CCT in Anaesthetics - Intermediate Level Training

Published: 05/09/2019

Management of respiratory and cardiac arrest in adults and children

It is anticipated that this unit of training will not be delivered as a dedicated block and that the learning outcomes will be gained throughout the entire duration of Intermediate Level training and that these should be achievable in most general hospitals.

Any trainee who has successfully completed a Resuscitation Council [UK] ALS course [for adults] and EPLS/APLS courses [for children] in the previous year, or who is an Instructor/Instructor candidate for these courses, may be assumed to have achieved the adult/paediatric outcomes

Learning Outcomes:

Build upon the knowledge and skills obtained during the management of respiratory and cardiac arrest during the ST1 year of training.
Develop the skills necessary to safely and effectively manage patients in the peri-arrest period

Core clinical learning outcome:

Is an effective member of the multi-disciplinary member of the resuscitation team and takes responsibility for the initial airway management

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Final examination identified in the FRCA examination blueprint section.

Knowledge

Competence	Description	Assessment Methods	GMP
RC_IK_01	Recalls/describes the interpretation of arrhythmias seen in the peri-arrest period, including but not limited to: Narrow complex tachycardias Broad complex tachycardias Atrial fibrillation Paroxysmal SVT Bradycardia 1^st 2^nd and 3^rd degree heart block	C,E,S	1
RC_IK_02	Recalls/describes the pharmacology of drugs used to treat common arrhythmias, dosage and frequency, including but not limited to: Adenosine Digoxin Magnesium Beta-blockers Amiodarone Atropine	C,E,S	1
RC_IK_03	Recalls the indications for performing cardioversion and the energies used	C,E,S	1
RC_IK_04	Recalls/outlines the indication for, and principles of, pacing including percussion, external and transvenous	C,E,S	1
RC_IK_05	Recalls the indications for use of thrombolysis	C,E,S	1
RC_IK_06	Recalls/discusses the indications and principles of therapeutic hypothermia after cardiac arrest	C,E,S	1
RC_IK_07	Outlines indications and principles of: Open chest cardiac compressions Resuscitative thoracotomy [Cross ref cardiothoracic]	C,E,S	1
RC_IK_08	Describes the principles of managing cardiac arrest in the prone position	C,E,S	1
RC_IK_09	Recalls/explains the difference in aetiology of cardiac arrest between adults and children	C,E,S	1
RC_IK_10	Describes how to recognize the sick/deteriorating ill child and what treatment should be initiated to reverse such deterioration and prevent, where possible, respiratory or cardiac arrest	C,E,S	1
RC_IK_11	Recalls the specific conditions likely to deteriorate to respiratory or cardiac arrest in children [e.g. meningococcal sepsis] and describes their initial management	C,E,S	1
RC_IK_12	Recalls/details the indications for, and use of, cuffed and uncuffed tubes in the critically ill child requiring tracheal intubation	C,E,S	1,2
RC_IK_13	Describes how to: Recognise supraglottic airway obstruction and understands the indications/contra-indications of supraglottic airway devices to bypass such obstruction Manage complications of tracheostomy in children [e.g. obstruction and displacement]	C,E,S	1,2
RC_IK_14	Outline the principles of safe inter-hospital transfer of the resuscitated patient	C,E,S	1,2,3,4

Skills

Competence	Description	Assessment methods	GMP
RC_IS_01	Demonstrates the use of external cardiac pacing	D,S	1
RC_IS_02	Demonstrates the treatment of arrhythmias using drugs and cardioversion	D,S	1,2
RC_IS_03	With specific reference to the paediatric airway, demonstrates the ability to: Control the airway rapidly using different airway devices Perform positive pressure ventilation using bag/mask systems [i.e. T-piece and self-inflating bags]	D,S	1,2
RC_IS_04	Demonstrates the ability to establish vascular access in children with ‘difficult veins’, including the use of intraosseous devices	D,S	1,2
RC_IS_05	Demonstrates leadership during resuscitation, including supporting less experienced members of the team	D,S	1,2,3,4
RC_IS_06	Demonstrates ability to teach and assess basic level competencies	D,S	1,3,4
RC_IS_07	Demonstrates ability to provide feedback to staff and relatives in post-resuscitation attempts debriefs	D,S	1,3,4