A 45-year-old man is admitted to the Emergency Department after ingesting an unknown quantity of “headache tablets”. His initial complaints are nausea, vomiting, shortness of breath and tinnitus. Fluid resuscitation has been commenced. You are asked to assess him as he is getting more dyspnoeic.

Outline the potential mechanisms of ventilator associated lung injury in patients with Acute Respiratory Distress Syndrome and the steps that can be taken to minimise them.

You are asked to review a 64-year-old male who has been brought to the Emergency Department having been burned in a house fire. He is drowsy and confused with a persistent cough and unable to give a coherent history.

The following questions refer to implantable cardiac pacemakers and implantable cardiac defibrillators.

3.1 A 70-year-old, 42kg female with chronic renal failure, Type 2 diabetes and a history of alcohol abuse was admitted for management of leg ulcers infected with MSSA. Ten days into her admission she became increasingly short of breath and was referred to ICU.

With reference to a randomized controlled trial, briefly describe the terms “blinding” and “allocation concealment”

The following questions relate to the ventilatory management of a critically ill adult patient with asthma.

A 40 year old previously well male presents with a ruptured appendix and associated peritonitis (Day 0). He returns to theatre 3 days later with ischaemic colitis and requires a right hemicolectomy.

A two year old child presents with fever, stridor and a harsh cough. His condition deteriorates and he requires intubation. Outline how you would do this.

Critically evaluate the use of albumin-containing solutions in critically ill patients.

List the factors predisposing to medication error in ICU. How can these be minimised?

This blood gas report was taken from a lady hospitalised for recurrent urinary tract infections. She was transferred to the ICU because of nosocomial pneumonia.