Scenario: A 13-year-old girl presents with a one-week history of nausea, dry retching and crampy abdominal pain. She has been up during the night to pass urine and this morning complained of feeling very cold. This morning she became rigid with her eyes staring. This was followed by a brief period of apnoea and cyanosis.
Her mother drove her to the local hospital where she was noted to be pale and cool peripherally. Her heart rate was 66 bpm with a BP of 100/80.
Introductory question: Describe your initial management?
Twenty out of twenty-eight candidates passed this section.
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.