Crises
Viva Crises
Group
Crisis or Problem
Completed Stems
General Stem
Cardiac Stem
Obstetric Stem
Airway Stem
Paediatric Stem
Trauma Stem
Pain/Regional Stem
Neuro Stem
Question 1
Question 2
Question 3
Proposed Structure
Airway + Breathing
16
a CICO scenario
1
Open
Open
What will you do?
Attempts at securing the airway from the mouth fail and the SpO2 continues to fall. What will you do now?
Open
a high risk extubation
1
Open
Open
Outline your approach to this situation.
Open
a pneumothorax
0
Open
Open
Open
a tracheobronchial injury
0
Open
Open
Open
a tracheostomy disaster
1
Open
Open
How do you manage this situation?
What are the possible causes of obstructed tracheostomy ventilation?
Open
acute pulmonary oedema
0
Open
Open
Open
acute severe asthma
1
Open
Open
What will you do?
What is the management pathway for acute severe asthma?
Open
an acute exacerbation of COPD
0
Open
Open
Open
an airway disaster on the ward
1
Open
Open
How will you manage this situation?
What is your general approach to the management of an airway disaster on the ward?
Open
an airway fire
0
Open
Open
Open
an inhalational injury
0
Open
Open
Open
flail chest
0
Open
Open
Open
massive haemoptysis
0
Open
Open
Open
perioperative aspiration
0
Open
Open
Open
respiratory arrest
0
Open
Open
Open
severe bronchospasm
0
Open
Open
Open
Circulation
26
a fat embolism
0
Open
Open
Open
a gas embolism
0
Open
Open
Open
a tension pneumothorax
0
Open
Open
Open
a traumatic aortic disruption
1
Open
Open
Describe your management of this situation
Open
acute myocardial ischaemia
1
Open
Open
What will you do?
What are the potential causes of myocardial ischaemia intraoperatively?
Open
an acute aortic dissection
1
Open
Open
How would you manage this situation?
Open
an intra-arterial injection
0
Open
Open
Open
cardiac arrest
0
Open
Open
Open
cardiac tamponade
0
Open
Open
Open
coagulopathy in association with trauma or surgery
0
Open
Open
Open
hypercalcaemia
0
Open
Open
Open
hyperglycaemia
0
Open
Open
Open
hyperkalaemia
0
Open
Open
Open
hypermagnesaemia
0
Open
Open
Open
hypernatraemia
0
Open
Open
Open
hypocalcaemia
0
Open
Open
Open
hypoglycaemia
0
Open
Open
Open
hypokalaemia
0
Open
Open
Open
hypomagnesaemia
0
Open
Open
Open
hyponatraemia and hypoosmolality
0
Open
Open
Open
life-threatening bradycardia
0
Open
Open
Open
life-threatening tachycardia
0
Open
Open
Open
metabolic acidosis
0
Open
Open
Open
myocardial contusion
1
Open
Open
How will you manage this patient?
What are the potential complications of a myocardial contusion?
Open
pulmonary embolism
0
Open
Open
Open
shock
0
Open
Open
Open
Disability
3
acute intracranial/subarachnoid haemorrhage
1
Open
Open
How will you manage this patient?
What are your haemodynamic targets in a patient with an acute subarachnoid haemorrhage?
What are the possible immediate complications of an acute subarachnoid haemorrhage?
Open
acute spinal cord injury/neurogenic shock
1
Open
Open
How will you manage this patient?
What are the principles of management for patients with acute spinal cord injury?
Open
acute traumatic brain injury
0
Open
Open
Open
Intraoperative
10
bradycardia
3
Open
Open
What do you do?
What are the potential causes of this patient’s bradycardia?
Open
dyspnoea
3
Open
Open
What do you do?
What are the possible causes of dyspnoea in this patient?
Open
high airway pressures
1
Open
Open
What do you do?
What are the possible causes of high airway pressures in this patient?
Open
hypercapnia
1
Open
Open
How do you manage this?
What are the possible causes of hypercapnia in this patient?
Open
hypertension
2
Open
Open
What do you do?
What are the potential causes of hypertension in this patient?
Open
hypocapnia
1
Open
Open
What would you do in this circumstance?
What are the possible causes of hypocapnia in this patient?
Open
hypotension
1
Open
Open
What do you do?
What are the potential causes of hypotension in this patient?
Open
hypoxia
1
Open
Open
What do you do?
What are the potential causes of hypoxia in this patient?
Open
oliguria/anuria
1
Open
Open
How do you approach this problem?
What are the possible causes of oliguria or anuria in this patient?
Open
tachycardia
1
Open
Open
How do you respond?
What are the possible causes of tachycardia in this patient?
Open
Recovery
13
airway compromise
1
Open
Open
How would you manage this situation?
What are the potential causes of airway compromise in this patient?
Open
altered postoperative mental state
1
Open
Open
How will you manage this situation?
What are the possible causes of this patient’s altered postoperative mental state?
Open
delirium
0
Open
Open
Open
emergence delirium
1
Open
Open
How will you manage this situation?
What are risk factors for emergence delirium?
Open
failure to wake from anaesthesia
1
Open
Open
Open
hypertension
0
Open
Open
Open
hypotension
0
Open
Open
Open
hypoxia
0
Open
Open
Open
nausea and vomiting
0
Open
Open
Open
oliguria
0
Open
Open
Open
severe postoperative pain
0
Open
Open
Open
shock
0
Open
Open
Open
tachycardia
0
Open
Open
Open
Obstetric
14
abnormal placental implantation
1
Open
Open
How will you approach this situation?
What are the considerations in a patient with placenta accreta syndrome?
Open
amniotic fluid embolism
0
Open
Open
Open
antepartum haemorrhage
0
Open
Open
Open
breech presentation
0
Open
Open
Open
cord prolapse
0
Open
Open
Open
eclampsia
0
Open
Open
Open
foetal death in utero
0
Open
Open
Open
maternal collapse
0
Open
Open
Open
neonatal resuscitation
0
Open
Open
Open
postpartum haemorrhage
1
Open
Open
What do you do?
What are the possible causes of postpartum haemorrhage?
Open
premature labour
0
Open
Open
Open
shoulder dystocia
0
Open
Open
Open
uterine rupture
0
Open
Open
Open
vaginal birth after caesarean (VBAC)
0
Open
Open
Open
Other
17
a breathing circuit malfunction (stuck valve, massive leak)
1
Open
Open
How do you manage this situation?
It becomes apparent that one of the valves inside the anaesthetic machine has become stuck. What do you do?
Open
a crush injury
0
Open
Open
Open
a high spinal
0
Open
Open
Open
a hyperosmolar, hyperglycaemic state
0
Open
Open
Open
a hypoosmolar state
0
Open
Open
Open
a pericardial effusion in the context of malignancy
0
Open
Open
Open
abdominal sepsis
0
Open
Open
Open
accidental awareness under anaesthesia
0
Open
Open
Open
acute cord compression in the context of malignancy
0
Open
Open
Open
acute drug intoxication
0
Open
Open
Open
acute pancreatitis
0
Open
Open
Open
altitude sickness
0
Open
Open
Open
an Addisonian crisis
0
Open
Open
Open
an anaesthesia machine/ventilator malfunction
0
Open
Open
Open
an ischaemic/haemorrhagic stroke
0
Open
Open
Open
an operating room fire
0
Open
Open
Open
envenomation
2
Open
Open
How would you manage this situation?
What are the principles of management for an envenomation injury?
Open
