Viva 6

This is a procedure viva. The Examiners will ask you specific questions regarding the situation below.
You will be asked to demonstrate as well as explain some of your answers.

You are the incoming intensivist following changeover from a weekend.

You are taken to the bedside of a 25-year-old female. She is Day 4 in the ICU after diving into a river
and hitting a submerged object, leading to near drowning and aspiration of a large volume of river water.

She has progressive bilateral infiltrates on chest X-ray and is requiring an FiO2 of 0.6 and high levels
of PEEP to achieve saturations of 88% and a PaO2 of 60 mmHg.

How would you decide if prone positioning was an appropriate option for this patient at this time?

(This viva dealt with the management of asthma in pregnancy.)

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.