Mr Smith is a 54 year old male who was admitted to the ICU 7 days ago. He presented with severe hypoxic respiratory failure and has a background of advanced motor neurone disease. He is currently unconscious, intubated and ventilated. Mr. Smith has a valid advanced care directive stating that he would not want life sustaining measures should he require invasive life support. There is consensus amongst you and your colleagues that extubation and palliation are appropriate. Mrs. Smith agrees that this is what her husband would want under these circumstances.
Mr Smith has a nephew/niece named Pat, who has not seen him for some years, and s/he has just arrived back from overseas to see him. Mrs Smith has asked that you talk to Pat to discuss his/her Uncle’s condition and treatment plan and is happy for you to discuss all of his medical information with Pat.
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.