Critical Care Medicine — Foundation of Discipline

F1 Evaluating, stabilizing, and managing patients presenting with common ICU conditions

Key Features:
- This EPA focuses on routine ICU care, including evaluating, stabilizing, admitting, and providing day-to-day management for patients with uncomplicated critical illness.
- This includes: diagnosis and management of the presenting problem, management of any underlying conditions, prevention and management of common ICU complications, and attention to and management of nutrition, sedation, and analgesia.
- This EPA does not include patients with complex, poorly differentiated or multi-type shock/organ dysfunction, polypharmacy overdose, multi-system or multicomorbid illness, multi-system trauma, and transplant, nor the critically ill obstetrical patient.

Assessment Plan:
Direct observation and/or review of admission/case discussion by attending physician or senior resident
Use Form 1. Form collects information on:
- Setting: initial assessment; daily care
- Presentation: surgical; medical
- Primary diagnosis (write in):
Collect 6 observations of achievement
- At least 3 initial assessment
- At least 3 daily care
- Variety of medical and surgical presentations
- At least 3 different observers

Form

F1: Observation

Milestones

• ME 1.3. Apply knowledge of basic physiology to the management of common ICU conditions

• ME 1.4. Perform focused clinical assessments that address all relevant issues

• ME 1.6. Develop a plan that considers the current complexity, uncertainty and ambiguity in a clinical situation

• ME 2.2. Select and interpret the results of investigations and imaging

• ME 2.3. Work with the patient and family to establish goals of care

• ME 2.4. Develop and implement initial and/or ongoing management plans for patients with common ICU conditions

• ME 2.4. Develop plans to monitor the evolution of the clinical course and/or the patient’s response to treatment

• ME 3.1. Integrate planned procedures or therapies into the overall plan of care

• ME 4.1. Determine the need and timing of consultation with other specialists

• ME 5.2. Organize safe intrahospital transport of patient to and from ICU, using all necessary human and equipment resources, recognizing when it may be inappropriate to transport patient

• COL 1.2. Implement a multidisciplinary approach to the care of ICU patients

• COL 1.3. Engage in respectful shared decision-making with physicians and colleagues in other health care professions

• P 2.2. Demonstrate a commitment to patient safety and quality improvement through adherence to institutional policies and procedures

Context Variables

• Setting (single-choice)
  • daily care
  • initial assessment
• Presentation (single-choice)
  • medical
  • surgical
• Primary diagnosis (free-text)

Requirements

• Collect 6 observations of achievement (minimum 6)
• At least 3 initial assessment (minimum 3)
  • Only counts when Setting is initial assessment
• At least 3 daily care (minimum 3)
  • Only counts when Setting is daily care
• Variety of medical and surgical presentations
• At least 3 different observers (minimum 3)
  • Counted once per distinct Assessor