Critical Care Medicine — Core of Discipline

C3 Managing the resuscitation of critically ill patients

Key Features:
- This EPA includes the rapid detection and correction of life-threatening situations such as hypoxia, end organ hypoperfusion, dysrhythmias and raised intracranial pressure, as well as the management of patients in cardiac arrest.
- It may include patients with a variety of underlying medical comorbidities and in a variety of clinical situations, such as traumatic shock, septic shock, traumatic brain injury, and cardiogenic shock.
- It includes the application of advanced crisis resources management skills to guide the team functioning.

Assessment Plan:
Direct observation by supervisor
Use Form 1. Form collects information on:
- Case mix: cardiac arrest; respiratory failure; sepsis; shock; trauma; other (write in)
Collect 8 observations of achievement
- At least 2 cardiac arrests
- At least 5 other case mixes
- At least 4 different observers

Form

F1: Observation

Milestones

• ME 2.2. Provide assessment and initial stabilization of ABCs

• ME 2.4. Provide concurrent treatment and ongoing assessment of the patient’s clinical condition

• ME 2.4. Reassess, re-evaluate and adjust resuscitative and diagnostic efforts as appropriate

• ME 5.2. Demonstrate situational awareness, avoid fixation error

• ME 4.1. Ask for additional assistance and/or other services when indicated

• COL 1.2. Delegate tasks and direct team members to aid in resuscitation

• COL 1.3. Use closed loop communication

• P 4.1. Maintain capacity for professional clinical performance in stressful situations

• ME 1.4. Act decisively and maintain control of crisis situations

• ME 2.2. Recognize when ongoing resuscitation efforts are no longer effective and should be discontinued

• ME 2.4. Manage hemodynamic support and monitoring

• ME 2.4. Manage non-invasive and/or invasive ventilation

• ME 3.1. Integrate planned procedures or therapies into resuscitative efforts

• ME 3.3. Triage a procedure or therapy, taking into account clinical urgency, potential for deterioration, and available resources

• L 4.2. Establish clear leadership in resuscitative efforts

• COL 1.2. Seek and respond to input from other health care professionals

Context Variables

• Case mix (single-choice)
  • shock
  • sepsis
  • trauma
  • cardiac arrest
  • respiratory failure
  • other (write details below)

Requirements

• Collect 8 observations of achievement (minimum 8)
• At least 2 cardiac arrests (minimum 2)
  • Only counts when Case mix is cardiac arrest
• At least 5 other case mixes (minimum 5)
  • Only counts when Case mix is not cardiac arrest
• At least 4 different observers (minimum 4)
  • Counted once per distinct Assessor