The objective of this small collection of links and recommendations is to shield the CICM Second Part Exam candidates against a wide range of possible written and viva questions about a diverse range of what can only be described as practical and pragmatic topics. Unlike the evidence-dense subjects like cardiology or neurosurgery, there are not a lot of trial acronyms to memorise here. Instead one should create an inventory of commonly used devices and procedires, and be familiar with the principles.
The past papers are no longer such a good guide to this material, and cannot be relied upon to describe the boundaries of the expected content. The syllabus document is probably a better guide, and it leaves us with some specific items, listed here in the same order and structure as they appear in the official syllabus:
Cardiac
Respiratory
Gastrointestinal
Renal
Neuro
Other
This is one of those few situation where a book can be recommended for this exam, as equipment in critical care tends to be stable and solid against the flowing current of evidence-based medicine:
How do you study for this? Everybody has a different structure. The current gold standard is the college syllabus, but it is not definitive, as anyone who has ever done one of the equipment vivas will attest that things were asked which do not neatly fit into these categories. Foot et al, the historic gold standard, also could not possibly cover every possible variation. Falter has a good structure for quick revision but it would be unsuitable for a lot of the ICU procedures (eg. prone ventilation or leading a CALS cardiac arrest).
| CICM Syllabus | Carole Foot's book | Falter (2012) | Exam through history |
| Description | Description | ||
| Safety features | Safety features | ||
| Indications | Uses/indications | Indications | Indications |
| Contraindications | Relative/absolute contraindications | ||
| Alternative options | |||
| Consent | Consent | ||
| Advantages | Advantages | ||
| Disadvantages | Disadvantages | ||
| Relevant anatomy | Positioning and anatomy | ||
| Site selection | |||
| Preparation | Environment, monitoring | ||
| Staff, team, roles | |||
| Insertion | Method of insertion/use | Technique | Procedure technique |
| Technical procedural caveats | |||
| Confirmation of success, correct placement, or correct function | |||
| Management | Safe maintenance of the device or process | ||
| Removal | Safe removal | ||
| Interpretation | Interpretation of data/output | ||
| Complications | Complications | Complications (early, late, etc) | |
| Strategies for risk mitigation |
The Exam through history column represents some kind of maximalist approach to anybody's description of a practical procedure or equipment item. It would not be necessary, and could even be harmful through time burglary, to apply every single point to every single item. However, given that the author has the luxury of reflecting on these exams from the distant vantage point of his middle age, all effort is made to represent each and every point for each and every item, even when to do so leads the reader into pointless culdesacs.