Anesthesia — Foundation of Discipline

F9 Initiating resuscitation and diagnosis of patients with life-threatening conditions in a time-appropriate manner

Key Features:
- This EPA focuses on identifying the urgency of the situation, generating relevant
differential diagnosis and initiating focused management directed at the presumed
etiology.
- This EPA includes recognizing a life threatening situation and beginning basic
resuscitation (e.g., assess the ABCs, begin bag mask ventilation, bolus fluids, start
pressors/inotropes).
- It also includes recognizing one’s limits and asking for assistance in a time
appropriate manner.
- This EPA does not require the development of a comprehensive long-term
management strategy. It is meant to apply to the first 5-10 min of resuscitation until
experienced help arrives.
- This EPA must be observed in a variety of environments such as PACU,
surgical/medical wards, ICU, ER or OR.

Form

F1: Observation

Milestones

• ME 1.4. Recognize urgent problems that may need the involvement of more experienced colleagues and seek their assistance

• ME 1.5. On the basis of patient-centred priorities, seek assistance to prioritize multiple competing tasks that need to be addressed

• ME 2.2. Synthesize patient information to determine diagnosis

• ME 2.4. Develop and implement initial management plans, prioritizing issues to be addressed, in a time appropriate manner

• ME 4.1. Coordinate investigation, treatment, and follow-up plans when multiple physicians and healthcare professionals are involved

• COM 3.1. Convey the diagnosis, prognosis and plan of care in a clear, compassionate, respectful, and accurate manner to the patient and/or family

• COM 3.1. Use strategies to verify and validate the understanding of the patient and/or family

• COM 5.1. Document clinical encounters to adequately convey clinical reasoning and the rationale for decisions

• COL 1.1. Contribute effectively in interprofessional teams (e.g. nurses, RTs)

• COL 1.3. Communicate appropriately with supervising staff (supervising resident or
  attending physician) if significant concerns are identified during patient assessment

• COL 1.2. Participate in debriefing, post critical incident

• S 3.4. Incorporate evidence-based medicine into clinical practice

• P 4.2. Report any medical/psychological/substance abuse/fatigue concerns that may limit one’s ability to provide optimal patient care

• P 1.1. Accept feedback readily and incorporate suggestions for improvement

• P 4.1. Demonstrate the ability to remain calm and professional in stressful
  situations

• P 2.2. Pay close attention to the continuing care of the patient beyond the technical execution of resuscitation, reliably and conscientiously

Context Variables

• Location (single-choice)
  • ER
  • OR
  • ICU
  • PACU
  • medical ward
  • surgical ward
  • other location
• Type of condition (single-choice)
  • shock
  • cardiac event
  • cardiac arrest
  • other condition
  • neurologic condition
  • respiratory distress

Requirements

• Collect a minimum of 3 observations (minimum 3)