You are taking over the care of Tina, 40-year-old female, who was admitted 5 days ago after an intentional overdose of propranolol. On presentation to the Emergency Department 5 days ago, she had a witnessed PEA cardiac arrest, and was resuscitated with return of spontaneous circulation after a downtime of 5 minutes.
Subsequently in the ICU, she has had a stormy course requiring mechanical ventilation, dialysis, high dose insulin dextrose therapy, and high dose adrenaline infusion resulting in ischaemic fingers and toes. However, this has been improving in the past 48 hours, with a reduction in adrenaline requirement. Sedation was ceased this morning to facilitate neurological assessment.
You are about to meet with Tina’s sister/brother Susan/Sam. Prior to the meeting, the bedside nurse tells you that Susan/Sam found a suicide note written by Tina describing she wanted to end her life and did not want to suffer anymore.
Susan/Sam is in the waiting room.
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.