OSCE 9

“A twenty-three (23) year old woman (Jane Bland) was admitted to your Intensive Care
Unit last night with a right lower lobe pneumonia, hypoxaemia and hypotension. Her blood pressure is now stable but she is breathless and has a pulse oximeter saturation of 85% while breathing humidified 90% oxygen at a flow of 50L/min. The pulse oximeter values have been consistent with a recent arterial blood gas:

pH

7.30

7.35 – 7.45

PaCO2

61

mmHg

35 -40

PaO2

51

mmHg

Approximately five (5) years ago she was diagnosed with a form of muscular dystrophy. She is normally wheel chair bound and needs help with feeding and washing. She lives at home with all care provided by her brother. She is now too breathless to speak and has indicated that she wants you to speak to her brother who has medical power of attorney.”

Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.