Viva 4

A 25-year-old man was involved in a high speed motor vehicle accident. His GCS was M4 E2 V2.

The patient was intubated and ventilated in the Emergency Department. Vital parameters post-intubation, SpO2 98% on 50% oxygen, BP 130/80, reactive pupils.

A CT head was reported as diffuse axonal injury (DAI). Other imaging confirmed rib fractures and lung contusions and excluded any other injury.

What is your understanding of DAI?

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.