usually alert or confused, so ask where they are and what month it is.
Ask about pain. Where is it, and what is the score from 0 (no pain) to 10 (worst pain)?
Ask the examiner for the latest blood glucose and the urine output for the last 24 hours, then comment on both.

Take the temperature and say the reading.
Ask the patient about any redness, bleeding, bruises, wounds, cuts or rashes under their clothes. Do not look under clothing.
Review the past medical history and medicines on the history form for anything that raises the risk of infection or sepsis.
If something raises the risk, say you will make sure the doctor is aware.

Learn the order first. Airway, Breathing, Circulation, Disability, Exposure, every time.
Practise out loud on a partner. Checking silently is not enough; the examiner can only mark what you say.
For every reading, give the value and say whether it is normal, high or low.
Time your practice runs so you complete a full, unhurried A to E within the station time.