Viva 4

A 45 year old man is brought to the Emergency Department following a motor vehicle accident. He was the driver in a frontal collision. The other occupant of the car is dead. There is no history of loss of consciousness and he is fully conscious on presentation to the Emergency Department. His airway is patent. Respiratory rate 26/min. BP 70/45 mm Hg, HR 110/min. He has two 14G IV cannulae in situ. Chest expansion is symmetrical but he has seatbelt abrasion across his chest.

Describe your initial management.

The rest of the questions focused on the management of severe trauma, recognition of abdominal injuries, damage control surgery, and management of ongoing hypotension, and oliguria.

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.