Viva 1

You are asked to review a 23-year old female in the Emergency Department who has presented via ambulance with her first seizure. She was still fitting after being given 5mg of diazepam IV by the ambulance officers and a further 20mg of midazolam by the staff in the Emergency Department. She was then intubated and taken for a head CT scan, which is reported as normal.

She is currently intubated, sedated with fentanyl and midazolam, has been paralysed with vecuronium, with a BP 140/80, HR 98, O2 saturation 100%, temp 37.8°C.

What will you look for on initial assessment as she arrives in the ICU?

The rest of the questions focused on the causes of seizures in a young patient, monitoring (including role of EEG) during status and management of status.

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.