Symptom Based Competencies - AIM
Emergency Presentations
Cardio-Respiratory Arrest AIM The trainee will have full competence in the assessment
and resuscitation of the patient who has suffered a cardio-respiratory arrest, as defined by the
UK Resuscitation Council
Knowledge
Assessment Methods
Evidence
Demonstrate knowledge of
ACAT, CbD, mini-CEX, SCE
when advanced life support
should be discontinued, in
consultation with colleagues
assisting with case
Demonstrate knowledge of safe SCE
transfer to ITU if required.
Demonstrate knowledge of
SCE
evidence base for best practice
Skills
Transfer the patient safely to
ACAT,
ITU
Shocked Patient AIM The trainee will be able to identify a shocked patient, assess their
clinical state, produce a list of appropriate differential diagnoses and initiate immediate
management
Knowledge
Assessment Methods
Evidence
Recognise rarer forms of shock
ACAT, CbD, mini-CEX SCE,
(e.g. spinal, Addisonian crisis)
Outline the indications for, and
ACAT, CbD, mini-CEX, SCE
(NB – Tutorial ‘central lines’)
limitations of, central venous
access and pressure monitoring
Outline the legal framework for
CbD, ACAT, SCE
organ donation
Demonstrate a detailed
CbD, ACAT, SCE
(These can be found in the
knowledge of the Surviving
‘further reading’ section’)
Sepsis 2008 International
Guidelines for the management
of severe sepsis and septic
shock.
Demonstrate a knowledge of
CbD, ACAT,SCE
non-invasive measurements of
cardiovascular haemodynamics
Demonstrate the knowledge for
CbD, ACAT, SCE
intra-aortic balloon pumping
Skills
Leads major (non-traumatic)
ACAT, CbD, mini-CEX
resuscitation
Identify incipient organ failure
ACAT, CbD, mini-CEX
Order, interpret and act on more ACAT, CbD, mini-CEX
specialist tests appropriately
based on initial investigations
Implement protocols and care
ACAT, CbD, mini-CEX
bundles appropriately e.g. septic
bundles
Expert assessment of
CbD, SCE
neurological status of acutely
unwell patient, including
diagnosis of brainstem death
Co-ordinate and manage care
within a HDU/Level 2 setting
Implement surviving sepsis
guidelines appropriately
Adjust therapy to non-invasive
measurements of
cardiovascular haemodynamics
Behaviours
Adopt leadership role
Arrange transfer of patient to
specialist team (cardiac, ICU)
when appropriate
Discuss prognosis with
patient/carer
Discuss issues of donation
appropriately with transplant
coordinators, and family/carers
of patient
ACAT, SCE
ACAT, SCE
ACAT, SCE
ACAT, CbD, mini-CEX
ACAT, CbD, mini-CEX
ACAT, CbD, mini-CEX
ACAT, mini-CEX
Unconscious Patient AIM The trainee will be able to promptly assess the unconscious
patient to produce a differential diagnosis, establish safe monitoring, investigate appropriately
and formulate an initial management plan, including recognising situations in which
emergency specialist investigation or referral is required
Knowledge
Assessment Methods
Evidence
Identify rarer causes of coma
ACAT, CbD, mini-CEX, SCE
and relevant investigations, NB
previous ones defined in CMT
Outline more complex
ACAT, CbD, mini-CEX, SCE
management options
Skills
Provide robust airways support
DOPS
(We will arrange some time in
for the unconscious patient
theatre)
including the use of tracheal
masks and endotracheal
intubation when appropriate
Order, interpret and act on more ACAT, CbD, mini-CEX, SCE
specialist tests based on initial
investigations
Behaviours
Assume leadership role
ACAT, CbD, mini-CEX
Involve carer/next-of-kin in
ACAT, CbD, mini-CEX
decision- making process where
appropriate
Make difficult ethical choices
ACAT, CbD, mini-CEX
(DNR) appropriately and
sensitively
Discuss issues of donation
ACAT, mini-CEX
appropriately with transplant coordinators, and family/carers of
patient
Interaction with Critical Care The trainee will acquire necessary competencies to ensure
that clinical communication with members of the critical care team are optimisd in the interest
of effective and safe patient care.
Knowledge
Outlines critical aspects of
ACAT, CbD, mini-CEX
(NB – Intro to critical care
patient assessment that dictate
tutorial)
need for higher levels of care
Outlines criteria that exist that
ACAT, CbD, mini-CEX
aid selection of patients for
critical care
Skills
Assesses patients with acute
ACAT, CbD, mini-CEX
medical illness accurately and
effectively
Commences inotropic support
ACAT, CbD, mini-CEX
when appropriate
Behaviours
Considers opinions of others
ACAT, CbD, mini-CEX
Practical Procedures
Procedure
Minimum 2x Formative
Assessments
Satisfactory Summative
Assessment
Arterial Line
US guided central line
1.
2.