Viva 8

You have just started your week on duty as the consultant. On handover you have been advised that the family representative is coming in for a discussion today about George. George is a 67-year-old man, day 7 after resuscitation following an unwitnessed cardiac arrest. He has had no sedation for 3 days, has a Glasgow Coma Score of 3, unresponsive pupils and a weak cough. CT scan of head shows evidence of diffuse hypoxic brain injury. George is also on high levels of respiratory support due to concomitant aspiration pneumonia.

The family has been unwilling to accept his poor prognosis. They have made it clear that he is to
have all active treatment, including CPR in the event of an arrest, as George would want "everything” done.

This morning he is looking increasingly unstable with worsening hypoxia.

The family spokesperson has arrived and is waiting to talk to you.

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.