ICU

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“Trainees should have a good understanding of the diagnosis and management of the critically ill patient. All trainees should be familiar with the monitoring and life support equipment used in the treatment of critically ill patients. Trainees must be able to demonstrate their knowledge of practical invasive procedures, with an understanding of the principles and hazards involved and the interpretation of data from such procedures”.

Logistics

1. An understanding of the potential benefits of high dependency and intensive care
2. Common causes of admission to high dependency and intensive care
3. The content of an ICU record
4. An insight into likely outcome based upon severity scoring
5. Scoring Systems and Audit
6. Ethics

Critical care pathologies

1. Sepsis (Pharmacological control of severe infections)
2. Sepsis and endotoxaemia :
3. An understanding of sepsis and the basic patterns of failure of the major organs
4. ALI and ARDS
5. The mucosal barrier, translocation and absorption disorders
6. Gut ischaemia
7. Gastrointestinal ulceration and bleeding
8. Critical illness neuropathy
9. Nosocomial infections including Ventilator Associated Pneumonia
10. Coma: traumatic and non-traumatic
11. Encephalopathies
12. Cerebral ischaemia
13. Status asthmaticus therapeutics
14. Status epilepticus
15. Acute pancreatitis
16. Hepatic failure – Acute and chronic
17. Near-drowning
18. Burns and smoke inhalation
19. Brain stem death
20. Reperfusion injury and antioxidants
21. Management of Acute Poisoning:
    1. Paracetamol
    2. Aminophylline
    3. Digoxin
    4. Ecstasy
    5. Tricyclics

Generic Techniques used in Critical Care

1. Examination and care of the unconscious patient
2. Analgesia, Anxiolysis and Sedation in the critical care setting
3. Assessment and management of oxygen delivery
4. Percutaneous tracheostomy
5. Change of tracheostomy tube
6. Management of tracheostomy and decannulation
7. Fibreoptic bronchoscopic clearance of sputum
8. Indications for ventilation
9. An understanding of the use of ventilation, modes of ventilation and ventilatory support (including NIPPV) in use on critically ill Patients, with a knowledge of the vocabulary
10. Set up ventilator for adult suffering from severe ARDS
11. Assist in prone positioning patient
12. Assist in weaning patient from IPPV via assist/CPAP
13. Renal Replacement Therapy
14. Nutrition:
    1. Enteral and parenteral nutrition: methods, nutrients, and complications
15. Thromboprophylaxis in intensive and high dependency patients
16. Antibiotics and immunotherapy
17. Insertion of flow directed pulmonary artery catheter
18. Insertion of transvenous pacemaker
19. Insertion of oesophageal Doppler probe
20. Peritoneal lavage
21. Outreach care:
    1. Early warning signs and symptoms
    2. Infection and Multiple Organ Failure
22. Transport of the critically ill:
    1. Assessment and organisation of transfer
    2. Physiological consequences of acceleration
    3. Problems of working in isolated environments
23. The principles of brain stem death diagnosis

Communication

1. Breaking bad news
2. The grief response
3. Requesting post mortem investigation
4. Explaining need for unexpected / early discharge
5. Introducing the concept of organ donation
6. Organ Donation