Respiratory Medicine

Kids Playing Tug of War
Draft proposed by Professor Simon Lam
Reviewed by Dr YK Shiu

Essential Skills

Domain 1 Professional Values & Behaviour

Domain 2 Communication

Domain 3 Procedural skills

  1. Airway management and resuscitation

    1. Face-mask seal and positive pressure ventilation

    2. Intubation (direct laryngoscopy)

    3. Use of laryngeal mask airway

    4. Use of oropharyngeal/ nasopharyngeal airway

    5. Replacing tracheostomy tube

  2. Measuring peak flow rate

  3. Thoracocentesis and chest drain insertion

Domain 4 Patient Management

Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises

Basic Training

Pulmonary physiology and anatomy

Basic knowledge of pulmonary embryology and its clinical relevance

Understanding of normal and abnormal anatomy of paediatric upper airway and lower airway

Basic knowledge of pulmonary physiology and variations according to age group and disease status

Understanding respiratory failure: clinical features and management strategies

Knowledge of normal sleep physiology

Pulmonary diagnostic tests

Understanding of indications for pulmonary function, sleep assessment, lung imaging and endoscopy

Understanding modality of pulmonary function and sleep assessment

Interpretation of simple spirometry results

Interpretation of arterial and capillary blood gas results

Interpretation of chest radiographs

Common respiratory presentations

Know how to approach, investigate and initiate management in a wide range of common respiratory presentations:

Chronic cough

Stridor

Hoarseness

Choking

Cervical lymphadenopathy

Acute infective respiratory diseases

Understanding of respiratory infections with or without complications

Acute bronchiolitis

Community acquired pneumonia

Acute epiglottitis, severe croup, tracheitis

Mycobacterial and non-tuberculous mycobacterial infections with focus on pulmonary tuberculosis, TB pleural effusion, TB lymph node and latent TB infection

 

Chronic suppurative lung disease

Bronchiectasis

Lung abscess

Pleural empyema

Allergic respiratory conditions

Asthma

Pre-school wheeze

Allergic rhinitis

Common/important respiratory conditions in newborn term and/or preterm infants

(Please refer to neonatology syllabus for details)

Chronic lung disease (in paediatric age group)

 

Pulmonary complications on the intensive care unit

Please refer to the PICU syllabus

Pleural diseases (pneumothorax and pleural effusion)

Know how to recognise, diagnose and manage pleural conditions which include:

Pneumothorax

Pleural effusion

Chylothorax

Haemothorax

Respiratory manifestations of diseases of non-respiratory systems

Connective tissue diseases

Cor pulmonale

Sudden infant death syndrome and apparent life-threatening events

Foreign body aspiration and chronic aspiration syndrome

Gastro-oesophageal reflux related lung disease

 

Sleep medicine

Knowledge of sleep disordered breathing including obstructive sleep apnoea syndrome

Recognises importance of sleep routine and sleep hygiene

 

Desirable skills 

  1. Assisted ventilation

Use of different modes of invasive mechanical ventilation

Use of different non-invasive ventilatory support and different choices of interface

Assess the need to initiate ventilator support       

Higher Training

Pulmonary diagnostic tests

Ability to conduct and interpret simple spirometry

Basic interpretation of polysomnography and recognise when to refer

Interpretation of CT scans

Behavioural aspects of respiratory lung disease

Functional cough

Hyperventilation syndrome

Environmental lung disease

Knowledge of hypersensitivity pneumonitis

Understanding the effects of active and passive smoking

Knowledge of the effects of toxin inhalation

Knowledge of common indoor/outdoor pollutants

Rare respiratory conditions

Cystic fibrosis

Obliterative bronchiolitis

Interstitial lung disease

Primary ciliary dyskinesia

Bronchiolitis obliterans

Bronchiolitis obliterans organizing pneumonia

Pulmonary haemorrhage syndrome

Respiratory malignancy

Congenital central hypoventilation syndrome

Narcolepsy

Pulmonary vascular disease

Pulmonary complications of children with complex medical conditions

Complex disabilities

Neuromuscular disorders

Musculoskeletal disorders

Haematological or oncological conditions

Respiratory and ventilatory care of children with complex medical conditions/needs

Peri-operative respiratory care

Long-term respiratory management

Long-term mechanical ventilation

Multidisciplinary approach

Discharge planning for chronic disease management

Multidisciplinary support

Assessment for need of maintenance/prophylactic therapy

Home oxygen therapy and/or respiratory support

Follow-up planning

Sleep medicine

Other sleep disorders including:

Behavioural sleep problems

Parasomnias

 

Desirable skills

  1. Advanced procedures

Chest physiotherapy for collapsed lung

Ultrasound assessment of pneumothorax, pleural effusion

Care and assessment of tracheostomy, change of tracheostomy tube