Primary Viva 10 (Clinical)

An 8-year-old girl is involved in a road traffic accident and is brought into Casualty intubated and ventilated.

1. How would you estimate her weight?

2. How would you assess her circulation?

3. What methods would you use to attain venous access?

4. How would you assess her neurological status?

5. How would you anaesthetise her to take her to the CT scanner for her suspected head injury?

The CT shows no intracranial pathology, so the child is taken to theatre for surgical repair of a fractured femur.

6. How would you anaesthetise her for this?

Surgery is uneventful but towards the end you notice that the patient is beginning to develop an unexplained tachycardia. You also notice that her end tidal CO₂ is beginning to rise and she is very hot to the touch.

7. What could be the cause of this and how would you treat it?

8. How could you confirm the diagnosis in the child and her family?

9. Where is the malignant hyperthermia research laboratory?