OSCE 1

Clinical case.
Candidates were asked to describe the X-ray findings, interpret arterial blood gases and an ECG, and suggest relevant further management. Questions included:“A 64 year old man is referred to the Intensive Care Unit with hypoxaemia 5 days post-lobectomy for lung carcinoma.
This is his Chest X-ray on admission to ICU. List the findings.”

On admission to ICU, he is NOT in respiratory distress, is afebrile with a normal white cell count and is otherwise stable. This is his arterial blood gas:

What measures could be used to improve his respiratory status?”

Potential problems to be identified included: intercostal catheters, pneumothorax, mediastinal shift, collapse/consolidation, pleural fluid and subcutaneous emphysema; Sinus tachycardia, P pulmonale, Right axis deviation and Right ventricular hypertrophy.
Seven out of sixteen 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.