Critical Care Medicine — Academic days

Trauma

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
1.3.1. Normal and abnormal anatomy, including the appearance with diagnostic imaging
1.3.2. Pathophysiology of:
1.3.2.1. Organ dysfunction
1.3.2.2. Sepsis
1.3.2.3. Blunt and penetrating trauma
1.3.2.4. Environmental injuries
1.3.3. Physiology in critically ill women who are pregnant
1.3.4. Developmental physiology and pharmacology in adolescents
1.3.5. Psychosocial needs of adolescent patients and their families
1.3.6. Pharmacology
1.3.6.1. Agents used for neuromuscular blockade
1.3.6.2. Antimicrobial therapies
1.3.6.3. Common intoxicants and poisons, and specific antidotes or supportive therapies
1.3.6.4. Sedatives and analgesics
1.3.6.5. Vasoactive agents
1.3.7. Principles and practice of resuscitation
1.3.8. Principles and practices of assisted mechanical ventilation and other methods of respiratory support
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
1.3.10. Principles of the determination of neurological death
1.3.11. Principles of medical transport
1.3.11.1. Physiology during transport, including air transport
1.3.11.2. Modes of transportation, patient care equipment, and monitoring methods
1.3.11.3. Role of paramedical personnel
1.3.12. Principles for the coordination and triage of services for mass casualty management
2. Perform a patient-centred clinical assessment and establish a management plan
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
2.3. Establish goals of care in collaboration with patients and their families, which may include slowing disease progression, treating symptoms, achieving cure, improving function, and palliation
2.3.1. Recognize and respond to changes in patient’s clinical status that indicate a need to reassess goals of care
2.3.2. Recognize when ongoing resuscitation efforts are no longer effective and should be discontinued
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
3.4.4. Airway
3.4.4.1. Airway maintenance
3.4.4.2. Endotracheal intubation
3.4.4.3. Management of the difficult and failed airway
3.4.4.4. Replacement of an existing tracheostomy tube
3.4.5. Breathing
3.4.5.1. Ventilation by bag and mask
3.4.5.2. Initiation of and weaning from assisted ventilation
3.4.5.3. Maintenance of long term assisted ventilation
3.4.5.4. Thoracostomy tube insertion
3.4.5.5. Thoracentesis
3.4.5.6. Fiberoptic bronchoscopy in the intubated patient