A 68-year-old man is brought to the ED with sudden-onset right-sided weakness and expressive dysphasia. His wife says symptoms started approximately two hours ago. How do you assess and manage this patient?
- FAST screening: Face drooping, Arm weakness, Speech difficulty, Time to call 999
- CT head urgently to differentiate ischaemic from haemorrhagic stroke - must be done before any treatment
- IV thrombolysis (alteplase): within 4.5 hours of symptom onset (NICE NG128)
- Mechanical thrombectomy: for large vessel occlusion, up to 6 hours (or 24 hours in selected patients with favourable imaging)
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How to approach this Emergency Medicine interview question
This quality improvement question is common in Emergency Medicine NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A 68-year-old man is brought to the ED with sudden-onset right-sided weakness and..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.
What the panel is testing
A strong quality-improvement answer uses method as well as enthusiasm. Be clear about the problem, baseline measurement, intervention, re-measurement, and how the change was made sustainable. For emergency medicine, keep the answer time-aware. Panels expect prioritisation, early senior involvement, concise handover, and awareness of department flow without losing sight of the individual patient.
- Separate audit, QI, research, and clinical governance clearly so the panel can follow your reasoning.
- Use a real cycle: baseline, intervention, re-measurement, learning, and sustainability.
- Link the project back to patient safety, service reliability, or measurable outcomes.
How to structure your answer
For a quality improvement prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.
- Open by naming the main issue in the question.
- Give a structured response rather than a memorised script.
- End with escalation, documentation, learning, or follow-up.
Common mistakes to avoid
The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.
- FAST screening: Face drooping, Arm weakness, Speech difficulty, Time to call 999
- CT head urgently to differentiate ischaemic from haemorrhagic stroke - must be done before any treatment
- IV thrombolysis (alteplase): within 4.5 hours of symptom onset (NICE NG128)