The Senior Registrar has just performed a percutaneous tracheostomy, on a 17-year-old female, Ashleigh, recovering from meningococcal sepsis.
As the supervising consultant you were unavoidably called away to a separate emergency. The procedure was undertaken with due diligence, but has been complicated by a posterior tracheal tear (acute bilateral pneumothoraces and massive subcutaneous emphysema).
You as the consultant need to inform the guardian (an ex nurse) of this unfortunate complication, but have also been made aware that the consent for the procedure was obtained by the junior registrar and was rushed, lacked detail and was incomplete.
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.