Primary Viva 1 (Clinical)

 An 80-year-old man presents with an acute abdomen for an emergency laparotomy. He is in atrial fibrillation at a rate of 80 bpm and has not passed urine for 8 hours. He is also mildly breathless.

1. How would you optimise the patient for surgery?
2. How would you assess his volume status?
3. Discuss fluid management, differential diagnoses and cardiac assessment.
4. How would you anaesthetise him?

 During surgery, the patient develops frequent ectopics, becomes compromised and subsequently progresses to ventricular tachycardia (VT).

1. How would you treat this emergency situation?

 The patient then develops ventricular fibrillation (VF).

1. How would you treat this situation now?
2. How is blood loss assessed?
3. How do you manage different severities of haemorrhage?