Zachary is a previously well 19-year-old male admitted to your ICU three days ago with refractory status epilepticus. No infective cause has been found and the working diagnosis is auto-immune encephalitis.
Zachary has been intubated and sedated. He continues to have frequent seizures despite adequate treatment with phenytoin, midazolam and levetiracetam and so propofol sedation has been increased to induce burst-suppression on continuous EEG monitoring.
This station contained 8 cases in total: 4 individual X-Rays and 4 CT scans displayed as a PowerPoint slide show.
Candidates spend the two-minute reading time reviewing the images as they wish.
A 50-year-old farmer with a history of alcohol abuse and depression is brought to the Emergency Department having been found collapsed in his garage.
He is semi-conscious and unable to move.
What is your differential diagnosis?
(it turned into a discussion of organophosphate poisoning)
You are working as a Locum Intensive Care Specialist in a regional hospital with no tertiary paediatric service. You are called as part of the trauma team to the Emergency Department to assist with the management of an 8 year old child with burns.
The paramedics report the child was found semi-conscious and breathing in the downstairs hallway of a home on fire less than an hour ago.
Describe your initial assessment and monitoring priorities for this child.
The focus of this viva is Evidence Based Medicine.
Please read this modified abstract.
High-Flow Nasal Oxygen vs Noninvasive Positive Airway Pressure in Hypoxemic Patients After Cardiothoracic Surgery
OBJECTIVE: To determine whether high-flow nasal oxygen therapy (HFNO2) was not inferior to BiPAP for preventing or resolving acute respiratory failure after cardiothoracic surgery.
DESIGN: Multicenter, randomized, non-inferiority trial