PACTS SP-LLM Trial Case

Setting: Emergency room during regular office hours

You are covering trauma consults for the team today. The patient is a 28-year-old with right sided posterior rib fractures after a fall 7 days ago. The patient was admitted to the trauma service and her initial workup included and chest x-ray and CT of the chest. The rest of the exam and findings were negative for other acute injuries. The Pain team was consulted and she underwent a local nerve block. She was then discharged the following day with two weeks of oral pain medication (oxycodone) and instructed to return to the clinic in two weeks. Over the past few days the patient has called the trauma service several times for complaints of pain and generalized discomfort and have requested additional pain medication or evaluation. She now returns to the emergency room as the pain is not well controlled. No Physical Exam is required by you.

Patient Information:

Patient Name: N. Ramnerine

Age: 28 years old

PMH: Right posterior rib fractures and pulmonary contusion

PSH: s/p fall 7 days ago

Medications: The only prescribed medication was oxycodone x 14 days

Vital Signs: HR 92 RR 14 BP 138/88 Temp 38

Lab Results: N/A

Image Results:

OSCE Goals:

  • Discuss with patient current status and need for pain medication
  • Provide the patient with a pain management plan

Click here to begin your encounter with patient N. RAMNERINE.