Intensive Care
Draft proposed by Dr NC Fong
Reviewed by Dr Sabrina Tsao
Essential Skills
Domain 1 Professional Values & Behaviour
Domain 2 Communication
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Communication skill with parents and relatives of critically ill patients
Domain 3 Procedural Skills
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Intubation and CPR
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Intra-osseous infusion
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Set up of arterial lines for monitoring
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Thoracocentesis and chest drain insertion
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Use ultrasound to rule out pericardial effusion or pleural effusion, to assist vascular access, and to use bladder scan.
Domain 4 Patient Management
Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises
Basic Training
Resuscitation
Basic concepts in paediatric cardiopulmonary resuscitation
Basic principle of mechanical ventilation
Knowledge of ventilator setting, short- and long-term complications of ventilation, appropriate use of oxygen, interpretation of blood gas
Basic pharmacology and drug interaction
Use of inotropes, analgesic, sedative, neuromuscular blocking agents, anticonvulsants
Toxicology & poisoning
Shock
Knowledge of different types of shock and its basic management
Acute management of congestive heart failure and common arrhythmia
Common causes
Common manifestations
Use of common cardiac drugs.
Respiratory intensive care
Recognition of respiratory failure
Medications for status asthmaticus
Use of invasive and noninvasive respiratory support
Emergency treatment of pleural effusion and pneumothorax
Upper airway obstruction: croup, anaphylaxis
Neurological intensive care
Management of severe meningitis
Presentation of brain tumors and intracranial bleeding
Knowledge of raised ICP
Status epilepticus and treatment
Comatose patients
GBS, Transverse myelitis
Endocrine intensive care
DKA, hypoglycemia, CAH
Thyrotoxic storm, Cerebral DI, IEM emergency
Renal intensive care and electrolytes abnormality
Recognition of types of renal failure
Basic management of acute renal failure
Management of Hypo/Hyper Na, K, Ca, acid-base balance
Haematology and oncology intensive care
Severe anaemia and bleeding tendency
Various emergency presentation of malignancy
Tumor lysis syndrome, Neutropenic fever
Use of blood products
Infection in intensive care
Rational use of antibiotics
Prevention of hospital acquired infection
Infection control routines
Gastrointestinal intensive care
Severe GI bleeding
Pancreatitis
Liver failure
Nutritional support
Enteral and parenteral nutrition in critically ill patients
Trauma
Management of multiple injuries
Management of head injury
Post-operative care
General surgery
Neurosurgery
Cardiac surgery (optional)
Psychological support and Bereavement
Psychological response of patients and their relatives towards PICU admission, morbidity and mortality
Counselling
Desirable Skill
Basic ventilator setting
Higher Training
Cardiology Intensive Care
Cardiogenic shock, malignant hypertension, arrhythmia, basic echocardiography, ECMO (optional)
Respiratory Intesive Care
Basic bronchoscopy, ARDS, advanced ventilation, ECMO (optional)
Renal Intensive Care
Knowledge of CRRT
Transport of PICU patients
Stabilization of sick children during interhospital transport
Palliative care in PICU
Ethical and legal issues related to withdrawal of
Support and organ donation
Understand the principle of diagnosing brain death
Medical audit
Use of standards and protocols in PICU
Quality assurance programmes
Desirable skills
1. Vascular access for central venous pressure
2. Basic echocardiography & POCT Ultrasound
3. Basic bronchoscopy
4. CRRT and plasmapheresis
5. Understanding the different modes of ventilation