CCT in Anaesthetics - Stage 1 Training
Published: 22/10/2024
General Anaesthesia (GA)
1_GA_A: Conducts comprehensive pre-anaesthetic and pre-operative checks
| 1_GA_A_1 | Describes the need for a targeted and relevant clinical examination |
| 1_GA_A_2 | Describes the basis for clinical signs and the relevance of positive and negative physical signs |
| 1_GA_A_3 | Anaesthetic history taking |
| 1_GA_A_4 | Recognises that patients do not always present history in a structured fashion |
| 1_GA_A_5 | Lists the likely causes and risk factors for conditions relevant to mode of presentation |
| 1_GA_A_6 | Uses the patient’s agenda and history to inform examination, investigation and management |
| 1_GA_A_7 | Indications for rapid sequence induction |
| 1_GA_A_8 | Specific complications of anaesthetic drugs including anaphylaxis, suxamethonium apnoea and malignant hyperpyrexia; prediction of patients who are at increased risk of these complications |
| 1_GA_A_9 | Risk factors for post-operative nausea and vomiting |
| 1_GA_A_10 |
Obtains a history specifically relevant to the planned anaesthesia and surgery including: A history of the presenting complaint for surgery A systematic comprehensive relevant medical history Information about current and past medication Drug allergy and intolerance Information about previous anaesthetics and relevant family history |
| 1_GA_A_11 |
Performs a relevant clinical examination including when appropriate: Cardiovascular system Respiratory system Central and peripheral nervous system Airway assessment |
| 1_GA_A_12 | Factors that influence the risk of gastric reflux/aspiration and strategies to reduce it |
1_GA_B: Safely manages induction and maintenance of anaesthesia by inhalational and intravenous techniques, extubation and emergence from anaesthesia
| 1_GA_B_1 | Gives examples of methods of anaesthesia that are suitable for common operations. |
| 1_GA_B_2 | Indications for pre-medication |
| 1_GA_B_3 |
Makes appropriate plans for anaesthesia: Reviews current medication and seeks advice where appropriate Plans appropriate anaesthetic technique[s] Secures consent for anaesthesia Recognises the need for additional investigation and acts accordingly Discusses issues of concern with relevant members of the team |
| 1_GA_B_4 | Explains the importance of maintaining the principles of aseptic practice and minimising the risks of hospital acquired infection |
| 1_GA_B_5 | Principles of management of the airway including maintenance of a clear airway and the use of airway adjuncts and supraglottic airway devices |
| 1_GA_B_6 | Advantages and disadvantages of intubation and supraglottic airway devices for airway management during anaesthesia |
| 1_GA_B_7 | Different types of supraglottic devices |
| 1_GA_B_8 |
Indications for tracheal intubation: Types of tracheal tube and identifies their applications Choice of the correct size and length of tracheal tube Advantages/disadvantages of different types of laryngoscopes and blades including, but not exclusively, the Macintosh and McCoy and videolaryngoscope Confirmation of correct placement of a tracheal tube; identification and complications of endobronchial or oesophageal intubation Confirmation of correct placement of a tracheal tube; identification and complications of endobronchial or oesophageal intubation Management of difficult intubation and failed intubation Identification of patients who are at increased risk of regurgitation and pulmonary aspiration; measures that minimise the risk |
| 1_GA_B_9 | Rapid sequence induction of anaesthesia |
| 1_GA_B_10 | Indication and techniques for fibre-optic intubation |
| 1_GA_B_11 | Problems associated with limb tourniquets and their safe use |
| 1_GA_B_12 | Hazards associated with positioning – supine, lateral, prone, sitting |
| 1_GA_B_13 | Anaesthesia for surgery in the prone and lateral positions |
| 1_GA_B_14 | Blood conservation in major surgery |
| 1_GA_B_15 | Surgical procedures for managing hip fractures, the anaesthetic requirements for each and the current evidence for the choice of anaesthetic technique |
| 1_GA_B_16 |
Pathophysiology, diagnosis and management of specific orthopaedic surgical complications that are relevant to anaesthesia including but not exclusively
|
| 1_GA_B_17 | Anaesthetic techniques appropriate for day cases including appropriate drugs |
| 1_GA_B_18 | Pre-oxygenation, effects, limitations and correct techniques for its use |
| 1_GA_B_19 | Intravenous and inhalational induction; techniques, advantages and disadvantages of both |
| 1_GA_B_20 | Factors influencing the choice of agent for inhalational or intravenous induction of anaesthesia |
| 1_GA_B_21 | Non anaesthetic physiological effects of intravenous and inhalational induction |
| 1_GA_B_22 | Identifies the special problems of induction associated with cardiac disease, respiratory disease, musculoskeletal disease, obesity and those at risk of regurgitation/pulmonary aspiration |
| 1_GA_B_23 | Removal of tracheal tubes and supraglottic airway devices and associated complications |
| 1_GA_B_24 | Tracheal extubation strategies and management of laryngospasm at extubation |
| 1_GA_B_25 | Physical and physiological effects of laparoscopic surgery including the effects of positioning (eg Trendelenberg, reverse Trendelenberg) |
1_GA_C: Plans recovery care, and manages recovery from anaesthesia utilising safe discharge criteria
| 1_GA_C_1 | Indications for, contra-indications to and complications of oxygen therapy in the post-operative period |
| 1_GA_C_2 | Techniques for administration of oxygen therapy and performance characteristics of available devices |
| 1_GA_C_3 | Identification and management of respiratory complications seen in recovery |
| 1_GA_C_4 | Identification and management of cardiovascular complications seen in recovery |
| 1_GA_C_5 | Identification and management of other common complications seen in recovery |
| 1_GA_C_6 | Monitoring and the frequency of observations required for patients having undergone different types of surgery |
| 1_GA_C_7 | Care of an unconscious patient in the recovery room, including safe positioning |
| 1_GA_C_8 | Patient factors possibly requiring higher levels (level 2 or 3) of care in the postoperative period |
| 1_GA_C_9 | Lists the appropriate discharge criteria for patients leaving the recovery room and for day stay patients |
| 1_GA_C_10 | Explains the importance of following up patients in the ward after surgery |
| 1_GA_C_11 | Principles of postoperative fluid regimes including volumes, types of fluid and monitoring of fluid balance |
1_GA_D: Diagnoses and manages common peri-operative complications
| 1_GA_D_1 | Contribution of PONV to post-operative outcomes and satisfaction |
| 1_GA_D_2 | Predisposing factors for PONV |
| 1_GA_D_3 | Regimes for prevention and treatment of PONV |
| 1_GA_D_4 | Recognition and management of incomplete reversal of neuromuscular blockade |
| 1_GA_D_5 | Causes and management of postoperative confusion |
| 1_GA_D_6 | Causes and management of postoperative hypo and hypertension |
| 1_GA_D_7 | Prevention, diagnosis and management of postoperative pulmonary atelectasis |
| 1_GA_D_8 | Causes and management of stridor |
| 1_GA_D_9 | Signs of pulmonary aspiration and its emergency management |
1_GA_E: Recognises anaesthetic critical incidents and explains their causes and management
| 1_GA_E_1 | Unexpected fall in SpO2 |
| 1_GA_E_2 | Unexpected increase in peak airway pressure |
| 1_GA_E_3 | Progressive fall in minute volume during spontaneous respiration or IPPV |
| 1_GA_E_4 | Fall in end tidal CO2 |
| 1_GA_E_5 | Rise in end tidal CO2 |
| 1_GA_E_6 | Rise in inspired CO2 |
| 1_GA_E_7 | Unexpected hypotension |
| 1_GA_E_8 | Unexpected hypertension |
| 1_GA_E_9 | Arrythmias |
| 1_GA_E_10 | Convulsions |
| 1_GA_E_11 | Regurgitation or aspiration of stomach contents |
| 1_GA_E_12 | Laryngospasm |
| 1_GA_E_13 | Difficulty with IPPV, sudden or progressive loss of minute volume |
| 1_GA_E_14 | Bronchospasm |
| 1_GA_E_15 | Pneumothorax and tension pneumothorax |
| 1_GA_E_16 | Gas, fat and pulmonary embolism |
| 1_GA_E_17 | Adverse drug reactions |
| 1_GA_E_18 | Anaphylactic reactions and the appropriate management including follow up and patient information |
| 1_GA_E_19 | Transfusion reactions (major and minor), management of inadvertent transfusion of mis-matched blood or blood products |
| 1_GA_E_20 | Inadvertent intra-arterial injection of irritant fluids |
| 1_GA_E_21 | High or total spinal block |
| 1_GA_E_22 | Local anaesthetic toxicity |
| 1_GA_E_23 | Accidental decannulation of tracheostomy or tracheal tube |
| 1_GA_E_24 | Brain stem herniation due to increased intracranial pressure |
| 1_GA_E_25 | Malignant hyperpyrexia |
| 1_GA_E_26 | Awareness of the importance of critical incident reporting |
| 1_GA_E_27 | The provision of information to the patient and where necessary ensuring that they get the appropriate counselling and advice with appropriate supervision |
| 1_GA_E_28 | The need to follow through a critical incident with proper reporting, presentation at morbidity meetings and warning flags as necessary |
1_GA_F: Demonstrates knowledge of standard equipment used in anaesthetic practice with an understanding of relevant underpinning physics and clinical measurement involved
F1: Equipment
| 1_GA_F1_1 | The functions and safety features of the anaesthetic machine |
| 1_GA_F1_2 | Patient warming systems: principles |
| 1_GA_F1_3 | Warming equipment for intravenous fluids: principles |
| 1_GA_F1_4 | Storage of gases and vapours including safety |
| 1_GA_F1_5 | Suction devices |
| 1_GA_F1_6 | Scavenging devices |
| 1_GA_F1_7 | Cylinders and pipelines, Bourdon gauge |
| 1_GA_F1_8 | Vaporisers: principles including plenum and draw over, temperature compensation, calibration |
| 1_GA_F1_9 | Electrical hazards: causes and prevention |
| 1_GA_F1_10 | Electrocution: including microshock, earth faults, leakage |
| 1_GA_F1_11 | Electrical equipment safety: medical, classification, types of equipment, symbols |
| 1_GA_F1_12 | ECG: principles including electrodes and electrode placement |
| 1_GA_F1_13 | Lasers: basic principles and safety |
| 1_GA_F1_14 | Cardiac pacemakers: Classification and safety |
| 1_GA_F1_15 | Defibrillators and defibrillation: principles including thoracic impedance, implantable devices |
| 1_GA_F1_16 | Diathermy: monopolar, bipolar; safety and uses |
| 1_GA_F1_17 | Plenum systems: warming blankets, theatre and anaesthetic room ventilation |
| 1_GA_F1_18 | Breathing systems: Mapleson classification, coaxial systems, circle systems, Tpiece, resuscitation breathing devices |
| 1_GA_F1_19 | Ventilators: principles including pressure and flow generators, cycling, jet and oscillator ventilators |
| 1_GA_F1_20 | Disconnections: monitoring of ventilator disconnection, warning devices |
| 1_GA_F1_21 | Fires and explosions: risks and prevention |
| 1_GA_F1_22 |
Infusion pumps and syringe drivers; PCA devices, epidural infusion devices. Principles, use, safety and relevant drug calculations |
| 1_GA_F1_23 | Principles of hygiene including disinfection and sterilisation of equipment |
| 1_GA_F1_24 | Methods of decontamination, disinfection and sterilisation |
| 1_GA_F1_25 | Describes the benefits and limitations of technology and equipment in maintaining patient safety |
F2: Physics
| 1_GA_F2_1 | SI units: fundamental and derived units |
| 1_GA_F2_2 | SI and non SI units relevant to anaesthesia including mmHg, bar, atmospheres, cm H2O, PSI |
| 1_GA_F2_3 | Simple mechanics: mass, force, work, energy, power where these are relevant to anaesthetic practice |
| 1_GA_F2_4 | Heat: including temperature, absolute zero |
| 1_GA_F2_5 | Heat transfer and loss with relevance to clinical anaesthesia: conduction, convection, radiation and evaporation |
| 1_GA_F2_6 | Latent heat |
| 1_GA_F2_7 | Colligative properties: relevance of the concepts of osmolarity, osmolality and diffusion to anaesthetic practice |
| 1_GA_F2_8 |
Physics of gases. Gas laws: kinetic theory of gases, Boyle’s, Henry’s, Dalton’s, Charles’ and Gay-Lussac’s |
| 1_GA_F2_9 | Critical temperature and pressure |
| 1_GA_F2_10 | Physics of vapours |
| 1_GA_F2_11 | Pressure; absolute and relative pressure, gauge pressure |
| 1_GA_F2_12 | Principles of laminar and turbulent flow; Hagen-Poiseuille equation, Reynold’s number |
| 1_GA_F2_13 | Relevance of gas density and viscosity. Examples including helium |
| 1_GA_F2_14 | Bernoulli principle |
| 1_GA_F2_15 | Venturi effect and entrainment devices |
| 1_GA_F2_16 | Vapour pressure; saturated vapour pressure |
| 1_GA_F2_17 | Vaporisation; process of vaporisation |
| 1_GA_F2_18 | Principles of surface tension |
| 1_GA_F2_19 | Capacitance, inductance |
| 1_GA_F2_20 | Ultrasound: basic principles of ultrasound |
| 1_GA_F2_21 | Physics relevant to optical fibres |
| 1_GA_F2_22 | Doppler effect: principle and clinical application |
| 1_GA_F2_23 | Resonance, damping, frequency response and their relevance to monitoring systems used in anaesthetic practice |
F3: Clinical measurement
| 1_GA_F3_1 | Basic measurement concepts relevant to understanding of monitoring in anaesthesia: linearity, drift, hysteresis, signal to noise ratio, static and dynamic response |
| 1_GA_F3_2 | Temperature measurement including mercury, alcohol, infrared, thermistor, thermocouple, Bourdon gauge, liquid crystal |
| 1_GA_F3_3 | Anatomical sites used for temperature measurement |
| 1_GA_F3_4 | Measurement of lung volumes and diffusion |
| 1_GA_F3_5 | Measurement of volume and flow in gases and liquids including pneumotachograph and other respirometers |
| 1_GA_F3_6 | Electrical interference; souces, methods of reduction |
| 1_GA_F3_7 | Pressure transducers |
| 1_GA_F3_8 | Capnography |
| 1_GA_F3_9 | Pulse oximetry |
| 1_GA_F3_10 | Measurement of gas pressures |
| 1_GA_F3_11 | Blood pressure: direct and indirect measurement including complications |
| 1_GA_F3_12 | Cardiac output: principles of measurement |
| 1_GA_F3_13 | Principles of measurement of pH, PCO2, PO2, electrolytes |
| 1_GA_F3_14 | Derived blood gas variables eg bicarbonate measures, base excess, oxygen consumption, respiratory quotient |
| 1_GA_F3_15 | Measurement of gas and vapour concentrations; including infrared, paramagnetic, fuel cell, oxygen electrode, mass spectrometry |
| 1_GA_F3_16 | Simple tests of pulmonary function: peak flow rate, spirometry |
| 1_GA_F3_17 | Assessment of neuromuscular blockade; quantitative and qualitative |
| 1_GA_F3_18 | Environmental monitoring; contamination by anaesthetic gases and vapours |
| 1_GA_F3_19 | Basic function and purpose of monitors |
| 1_GA_F3_20 | Minimum monitoring standards and indications for additional monitoring |
| 1_GA_F3_21 | Principles of calibration of monitoring equipment |
| 1_GA_F3_22 | Understanding the limits of monitoring equipment |
| 1_GA_F3_23 | CO2 absorption: chemistry and complications |
| 1_GA_F3_24 | Principles of measurement of parameters such as haemoglobin, blood glucose and coagulation using near-patient testing devices |
1_GA_G: Demonstrates knowledge of anatomy, physiology, biochemistry and pharmacology relevant to anaesthetic practice
G1: Anatomy
| 1_GA_G1_1 | Mouth, nose, pharynx, larynx, trachea, main bronchi, segmental bronchi, structure of the bronchial tree; age related changes from the neonate to the adult |
| 1_GA_G1_2 | Airway/respiratory tract blood supply and innervation |
| 1_GA_G1_3 | Pleura, including surface anatomy, mediastinum and its contents |
| 1_GA_G1_4 | Lungs: lobes and microstructure of lungs |
| 1_GA_G1_5 | Diaphragm, other muscles of respiration including innervation |
| 1_GA_G1_6 | The thoracic inlet and first rib; interpretation of the normal adult chest X ray |
| 1_GA_G1_7 | Heart: chambers, valves, conducting system and pericardium, blood supply and innervation |
| 1_GA_G1_8 | Great vessels, main peripheral arteries and veins |
| 1_GA_G1_9 | Brain and its subdivisions; blood supply |
| 1_GA_G1_10 | Spinal cord, structure of spinal cord, major ascending and descending pathways and blood supply |
| 1_GA_G1_11 | Anatomical organisation of pain and sensory pathways from the periphery to the central nervous system |
| 1_GA_G1_12 | Pain pathways relevant to the stages of obstetric labour and delivery |
| 1_GA_G1_13 | Spinal meninges, subarachnoid and extradural space, contents of extradural space |
| 1_GA_G1_14 | Anatomy of CSF system |
| 1_GA_G1_15 | Spinal nerves; dermatomes and applied knowledge of dermatomes in regional anaesthesia |
| 1_GA_G1_16 | Brachial plexus; nerves of the upper limb |
| 1_GA_G1_17 | Intercostal nerves |
| 1_GA_G1_18 | Nerves of the abdominal wall including innervation of the inguinal region |
| 1_GA_G1_19 | Lumbar and sacral plexuses; nerves of the lower limb |
| 1_GA_G1_20 | Anatomical organisation of the autonomic nervous system |
| 1_GA_G1_21 | Sympathetic innervation, sympathetic chain, ganglia and plexuses |
| 1_GA_G1_22 | Parasympathetic innervation; cranial and sacral outflow |
| 1_GA_G1_23 | Stellate ganglion |
| 1_GA_G1_24 | Cranial nerves |
| 1_GA_G1_25 | Innervation of the pharynx and larynx |
| 1_GA_G1_26 | Eye and orbit |
| 1_GA_G1_27 | Functional anatomy of the hypothalamic/pituitary system |
| 1_GA_G1_28 | Functional anatomy of the adrenal gland |
| 1_GA_G1_29 | Functional anatomy of the thyroid and parathyroid glands |
| 1_GA_G1_30 | Cervical, thoracic and lumbar vertebrae |
| 1_GA_G1_31 | Sacrum, sacral hiatus |
| 1_GA_G1_32 | Ligaments of the vertebral column where relevant to anaesthetic practice |
| 1_GA_G1_33 | Surface anatomy of vertebral spaces; length of the spinal cord and subarachnoid space, age related differences from the neonate to the adult |
| 1_GA_G1_34 | Structures in the antecubital fossa |
| 1_GA_G1_35 | Structures in the axilla |
| 1_GA_G1_36 | Large veins of the neck. Anterior triangle of the neck: surface anatomy and ultrasound demonstrated anatomy relevant to insertion of central venous cannulae |
| 1_GA_G1_37 | Large veins of the leg; femoral triangle |
| 1_GA_G1_38 | Arteries of upper and lower limbs |
| 1_GA_G1_39 | Landmarks for performance of cricoid pressure and surgical airway procedures |
| 1_GA_G1_40 | Landmarks for the insertion of intercostal drainage catheters and needle decompression of pneumothorax |
G2: Physiology
| 1_GA_G2_1 | Organisation of the human body and the control of the internal environment |
| 1_GA_G2_2 | Changes with advancing age |
| 1_GA_G2_3 | Cells: components and organelles |
| 1_GA_G2_4 | Function of cells: genes and their expression |
| 1_GA_G2_5 | Cell membrane characteristics; cell junctions, receptors |
| 1_GA_G2_6 | Protective mechanisms of the body |
| 1_GA_G2_7 | Definition of pH, strong and weak acids |
| 1_GA_G2_8 | Acid base balance; buffers, Henderson Hasselbach equation and anion gap |
| 1_GA_G2_9 | Ions eg Na+, K+, Mg2+, Ca2+, Cl-, HCO3- |
| 1_GA_G2_10 | Cellular metabolism; aerobic vs anaerobic |
| 1_GA_G2_11 | Fetus: physiological changes at birth |
| 1_GA_G2_12 | Enzymes |
| 1_GA_G2_13 | Capillary dynamics and interstitial fluid; osmosis, filtration and convection |
| 1_GA_G2_14 | Osmolarity; osmolality, partition of fluids across membranes, tonicity |
| 1_GA_G2_15 | Lymphatic system |
| 1_GA_G2_16 | Special fluids: CSF, pleural, pericardial, peritoneal |
| 1_GA_G2_17 | Active cellular transport mechanisms |
| 1_GA_G2_18 | Blood: physical properties, components, functions |
| 1_GA_G2_19 | Red blood cells: production and turnover, haematinics, haemoglobin and its variant including abnormal haemoglobins |
| 1_GA_G2_20 | Anaemia; acute and chronic adaptations, iron absorption, transportation and metabolism |
| 1_GA_G2_21 | Polycythaemia: causes and implications |
| 1_GA_G2_22 | Blood groups: ABO, Rhesus, others |
| 1_GA_G2_23 | Transfusion reactions; Rhesus incompatibility |
| 1_GA_G2_24 | Haemostasis and coagulation, fibrinolysis. Abnormalities, congenital and acquired |
| 1_GA_G2_25 | Alternative oxygen carrying solutions |
| 1_GA_G2_26 | White blood cells: types, origins, characteristics, turnover |
| 1_GA_G2_27 |
The inflammatory response, systemic inflammatory responses, hypersensitivity reactions. Immunity and allergy: innate vs acquired, non-specific vs specific, humoral vs cellular. Immunodeficiency – congenital and acquired |
| 1_GA_G2_28 | Action potential generation and transmission |
| 1_GA_G2_29 | Neuromuscular junction and transmission, motor end-plate |
| 1_GA_G2_30 | Disturbances of neuromuscular transmission |
| 1_GA_G2_31 | Myopathies, congenital and acquired |
| 1_GA_G2_32 | Muscle contracture: malignant hyperthermia, myoclonus, burns |
| 1_GA_G2_33 | Muscle types: skeletal, smooth, cardiac |
| 1_GA_G2_34 | Skeletal muscle excitation-contraction coupling |
| 1_GA_G2_35 | Smooth muscle contraction; sphincters |
| 1_GA_G2_36 | Motor unit concept |
| 1_GA_G2_37 | Cardiac muscle contraction |
| 1_GA_G2_38 | Cardiac cycle: pressure volume relationships, work and power |
| 1_GA_G2_39 | Rhythmicity of the heart; cardiac impulse generation |
| 1_GA_G2_40 | Regulation of cardiac function; general and cellular |
| 1_GA_G2_41 | Control of cardiac output; Starling relationship |
| 1_GA_G2_42 | Fluid challenge and heart failure, types of shock |
| 1_GA_G2_43 | Electrocardiogram and arrhythmias, origin of ECG, effects of temperature, ischaemia, infarction and electrolyte imbalance |
| 1_GA_G2_44 | Neurological and humoral control of systemic blood pressure, blood volume and blood flow; at rest and during physiological disturbance eg exercise, haemorrhage and Valsalva manoeuvre |
| 1_GA_G2_45 | Peripheral circulation: capillaries, vascular endothelium and arteriolar smooth muscle |
| 1_GA_G2_46 | Functions of endothelium |
| 1_GA_G2_47 | Characteristics of special circulations including pulmonary, coronary, cerebral, renal, portal, transitional and fetal |
| 1_GA_G2_48 | Structure and function of renal circulation |
| 1_GA_G2_49 | Blood flow and glomerular filtration, plasma clearance and tubule-glomerular feedback |
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1_GA_G2_50 |
Tubular function and urine formation; transport processes in kidney |
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1_GA_G2_51 |
Assessment of renal function |
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1_GA_G2_52 |
Regulation of water and electrolyte balance; response to fluid loss/hypovolaemia |
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1_GA_G2_53 |
Role of urea and creatinine measurement |
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1_GA_G2_54 |
Regulation of acid-base balance |
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1_GA_G2_55 |
Pathophysiology of acute kidney injury and renal failure |
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1_GA_G2_56 |
Gaseous exchange: O2 and CO2 transport, hypoxia and hyper/hypocapnia, hyper and hypobaric pressures |
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1_GA_G2_57 |
Function of haemoglobin in oxygen carriage and acid-base equilibrium |
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1_GA_G2_58 |
Pulmonary ventilation: volumes, capacities, flows, dead space, compliance, work of breathing |
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1_GA_G2_59 |
Effect of IPPV on lungs |
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1_GA_G2_60 |
Mechanics of ventilation; ventilation/perfusion abnormalities, regional V/Q, surfactant |
| 1_GA_G2_61 | Control of breathing, acute and chronic ventilator failure, effect of oxygen therapy |
| 1_GA_G2_62 | Effects of altitude |
| 1_GA_G2_63 | Non-respiratory functions of the lungs |
| 1_GA_G2_64 | Neuronal structure and function, resting membrane potential, action potentials, conduction, synaptic mechanisms, actions of neurotransmitters |
| 1_GA_G2_65 | The brain; functional divisions |
| 1_GA_G2_66 | Brain stem: organisation, interconnections. Intracranial pressure, CSF and blood flow |
| 1_GA_G2_67 | Autonomic nervous system: organisation, ganglia, adrenergic vs cholinergic |
| 1_GA_G2_68 | Neurological reflexes: monosynaptic, polysynaptic, stretch, inhibition |
| 1_GA_G2_69 |
Motor function: basal ganglia, spinal and peripheral Sense: receptors, nociception, proprioception, sight, taste, smell, hearing, balance, touch, temperature |
| 1_GA_G2_70 | Pain: afferent nociceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms, visceral pain, neuropathic pain, influence of therapy on nociceptive mechanisms |
| 1_GA_G2_71 | Physiology of nausea and vomiting |
| 1_GA_G2_72 | Metabolic and digestive functions |
| 1_GA_G2_73 | Gastric function: motility, secretions, nausea and vomiting |
| 1_GA_G2_74 | Digestive functions: composition of secretions, digestion of carbohydrates, lipids, proteins. Energy homeostasis |
| 1_GA_G2_75 | Body mass/composition. Body mass index, body fat estimation |
| 1_GA_G2_76 | Principles of nutrition: carbohydrates, fats, proteins, vitamins and minerals |
| 1_GA_G2_77 | Energy requirements/expenditure and measurement |
| 1_GA_G2_78 | Metabolic pathways, energy production and enzymes, metabolic rate, lactate metabolism |
| 1_GA_G2_79 | Hormonal control of metabolism: regulation of plasma glucose, response to trauma |
| 1_GA_G2_80 | Physiological alterations in starvation, exercise and the stress response |
| 1_GA_G2_81 | Body temperature and its regulation including at extremes of age |
| 1_GA_G2_82 | Hormones: types, receptors, hierarchy, extracellular signalling |
| 1_GA_G2_83 | Mechanisms of hormonal control: feedback mechanisms, effects on membrane and intracellular receptors |
| 1_GA_G2_84 | Hypothalamic and pituitary function |
| 1_GA_G2_85 | Adrenocortical hormones |
| 1_GA_G2_86 | Adrenal medulla: adrenaline and noradrenaline |
| 1_GA_G2_87 | Pancreas: insulin, glucagons and exocrine function |
| 1_GA_G2_88 | Thyroid and parathyroid hormones and calcium homeostasis |
| 1_GA_G2_89 | Physiological changes associated with pregnancy |
| 1_GA_G2_90 | Materno-fetal, fetal and neonatal circulation |
| 1_GA_G2_91 | Functions of the placenta; placental transfer |
G3: Biochemistry and pharmacology
| 1_GA_G3_1 | Exponential functions including wash-in, wash-out where relevant to anaesthetic practice |
| 1_GA_G3_2 | Logarithms relevant to anaesthetic or critical care practice |
| 1_GA_G3_3 | Area under the curve (integration) and rate of change (differentiation) relevant to anaesthetic practice |
| 1_GA_G3_4 | Organic chemistry: drugs as organic molecules, types of intermolecular bonds, interactions between molecules, organic compared with inorganic compounds, bond strength, important atomic constituents, C, N, O, P, S and halides |
| 1_GA_G3_5 | Organic chemistry: ionisation of molecules, types of group that ionise, amides, hydroxyl, carboxyl |
| 1_GA_G3_6 | Oxidation and reduction |
| 1_GA_G3_7 | Permanently charged (quaternary ammonium) drugs |
| 1_GA_G3_8 | Drug chemistry: solubility, partition coefficients and movement of drugs through membranes, lipid solubility, influence of pKa and pH |
| 1_GA_G3_9 | Passive and active transport mechanisms |
| 1_GA_G3_10 | Isomers: structural and stereo, classification systems, clinical relevance |
| 1_GA_G3_11 | Mechanisms of drug action: physicochemical, pharmacodynamics, pharmacokinetic, drug-receptor interactions, dose response and log doseresponse curves, agonists, partial agonists, antagonists |
| 1_GA_G3_12 | Reversible and irreversible antagonism. Potency and efficacy |
| 1_GA_G3_13 | Non-specific drug actions; physic chemical mechanisms eg adsorption, chelation, neutralisation |
| 1_GA_G3_14 | Voltage-gated ion channels, membrane bound transport pumps |
| 1_GA_G3_15 | Sodium, potassium and calcium channels as targets for drug action |
| 1_GA_G3_16 | Receptors as proteins, ion channels, transmembrane transduction and intermediate messenger systems, intracellular/nuclear receptors |
| 1_GA_G3_17 | Receptor regulation and tachyphylaxis |
| 1_GA_G3_18 |
Response time of ligand gated receptor interaction, enzymes as drug targets, Michaelis-Menten kinetics |
| 1_GA_G3_19 | Direct and allosteric mechanisms eg acetylcholinesterase, cyclo-oxygenase, phosphodiesterase |
| 1_GA_G3_20 | Anticholinesterases; classification of drugs that inhibit acetylcholinesterase and plasma cholinesterase including organophosphates |
| 1_GA_G3_21 | Predictable side effects of drugs, non selective actions of drugs, action at multiple receptors, multiple anatomical locations, predictable enzyme induction/inhibition |
| 1_GA_G3_22 | Idiosyncratic side effects of drugs eg blood and bone marrow dyscrasias, pulmonary fibrosis, antiplatelet effects |
| 1_GA_G3_23 | Anaphylactic and anaphylactoid reactions; comparison, treatment, identification of responsible drug, risks of polypharmacy |
| 1_GA_G3_24 | Tachyphylaxis and tolerance; examples of drugs demonstrating tachyphylaxis, proposed mechanisms |
| 1_GA_G3_25 | Drug interactions: types of interaction, synergism, additivity, antagonism, isobolograms |
| 1_GA_G3_26 | Classification of mechanisms of drug interactions |
| 1_GA_G3_27 |
Pharmacokinetics: general principles – absorption, distribution and redistribution, elimination, excretion. Chemical properties of drugs and their pharmacokinetics. Blood-brain barrier and placental barrier. Protein binding – plasma and tissue. Body compartments, adipose and vessel poor tissue. Bioavailability, clearance |
| 1_GA_G3_28 | Administration and absorption; routes of administration; first pass metabolism and bioavailability. Selection of appropriate route. Drug delivery systems eg sustained release, enteric coated, transdermal patch and iontophoretic systems |
| 1_GA_G3_29 | Oral administration: time course for systemic appearance, factors eg pKa, lipid solubility, active transport |
| 1_GA_G3_30 | Bioavailability of drugs given orally and its measurement |
| 1_GA_G3_31 | Drug elimination from plasma. Mechanisms: distribution, metabolism, excretion, exhalation, renal, biliary, sweat, breast milk |
| 1_GA_G3_32 | Factors affecting drug elimination eg pathological state, renal and hepatic failure, age, gender, drug interactions |
| 1_GA_G3_33 | Active and inactive metabolites, pro-drugs. Enzyme induction and inhibition |
| 1_GA_G3_34 | Non-enzymatic drug elimination. Hofmann degradation |
| 1_GA_G3_35 | Pharmacokinetic modelling: types of models available, one, two and three compartment models, non-compartmental, physiological |
| 1_GA_G3_36 | Pharmacokinetic parameters: volume of distribution, half-life and time constant, clearance |
| 1_GA_G3_37 | Context sensitive half-time: comparison of drugs eg propofol, fentanyl and remifentanil. Target controlled infusions (TCI) |
| 1_GA_G3_38 | TCI in practice: accuracy, applicability, cost. Variations due to patient differences – predictable and unpredictable |
| 1_GA_G3_39 | Pharmacogenetics: pharmacokinetic variation eg pseudocholinesterase, acetylation, CYP450 variants |
| 1_GA_G3_40 | Differences in patient response to therapy: gender, pathology, polypharmacy, changes occurring with increasing age |
| 1_GA_G3_41 | Poor and fast metabolisers, racial and geographic distribution of common abnormal genes |
| 1_GA_G3_42 | Volatile and gaseous anaesthetic agents: structure of available agents, MAC, clinical effects on CNS, CVS, RS, pharmacokinetics including metabolism |
| 1_GA_G3_43 | Mechanisms of general anaesthetic action |
| 1_GA_G3_44 | Factors that affect the onset and offset time. Oil/gas partition coefficient. Intravenous anaesthetic agents: chemical classes, properties of an ideal induction agent, adverse effects on CNS, CVS, RS, pharmacokinetics including metabolism |
| 1_GA_G3_45 | Benzodiazepines: classification of action, clinical actions, synergism with anaesthetic agents, antidote in overdose |
| 1_GA_G3_46 | Local anaesthetic agents. Additional effects including anti-arrhythmic effects. Mechanism of action. Clinical factors influencing choice: operative site, patient, available agents. Toxicity syndrome: safe clinical and maximum clinical doses, treatment of overdose |
| 1_GA_G3_47 | Analgesics. Simple analgesics, NSAIDs and opioids. Available routes of administration, perioperative prescribing, chronic compared with acute pain prescribing |
| 1_GA_G3_48 | Aspirin and paracetamol. Comparison of structures, indications and contraindications, mechanism of action, bioavailability, metabolism, toxicity |
| 1_GA_G3_49 | Non steroidal anti inflammatory analgesics: classification, mechanism of action, clinical effects and uses, unwanted effects, contraindications |
| 1_GA_G3_50 | Opioid analgesics: receptor classification, mechanism of action, inhibitory effects, sites of action on pain pathways, unwanted effects, full and partial agonists, routes of administration. Opioid dependence and tolerance |
| 1_GA_G3_51 |
Muscle relaxants: Classification. Sites of action. Properties of an ideal muscle relaxant. Dantrolene and management of MH Depolarizing muscle relaxants: Structure, mechanism of action. Organophosphate poisoning Adverse effects and contraindications
|
| 1_GA_G3_52 | Non-deploarising muscle relaxants: structural classification, sub-classification according to onset time and duration of action. Comparison of aminosteroids and benzylisoquinoliniums. Comparison of individual agents: metabolism and active metabolites. Unwanted effects |
| 1_GA_G3_53 | Reversal of neuromuscular blockade: indications for use, mechanism of action, clinically unwanted effects of reversal of neuromuscular blockade |
| 1_GA_G3_54 | Drugs and the autonomic nervous system: anatomy, myelinated and unmyelinated nerves, ganglia and rami communicantes |
| 1_GA_G3_55 | Neurotransmitters: sites at which drugs and interfere with autonomic transmission |
| 1_GA_G3_56 | Drugs and the sympathetic nervous system: adrenergic receptors and molecular mechanisms of action, indications for pharmacological use of naturally occurring and synthetic analogues. Other classes of drugs active in the sympathetic system eg MAOIs |
| 1_GA_G3_57 | Drugs and the parasympathetic nervous system: nicotinic and muscarinic receptors with subgroups, mechanism of action agonists and antagonists, comparison of available drugs |
| 1_GA_G3_58 | Cardiovascular system: drug effects on the heart and on the circulation, arterial and venous effects, systemic and pulmonary effects |
| 1_GA_G3_59 | Inotropes and pressors: classification, site of action, synthetic inotropes compared with adrenaline |
| 1_GA_G3_60 | Drugs used in ischaemic heart disease: classification of drugs uses, mechanism of drug action, use in unstable angina |
| 1_GA_G3_61 | Antiarrhythmic drugs: classification, indications for use including in resuscitation |
| 1_GA_G3_62 | Hypotensive agents: classes of drugs to produce acute hypotension in theatre. Therapeutic antihypertensive agents: classification according to mechanism of action. Adverse effects of drugs in each class |
| 1_GA_G3_63 | Anticoagulants: oral and parenteral. Sites of action, indications for use, monitoring effect. Comparison of heparins: unfractionated and fractionated. Newer anticoagulants. Antiplatelet agents. Perioperative management of antiplatelet and anticoagulant medication |
| 1_GA_G3_64 | Pro-coagulants: drugs, individual factor concentrates, multifactor preparations including FFP, vitamin K |
| 1_GA_G3_65 | Colloids including blood and blood products: composition of preparations, safe use and avoidance of errors |
| 1_GA_G3_66 | Crystalloid fluids: composition, suitable fluids for maintenance and replacement of losses. Comparison with colloids, unwanted effects |
| 1_GA_G3_67 | Electrolyte solutions including conversion between units eg molar, mg/ml, % |
| 1_GA_G3_68 | Respiratory system: classes of drug acting on the respiratory tract including bronchodilators, oxygen, surfactant, mucolytics, pulmonary vasodilators. Methods of administration, indications for use, mechanism of action, adverse effects |
| 1_GA_G3_69 | Respiratory system: drugs used in acute severe asthma and chronic asthma, volatile agents, mechanisms of action |
| 1_GA_G3_70 | Gastrointestinal system: antisialogogues, drugs reducing gastric acidity, drug effects on the GI tract including gastric and bowel motility |
| 1_GA_G3_71 | Applied pharmacology of pro-kinetic and antacids including simple alkalis, H2 receptor antagonists and proton pump inhibitors |
| 1_GA_G3_72 | Antiemetics including anatomical sites for antiemetic action, central and peripheral inputs to the vomiting centre, use of dexamethasone |
| 1_GA_G3_73 | Renal system: diuretics, classification of diuretics, unwanted effects, indications for use |
| 1_GA_G3_74 | CNS: antiepileptic agents, mechanism of action and unwanted effects |
| 1_GA_G3_75 | CNS: antidepressants, classes of drug, anaesthetic relevance, toxicity in overdose |
| 1_GA_G3_76 | Diabetes mellitus: drugs used in type 1 and type 2 diabetes, insulins: classification, routes of administration. Perioperative management of diabetic therapy. Unwanted effects and risks of hyper/hypo glycaemia and its therapeutic management |
| 1_GA_G3_77 | Hormones – corticosteroids: indications for use, clinical effects, long term complications of glucocorticoid use |
| 1_GA_G3_78 | Hormones – treatment of thyroid disorders: synthesis and release of thyroid hormones, preparations used in hyper and hypothyroidism |
| 1_GA_G3_79 | CNS stimulants: classes, mechanisms of action, uses in anaesthesia |
| 1_GA_G3_80 | RS stimulants including theophyllines and doxapram |
| 1_GA_G3_81 | Antimicrobial agents: general classification, types of antimicrobial agent, antiviral, antibacterial, antifungal, bacteriostatic and bacteriocidal, mechanisms of action, indications for use of different classes of antibiotics, bacterial resistance |
| 1_GA_G3_82 | Effects of drugs on the eye and vision including effect on intra-ocular pressure |
| 1_GA_G3_83 | Social and recreational drugs including tobacco, alcohol and non-legal drugs and their anaesthetic relevance |
1_GA_H: Provides safe general anaesthesia with distant supervision for ASA 1-3 adults undergoing non-complex elective and emergency surgery within the general theatre setting
| 1_GA_H_1 |
Universal precautions and good working practices for the control of infection including:
|
| 1_GA_H_2 | Pharmacology and pharmacokinetics, including doses, interactions and significant side effects of drugs used during induction of anaesthesia |
| 1_GA_H_3 | Management of common problems encountered in patients requiring emergency surgery |
| 1_GA_H_4 | Discusses how patients may be inadequately fasted and how this problem is managed |
| 1_GA_H_5 | Describes the NCEPOD classifications and explains the importance of these in delivering surgical care to patients |
1_GA_I: Describes the specific needs of the obese, frail and elderly patients undergoing general anaesthesia
| 1_GA_I_1 | Anaesthetic management of obese, frail and elderly patients |
1_GA_J: Manages intra-operative fluid balance appropriately
| 1_GA_J_1 | Principles of postoperative fluid regimes including volumes, types of fluids and monitoring of fluid balance |
| 1_GA_J_2 | Perioperative fluid and feeding |
1_GA_K: Can identify patients with difficult airways. Demonstrates management of the ‘cannot intubate cannot oxygenate’ scenario in simulation, and describes difficult airway guidelines
| 1_GA_K_1 | Methods commonly used for assessing the airway to predict difficulty with tracheal intubation, including radiology and its interpretation |
| 1_GA_K_2 | Difficult/failed mask ventilation |
| 1_GA_K_3 | Failed intubation |
| 1_GA_K_4 | Management of the ‘can’t intubate, can’t oxygenate’ scenario |
| 1_GA_K_5 | Indications for emergency front of neck access |
| 1_GA_K_6 | Conditions that may complicate airway management eg anatomical variation, tumour, bleeding |
1_GA_L: Recognises the challenges associated with shared airway surgery
| 1_GA_L_1 | Anaesthetic issues of the shared airway |
| 1_GA_L_2 | Specialised devices used to maintain the airway during head and neck surgery |
| 1_GA_L_3 | Anaesthetic implications of special surgical devices used during head and neck surgery |
| 1_GA_L_4 | Anaesthetic techniques for common ENT and dental procedures; specific anaesthetic issues of ENT and maxilla-facial procedures |
| 1_GA_L_5 | Principles of management of bleeding tonsils |
| 1_GA_L_6 | Principles of the emergency management of the obstructed airway including tracheostomy |
| 1_GA_L_7 | Equipment and safety features associated with the use of LASER |
1_GA_M: Provides safe anaesthesia for diagnostic or therapeutic procedures in the non-theatre environment for ASA 1-2 adults with local supervision
| 1_GA_M_1 | Risks and benefits to patients, and risks to staff from common radiological investigations and procedures including the use of contrast media |
| 1_GA_M_2 | Awareness of statutory radiological regulations as applied to the referrer, practitioner or operator of diagnostic services |
| 1_GA_M_3 |
Safe precautions and equipment requirements in specific environments eg MRI suites |
| 1_GA_M_4 | Specific anaesthetic implications of imaging techniques including but not limited to MRI and CT scanning, angiography |
| 1_GA_M_5 | Hazards associated with induction of anaesthesia in unusual/remote places eg emergency room and in special circumstances including, but not exclusively, brain injury, full stomach, sepsis, upper airway obstruction |
1_GA_N: Explains the principles of anaesthetic care for patients presenting with major trauma
| 1_GA_N_1 | Principles of the perioperative management of the trauma patient |
| 1_GA_N_2 | Vascular access in trauma patients including the intraosseous route |
| 1_GA_N_3 | Investigations and imaging in trauma |
| 1_GA_N_4 | Management of patients with brain injury, including the use of the Glasgow coma scale; mechanisms for the prevention of secondary brain injury |
| 1_GA_N_5 | Management of patients with potential cervical spine trauma |
| 1_GA_N_6 | Principles of the primary and secondary survey in trauma patients |
| 1_GA_N_7 | Pathophysiology associated with trauma |
| 1_GA_N_8 | Airway management in the trauma patient including recognition of the compromised airway |
| 1_GA_N_9 | Effects of hypothermia in trauma and its prevention |
1_GA_O: Explains the principles of paediatric anaesthesia taking into account the anatomical, physiological, psychological and pharmacological differences from adults and their implications for safe practice
| 1_GA_O_1 | Basic sciences specific to children aged one year and above |
| 1_GA_O_2 | Preoperative assessment and psychological preparation of children aged one year and above (and their parents) for surgery |
| 1_GA_O_3 | Pre-operative fasting in children |
| 1_GA_O_4 | Premedication including topical anaesthesia for venepuncture in children |
| 1_GA_O_5 | Significance of upper respiratory tract infections and, as a result, when to cancel operations |
| 1_GA_O_6 | Obtaining consent for anaesthesia in children |
1_GA_P: Provides safe general anaesthesia for ASA 1-2 children 5 years and over with local supervision and 10 years with distant supervision undergoing non-complex elective and emergency surgery
| 1_GA_P_1 | Induction of anaesthesia for children aged 5 years and above |
| 1_GA_P_2 | Maintenance of anaesthesia for children aged 5 years and above |
| 1_GA_P_3 | Recovery from anaesthesia for children aged 5 years and above |
| 1_GA_P_4 | Management of perioperative pain, nausea and vomiting in children including common regional techniques eg caudal |
| 1_GA_P_5 | Fluid and electrolyte management in children |
| 1_GA_P_6 | Drug dosing in children |
| 1_GA_P_7 | Paediatric anaesthetic equipment and the differences from adult practice |
| 1_GA_P_8 | Sizing tracheal tubes, supraglottic devices and other airway adjuncts |
| 1_GA_P_9 | Breathing systems and the appropriate fresh gas flow rates |
1_GA_Q: Explains the anaesthetic implications of pregnancy and undertakes safe general anaesthesia for ASA 1-3 obstetric patients
| 1_GA_Q_1 | The anatomy, physiology and pharmacology related to pregnancy and labour |
| 1_GA_Q_2 | Common obstetric indications for anaesthetic intervention of the delivery suite |
| 1_GA_Q_3 | The effects of aortocaval compression and how to avoid it |
| 1_GA_Q_4 | How to assess fetal well-being in utero |
| 1_GA_Q_5 | Local feeding/starvation policies and the reasons behind them |
| 1_GA_Q_6 | Thromboprophylaxis requirements in pregnancy |
| 1_GA_Q_7 | The grading of urgency of Caesarean section |
| 1_GA_Q_8 | Why anaesthetic techniques must be modified in the pregnant patient |
| 1_GA_Q_9 | How to access local maternity guidelines and the value of having these guidelines |
| 1_GA_Q_10 | Explains the implications of exposing the pregnant or potentially pregnant patient to ionising radiation |
1_GA_R: Performs immediate resuscitation and care for patients with acute obstetric emergencies under distant supervision, recognising when additional help is required
| 1_GA_R_1 | The management of pre-eclampsia and eclampsia |
| 1_GA_R_2 | Risk factors and management of major obstetric haemorrhage |
| 1_GA_R_3 | Modification of ALS guidelines in the pregnant patient |
1_GA_S: Describes the principles of total intravenous anaesthesia and uses it safely in clinical practice for non-complex cases
| 1_GA_S_1 | Principles of use of total intravenous anaesthesia |