You are the Intensive Care Consultant caring for Aisha, an 18-year-old female with a background of cerebral palsy. She has recently transitioned from the paediatric to the adult hospital. She is cared for at home by her parent.
She was admitted to ICU yesterday with severe pneumonia, and was intubated and commenced on a noradrenaline infusion.
You decided on the ward round to insert a central line in the jugular vein. During insertion, your registrar has caused a pneumothorax. A chest drain is now required to treat the pneumothorax, although not urgently.
Previous discussions with her parent have identified that there should be no treatment limitations. Informed consent was obtained for the central line.
You are about to meet her parent for the first time, to explain the pneumothorax and the need for a chest drain.
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.