Hear the examiner cut off a rambling answerLength 1:20
Excerpt from an automated practice run, cut from the call recording in one unedited stretch. The candidate is simulated; the examiner is the real examiner.
Read the transcript
Examiner: You said you would avoid volatile anesthetics and succinylcholine because of a family history of malignant hyperthermia. How will you prepare the anesthesia machine for a TIVA case?
Candidate (simulated): Absolutely, that's an important step. And I appreciate the opportunity to walk through it. Preparing the anesthesia machine for a malignant hyperthermia susceptible patient is a process that requires attention to detail to minimize any risk of exposure to residual volatile anesthetics. The first thing I do is remove or disable the vaporizers from the machine entirely to prevent accidental administration. Then I flush the anesthesia machine with high fresh gas flows, usually 10 liters per minute of 100 percent oxygen, for at least 20 to 60 minutes, depending on the specific machine and manufacturer recommendations. Since different models have different internal volumes, and absorbent surfaces that...(cut off by the examiner)
Examiner: Let me stop you there. In one sentence, what is your plan?
Candidate (simulated): My plan is to remove vaporizers, flush the anesthesia machine with high fresh gas flows for at least 20 minutes, use a clean circuit and new CO2 absorbent, and administer only non-triggering agents for TIVA.
Examiner: What is the most likely thing to go wrong with that plan?
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