Critical Care Medicine — Foundation of Discipline

F2 Evaluating and managing uncomplicated and/or routine patients requiring mechanical ventilation

Key Features:
- This EPA focuses on applying knowledge of invasive and non-invasive (NIV) mechanical ventilation, its indications, and complications.
- It includes the initiation, maintenance, weaning, and discontinuation of mechanical ventilation in the context of common clinical scenarios with respiratory failure due to pulmonary and non-pulmonary reasons.
- This EPA may be observed during clinical assessment, patient rounds, or while teaching other trainees.
- This EPA does not include patients with complicated, severe, refractory disease (e.g., severe hypoxic or hypercapnic respiratory failure, severe airway obstruction, patient/ventilator asynchrony, complicated waveform analysis, etc.).

Assessment Plan:
Direct and indirect observation by attending physician
Use Form 1. Form collects information on:
- Ventilation technique: invasive; non-invasive
- Reason for resp support: pulmonary; non-pulmonary
Collect 9 observations of achievement
- At least 3 non-invasive ventilations
- At least 4 different observers

Form

F1: Observation

Milestones

• ME 1.3. Apply knowledge of respiratory physiology and cardiopulmonary interactions

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

• ME 2.2. Interpret diagnostic imaging of the respiratory system

• ME 2.4. Develop and implement an initial management plan for uncomplicated patients requiring non-invasive or invasive ventilation

• ME 3.2. Ensure that the patient and family are informed about the risks and benefits of each treatment options in the context of best evidence and guidelines

• ME 5.2. Use cognitive aids such as clinical care paths to enhance patient safety

• ME 3.1. Use strategies to verify and validate the understanding of the patient and family

• COM 4.3. Answer questions from the patient and family about next steps

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

Context Variables

• Ventilation technique (single-choice)
  • invasive
  • non-invasive
• Reason for resp support (single-choice)
  • pulmonary
  • non-pulmonary

Requirements

• Collect 9 observations of achievement (minimum 9)
• At least 3 non-invasive ventilations (minimum 3)
  • Only counts when Ventilation technique is non-invasive
• At least 4 different observers (minimum 4)
  • Counted once per distinct Assessor