Examination Syllabus Stage 2

Published: 22/10/2024

Intensive Care Medicine (ICM)

2_IC_A: Recognises the limitations of intensive care; employs appropriate admission criteria

2_IC_A_1

Discusses requirements for organ support and its limitations

2_IC_B

Performs safely and effectively the clinical invasive procedures required to maintain respiratory, cardiovascular, and renal, support

2_IC_C: Recognises, assesses, and initiates management for acutely ill adults across the spectrum of single or multiple organ failure

2_IC_C_1	Anatomy relevant to the range of practical procedures required in intensive care medicine
2_IC_C_2	Indications for postoperative ventilation
2_IC_C_3	Management of the patient with respiratory failure including: Severe asthma Disorders of respiratory mechanics, gas exchange and gas transport Disorders of the pulmonary circulation- arterial and venous Respiratory failure and ventilatory support, consequences of positive pressure ventilation Choices of modes ventilation eg asthma/COPD/restrictive defects Effect of prone ventilation Effect of changes in ambient pressure Use of gases: helium and nitric oxide Use of ECMO
2_IC_C_4	Management of the patient with cardiac dysfunction including: Cardiomyopathy and abnormal ventricular function – congenital and acquired High and low cardiac output states Valvular disease Hypertension- pulmonary and systemic Ischaemic heart disease Uses of vasopressors and inotropes Assessment of cardiac function
2_IC_C_5	Management of the patient with neurological deterioration including: Seizures Delirium Reduced conscious level, including infection and drug toxicity Spinal cord injury Raised intracranial pressure Control of cerebral circulation Myasthenia Guillain-Barre Disorders of the autonomic nervous system Hypoxic brain injury and brain stem death Traumatic brain injury
2_IC_C_6	Management of the patient with renal dysfunction including: Disturbances of fluid balance, oedema, and dehydration Acid-base abnormalities Plasma electrolyte disturbances Renal tubular acidosis Assessment of renal function Diuretics and their action Principles of haemofiltration and other renal support Influence of renal replacement therapies on commonly used drugs
2_IC_C_7	Management of the patient with liver dysfunction Jaundice Acute liver failure Chronic liver failure Porphyria
2_IC_C_8	Management of the patient with gastro-intestinal dysfunction including: Nausea and vomiting Oesophageal reflux Bowel obstruction and gastric stasis Pancreatitis Swallowing disorders The mucosal barrier Starvation and obesity Malnutrition
2_IC_C_9	Management of the patient with an endocrine emergency Diabetes mellitus/insipidus Thyroid Adrenal
2_IC_C_10	Management of the patient with a haematological issue including Haematological malignancies Congenital and acquired blood disorders Anaemia Thrombocytopenia Abnormalities of coagulation Blood bourne viruses including hepatitides and HIV
2_IC_C_11	Knowledge of enteral and parenteral nutritional formulas in intensive care Principles Risks Pre and post pyloric feeding Consequences of overfeeding (CO2, uraemia, hypermetabolism, hypertrigliceridaemia, hepatic steatosis Changes in intestinal blood flow with injury/sepsis/critical illness

2_IC_D: Recognises the acutely ill child and initiates management of paediatric emergencies

2_IC_D_1	Recognition/initial management of the sick/deteriorating child
2_IC_D_2	Recognition of the specific conditions likely to deteriorate to respiratory or cardiac arrest in children [e.g. meningococcal sepsis] and describe their initial management
2_IC_D_3	Recognition/management of the critically ill child with e.g. sepsis, trauma, convulsions, dehydration, respiratory and diabetic emergencies and describes their timely management

2_IC_E: Recognises and manages the patient with sepsis and employs local infection control policies

2_IC_E_1	Recognition and management of the patient with sepsis
2_IC_E_2	Antimicrobials, antivirals, and antifungals: principles of action; choice of drug.
2_IC_E_3	Antibiotic resistance and stewardship
2_IC_E_4	Antibiotic prophylaxis against surgical infection including prevention of surgical site infection

2_IC_F: Undertakes and evaluates laboratory and clinical imaging investigations to manage patients while critically ill during their intensive care stay

2_IC_F_1

Interpretation of investigations and monitoring techniques to aid the diagnosis and management of the critically ill patient

2_IC_G: Manages the medical / surgical needs and organ support of patients during their critical illness, including the holistic care of patients and relatives

2_IC_G_1

Management of the continuing needs of patients in critical care including organ support and

2_IC_H: Plans and communicates the appropriate discharge of patients from intensive care to healthcare professionals, patients, and relatives

2_IC_H_1

Ability to plan and communicate decisions for care of critically unwell patients with relatives and other healthcare workers, including discharge, escalation, and ceilings of care.

2_IC_I: Manages end of life care within the intensive care environment with patients, relatives, and the multi-professional team

2_IC_I_1	To facilitate sensitive discussions, considering the views of patients and relatives, about the process of withholding or withdrawing life sustaining treatment and the provision for palliative care.
2_IC_I_2	Manages the palliative care of those with end-stage disease

2_IC_J: Liaises with transplant services when appropriate, can perform brain stem death testing and provides the physiological support of the donor

2_IC_J_1

Management of organ donation in critical care

2_IC_K: Supports clinical staff outside the ICU to enable the early detection of the deteriorating patient

2_IC_K_1

Understands risk scoring systems in the context of the deteriorating patient