Critical Care Medicine — Academic days
Hemodynamics
This academic day will cover the following topics:
1. Fundamental of hemodynamics
2. Pressure/Volume loops
3. Heart-lung interaction
4. Monitoring equipment for hemodynamics
5. Vasopressors and inotropes
6. Journal club: SAFE trial
Competencies covered in this activity
| 1. Practise medicine within their defined scope of practice and expertise | ||||||
| 1.3. Apply knowledge of the clinical and biomedical sciences relevant to Critical Care Medicine | ||||||
| 1.3.7. Principles and practice of resuscitation | ||||||
| 1.3.9. Principles and methods of invasive and/or non-invasive monitoring | ||||||
| 1.3.9.1. Respiratory status | ||||||
| 1.3.9.2. Hemodynamic status | ||||||
| 1.3.9.3. Neurologic status | ||||||
| 1.3.9.4. Nutritional status | ||||||
| 2. Perform a patient-centred clinical assessment and establish a management plan | ||||||
| 2.1. Prioritize issues to be addressed in a patient encounter | ||||||
| 2.1.1. Recognize, resuscitate, and stabilize patients sustaining, or at risk of, cardiopulmonary arrest or other life-threatening conditions | ||||||
| 2.2. Elicit a history, perform a physical exam, select appropriate investigations, and interpret their results for the purpose of diagnosis and management, disease prevention, and health promotion | ||||||
| 2.2.1. Interpret results of invasive and non-invasive monitoring | ||||||
| 2.2.1.1. Hemodynamic | ||||||
| 2.2.1.2. Neurologic | ||||||
| 2.2.1.3. Respiratory | ||||||
| 2.2.2. Interpret diagnostic imaging examinations, including general radiography, computerized tomography (CT), and point of care ultrasound | ||||||
| 2.4. Establish a patient-centred management plan, for the following | ||||||
| 2.4.1. Shock: distributive; hypovolemic; cardiogenic; obstructive | ||||||
| 2.4.2. Acute critical illness of any etiology | ||||||
| 2.4.2.1. Single or multiple organ dysfunction | ||||||
| 2.4.2.2. Oncologic emergencies | ||||||
| 2.4.2.3. Trauma and environmental injuries | ||||||
| 2.4.2.4. Sepsis | ||||||
| 2.4.2.5. Intoxication | ||||||
| 2.4.2.6. Perioperative care | ||||||
| 2.4.3. Chronic critical illness | ||||||
| 2.4.4. Pain and symptom control | ||||||
| 2.4.5. End of life, including goal-directed life-sustaining therapies | ||||||
| 2.4.6. Organ and tissue donation | ||||||
| 2.4.7. Critical illness in pregnancy | ||||||
| 2.4.8. Perioperative risk optimization | ||||||
| 3. Plan and perform procedures and therapies for the purpose of assessment and/or managemen | ||||||
| 3.1. Determine the most appropriate procedures or therapies | ||||||
| 3.1.1. Blood component therapy, and alternatives | ||||||
| 3.1.2. End of life care | ||||||
| 3.1.3. Hemodynamic support | ||||||
| 3.1.4. Invasive and non-invasive ventilation | ||||||
| 3.1.5. Medical equipment and monitoring device application | ||||||
| 3.1.6. Nutritional therapy: enteral and parenteral | ||||||
| 3.1.7. Pharmacotherapy | ||||||
| 3.1.8. Renal replacement therapy | ||||||
| 3.1.9. Supportive care | ||||||
| 3.1.10. Surgical intervention | ||||||
| 3.4. Perform diagnostic and therapeutic procedures in a skilful and safe manner, adapting to unanticipated findings or changing clinical circumstance | ||||||
| 3.4.1. Diagnostic and monitoring procedures | ||||||
| 3.4.1.1. Use, zero, and calibrate transducers | ||||||
| 3.4.1.2. Use monitoring equipment | ||||||
| 3.4.1.2.1. Cardiac output | ||||||
| 3.4.1.2.2. Intra-abdominal pressure | ||||||
| 3.4.1.2.3. Intracranial pressure (ICP) | ||||||
| 3.4.1.2.4. Peripheral nerve stimulation for neuromuscular blockade | ||||||
| 3.4.2. Use point-of-care ultrasound (POCUS) assessment for | ||||||
| 3.4.2.1. Ascites | ||||||
| 3.4.2.2. Cardiac ventricular size and function | ||||||
| 3.4.2.3. Identification of a pneumothorax | ||||||
| 3.4.2.4. Pericardial effusion | ||||||
| 3.4.2.5. Pleural effusion | ||||||
| 3.4.2.6. Vascular access, including central venous access | ||||||
| 3.4.2.7. Intravascular volume status | ||||||
| 3.4.6. Circulation | ||||||
| 3.4.6.1. Cardiopulmonary resuscitation | ||||||
| 3.4.6.2. Insertion of arterial catheters | ||||||
| 3.4.6.3. Insertion of central venous catheters | ||||||
| 3.4.6.4. Intraosseous vascular access if available | ||||||
| 3.4.6.5. Insertion of a pulmonary artery catheter | ||||||
| 3.4.6.6. Defibrillation | ||||||
| 3.4.6.7. Elective cardioversion | ||||||
| 3.4.6.8. Transcutaneous pacing | ||||||
| 3.4.6.9. Insertion and management of a transvenous pacemaker | ||||||