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Primary Viva 5 (Clinical)

Created: 14/9/2004


1. Before your viva, you are given a card to read, which says the following:

“You have been called to A&E to provide anaesthesia for reduction of a Colles’ fracture. The patient is a 68-year-old heavy smoker and drinker, who has been involved in a house fire; she has burns to her face, chest and arms.”

– What assessment of the patient would you make?

– Discuss airway assessment, the significance of SaO2 and any other investigations you would perform(COHb).

– What are the indications for intubation?

– What fluid requirements will the patient have? What fluid would you give, when would you give it and why?

– Discuss analgesia – are burns painful?

– Would you give an anaesthetic for the fracture?

– Where should the patient be looked after?

2. What would you do if an anaesthetised patient suddenly became hard to ventilate?

– Discuss your management in this critical situation.

– What are the signs of a pneumothorax?

– How should a pneumothorax be treated?

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