MBBS OSCE · Paediatrics
OSCE — Neonatal Sepsis
Eight-minute OSCE station on Neonatal Sepsis: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Neonatal Sepsis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Neonatal sepsis is a systemic inflammatory response to a documented or suspected infection in the first 28 days of life. It is the great mimic of neonatology: presentation is non-specific (temperature instability, poor feeding, lethargy, respiratory distress, apnoea). Divided into early-onset sepsis (EOS, within 72 hours or 7 days) — vertically acquired from the maternal genital tract, organisms Group B Streptococcus (GBS), E coli (K1 capsule), Listeria monocytogenes — and late-onset sepsis (LOS, after 72 hours or 7 days) — horizontally/nosocomially acquired, organisms coagulase-negative staphylococci (CoNS, S epidermidis), S aureus (incl MRSA), Klebsiella, E coli, Pseudomonas, Candida.
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Any unwell neonate in first 28 days - sepsis until proven otherwise; ABCDE and e |
| Safety | Temperature instability (fever in term, hypothermia in preterm), poor feeding, l |
| Safety | Maternal GBS colonisation, prolonged rupture of membranes over 18 hours, chorioa |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.