Course Content
💊 Station 1 — Prescription Writing for Pulmonary Tuberculosis
Learning Outcomes Write an appropriate prescription for a supplied case of pulmonary tuberculosis. Include the essential components of a complete prescription: drugs, dose, route, frequency and duration. Demonstrate rational and safe anti-tuberculous prescribing according to the supplied clinical scenario.
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Prescription Writing for Pulmonary Tuberculosis
⚖️ Station 2 — Differentiation of Hanging and Strangulation on a Model
Learning Outcomes Examine the provided model and differentiate hanging from strangulation. Demonstrate the important distinguishing features on the model. State the relevant medico-legal significance of the demonstrated findings.
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Differentiation of Hanging and Strangulation on a Model
⚖️ Station 3 — Identification of Different Types of Hanging on a Model
Learning Outcomes Examine the provided model depicting hanging. Differentiate the demonstrated types of hanging. Identify the features on the model that support the classification.
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Identification of Different Types of Hanging on a Model
😷 Station 4 — Identification and Correct Wearing of Respiratory Masks
Learning Outcomes Identify the different masks provided at the station. State their appropriate uses. Demonstrate the correct protocol for wearing the selected mask.
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Identification and Correct Wearing of Respiratory Masks
💨 Station 5 — Correct Use of a Metered-Dose Inhaler with Spacer
Learning Outcomes Demonstrate the correct stepwise use of a metered-dose inhaler with a spacer. Perform the steps in the correct sequence. Demonstrate appropriate coordination of inhaler actuation and inhalation using the spacer.
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Correct Use of a Metered-Dose Inhaler with Spacer
💊 Station 6 — Prescription Writing for Acute and Chronic Asthma
Learning Outcomes Write an appropriate prescription for a supplied acute or chronic asthma scenario. Select appropriate medication(s), dose, route, frequency and duration. Demonstrate safe and complete prescription-writing practice.
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Prescription Writing for Acute and Chronic Asthma
🚨 Station 7 — Prescription Writing for Status Asthmaticus
Learning Outcomes Recognize that the supplied scenario represents severe/status asthmaticus requiring emergency treatment. Write the appropriate emergency pharmacological prescription/order. Include appropriate drugs, routes and dosing instructions in a clear prescription format.
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Prescription Writing for Status Asthmaticus
📈 Station 8 — Interpretation of Spirometry in Asthma/COPD
Learning Outcomes Interpret a provided spirometry report. Identify an obstructive ventilatory pattern when present. Relate the spirometry findings to the supplied asthma/COPD clinical scenario.
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Interpretation of Spirometry in Asthma/COPD
🩺 Station 9 — Focused Assessment of an Asthma/COPD Patient
Learning Outcomes Perform a focused routine assessment of a patient with asthma or COPD. Identify important findings and relevant complications/red flags. Determine when specialist referral is required.
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Focused Assessment of an Asthma/COPD Patient
🩻 Station 10 — Identification of Common Abnormalities on Chest X-Ray
Learning Outcomes Examine a provided chest radiograph systematically. Identify and describe the major radiological abnormality demonstrated. Correlate the radiological finding with the supplied respiratory clinical scenario.
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Identification of Common Abnormalities on Chest X-Ray
🫁 AIM OSPE/OSCE Lab — Respiratory-II Module | 3rd Year MBBS
AIM OSCE / OSPE • MBBS

Station 7 — Prescription Writing for Status Asthmaticus

Rapid Revision • Emergency Prescribing • Viva

🎯 Task

CANDIDATE TASK

A 28-year-old adult with known asthma presents with marked breathlessness, inability to complete sentences, respiratory rate 32/min, SpO₂ 88% on room air and markedly reduced peak expiratory flow. Write the immediate emergency pharmacological prescription/order, clearly stating the drugs, doses, routes and dosing instructions.

⚡ Model Station Answer

⚡ Model Station Answer

What to write / say in the exam
This is a severe, potentially life-threatening acute asthma exacerbation requiring immediate supervised emergency treatment.
Rx
1. Oxygen: Give controlled supplemental oxygen and titrate to maintain adult SpO₂ approximately 92–95%.
2. Salbutamol: 5 mg by nebulization; repeat every 20 minutes during the first hour if required, with close reassessment.
3. Ipratropium bromide: 500 micrograms by nebulization, given with repeated bronchodilator treatment during initial management of severe/life-threatening asthma.
4. Prednisolone: 40–50 mg orally once daily, usually for 5–7 days. If oral treatment cannot be given, use an appropriate intravenous systemic corticosteroid according to the emergency protocol.
5. If inadequate response to intensive initial treatment: consider magnesium sulfate 1.2–2 g IV over approximately 20 minutes with senior/emergency supervision.
Emergency point: Status asthmaticus is not managed as a routine home prescription. Call for senior/emergency help, monitor continuously and escalate to critical care if the patient deteriorates or has life-threatening features.

🔎 Stepwise Procedure / Approach

  1. Review the scenario first. Recognize severe or life-threatening asthma and treat the prescription as an emergency order.
  2. Check patient identifiers, allergies, date and time. Confirm that the prescription/order belongs to the correct patient.
  3. Prescribe supplemental oxygen with a clearly stated target saturation rather than writing “oxygen PRN”.
  4. Prescribe rapid inhaled bronchodilation. Write salbutamol with the exact dose, nebulized route and repeat instructions.
  5. Add inhaled ipratropium in severe or life-threatening exacerbation and specify the nebulized dose.
  6. Prescribe an early systemic corticosteroid. State drug, dose, route, frequency and intended short course.
  7. Escalate if response is inadequate. Consider IV magnesium sulfate under supervised acute-care management rather than adding routine sedatives or unnecessary drugs.
  8. Check the completed order. Verify generic drug names, units, routes, frequencies, allergies and avoid ambiguous abbreviations.
  9. Authenticate the prescription. Add prescriber name/identifier, signature and date/time according to local practice.
Exam tip: Marks are commonly lost by writing only drug names without the dose + route + frequency/repeat instruction, or by forgetting patient details, allergies, date/time and prescriber authentication.

🖼️ Visual Learning

VISUAL 1

Emergency Prescription Writing for Severe / Status Asthmaticus

🎥 Practical Video

🎥 Practical Demonstration — ABCDE Assessment: Asthma Exacerbation
Source: Geeky Medics
Demonstrates recognition and immediate management of an acute asthma exacerbation using an ABCDE emergency approach, including treatment, reassessment and escalation relevant to the clinical context in which the emergency prescription is written.

▶ Watch Practical Video

📝 Important Viva Questions

Q1. Why is status asthmaticus treated as a medical emergency?

Answer: It is a severe asthma exacerbation that may fail to respond adequately to usual reliever therapy and can progress to respiratory failure, so rapid treatment, monitoring and escalation are required.

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Q2. What is the principal rapid bronchodilator used initially?

Answer: An inhaled short-acting β₂-agonist such as salbutamol, administered repeatedly during initial treatment according to severity and response.
Q3. Why is ipratropium added in severe acute asthma?

Answer: It provides additional bronchodilation when combined with a short-acting β₂-agonist and is particularly useful in severe or life-threatening exacerbations.
Q4. Why should systemic corticosteroids be given early?

Answer: They suppress airway inflammation, reduce the risk of continuing deterioration or relapse and improve recovery, although their clinical effect is not immediate.
Q5. When may intravenous magnesium sulfate be considered?

Answer: It may be considered in severe or life-threatening exacerbation when the response to intensive initial bronchodilator and corticosteroid treatment is inadequate.
Q6. Which prescribing details must accompany every emergency drug order?

Answer: The prescription should clearly state the generic drug name, dose, route and frequency or repeat instructions, together with patient identifiers, allergies, date/time and prescriber authentication.
Q7. Name two drugs or treatments that should not be prescribed routinely in an uncomplicated asthma exacerbation.

Answer: Sedatives should be avoided, and antibiotics should not be prescribed routinely unless there is a separate clinical indication for bacterial infection.
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