Trial Clinical Scenarios

5 minute questions

  1. You are called to ED because of a stabbing to the left chest. A large knife is still in place, entering the chest immediately left parasternal 3rd intercostal space. Patient is conscious. HR 110, BP 95/60 with blood being transfused. What is your management plan?

  2. A 70kg patient undergoing an AVR has received 30,000IU of Heparin and the ACT has stopped at 390. You are ready to cannulate. What are your next steps?

  3. Cardiopulmonary bypass has been commenced. The perfusionist reports the arterial line pressure is high and full flows cannot be achieved. How do you troubleshoot this?

  4. After a CABG you have drained your lines and are closing the pericardium when the patient goes into VF. What is your management plan?

  5. A patient with significant 3VCAD is underoing CABG. A crossclamp has been applied and cardioplegia being run, but diastolic arrest is not being achieved. The heart remains in SR. What do you troubleshoot?

  6. A patient with a previous AVR is undergoing a redo AVR. During division of the manubrium, large volumes of dark blood well up, and the patient develops systemic hypotension. What is your management plan?

  7. A patient two weeks after lobectomy represents to hospital with a chest wall swelling that on examination is subcutaneous emphysema. It progressively worsens whilst waiting in ED for assessment. What is your approach to this problem?

  8. You are doing a thoracoscopic left upper lobectomy. Whilst dissecting out the left superior pulmonary vein, large volume dark bleeding occurs. What is your approach to this problem?

  9. Day 2 after a right lower lobectomy, the patient develops worsening respiratory failure and consolidation of the right middle lobe on CXR. How would you approach this problem?

  10. Whilst still under anaesthetia after an uncomplicated left pneumonectomy, the patient is hypotensive and has rising noradrenaline requirements through the central line. What is your approach to this situation?