While dealing with an aggressive patient in an OSCE encounter, remember to look for hints in the room and always think about the 7 H's of aggressive behavior:
Hypoxia
Hyperglycemia/Hypoglycemia
Head Injury
Hash: Illicit drugs/alcohol
High Temperature: fever/SepsisEncephalopathy
HIDDEN AGENDA (Letter for work leave, insurance agency, or follow up for GP)
Hints in the Exam Room
Most importantly,
Stay Calm, Listen to the patient uninterrupted, Look at the patient's problem from their perspective, Relate to the patient, provide information in short chunks, address their concerns, appreciate them, reassure, and educate.
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