OSCE 4

Clinical Case 1.

Case presented regarding investigation and management of a patient with multiple trauma
(including a pelvic fracture).  Introductory material and initial question was:

“You are asked to see a male motorbike rider in his early 20’s.  He was the rider of a bike that hit a car at high speed.  He was wearing a helmet.  Ambulance officers say that he was thrown 15 meters and sustained a brief loss of consciousness at the scene. Vital signs en route to hospital included: GCS 15, P 125/min, BP 70 systolic. He was pale, complaining of back, abdominal and pelvic pain.  Ambulance officers have commenced IV fluid resuscitation.
You are attending to him in the Emergency Department as part of the hospital Trauma Team. He has GCS 15, but is agitated and uncooperative. He has low BP and tachycardia with impaired peripheral perfusion.


What are your immediate priorities and what immediate investigations do you order?”

Eighteen out of twenty-two candidates passed this station.

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.