1 / 26

Introduction to Intensive Care Medicine for ACCS trainees

Introduction to Intensive Care Medicine for ACCS trainees. Sabine Eggert Swansea 2012. Intensive Care Medicine. Copenhagen 1952 – Ibsen: Technique of positive pressure ventilation widely adopted in polio epidemic with mortality reduction from 90% to 25%.

dante
Download Presentation

Introduction to Intensive Care Medicine for ACCS trainees

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Introduction to Intensive Care Medicine for ACCS trainees Sabine Eggert Swansea 2012

  2. Intensive Care Medicine • Copenhagen 1952 – Ibsen: Technique of positive pressure ventilation widely adopted in polio epidemic with mortality reduction from 90% to 25%. (Manpower required - 1400 students) • Positive-pressure ventilators developed (Engstrom)

  3. Intensive Care Medicine

  4. Intensive Care Medicine • 1970–1980’s – modern concept of critical illness developed. Respiratory support only run by anaesthetists • 1999 - Awarded specialty status • 2000 - IBITCM established • 2002 - Dual CCT in ICM • 2010 - FICM approved • 2012 - Single CCT in ICM

  5. Intensive Care Medicine

  6. Principles • Diffusion (Fick’s law) • Filtration • Absorption

  7. Intensive Care Medicine Change over time: • Equipment • Environment • Patients are older, sicker with higher expectations

  8. Intensive Care Medicine Help: • Colleagues • Nurses • ITU guidelines • Computer

  9. Intensive Care Medicine The ICM team: Consultants (11) Trainees (21) Parent specialty doctors Microbiologists, pathologists Nursing staff Technicians Secretaries Physiotherapists Pharmacists Dieticians Receptionists Cleaners

  10. Intensive Care Medicine

  11. Intensive Care Medicine Swansea • 28 ITU beds in Morriston Hospital • No. of admissions: over 1100 per year • 42% surgical, 58% medical • Tertiary centre – trauma / vascular / pancreatic disease / renal • Other critical care areas: • Burns unit • Cardiac ITU

  12. Intensive Care Medicine

  13. Intensive Care Medicine • Induction Meeting, Appraisal meetings • 2 ACCS trainees on 1st on call rota • Allocated to one section of the unit during morning hand-over • 2 consultant-led ward rounds • Member of trauma and arrest team • Ward referrals

  14. Intensive Care Medicine • Microbiology ward rounds • Weekly audit / case presentations and journal clubs • Weekly team based “long stay” patient reviews • X ray teaching • Bed side teaching

  15. Intensive Care Medicine Ward round • System-based presentation: CVS Respiratory Neurological Renal GI tract Haematological/ Infections • Problems • Management plan

  16. Intensive Care Medicine Duties: • Interventions • Referrals • Relatives • Discharge summaries • Death Certificates

  17. Intensive Care Medicine “ACCS paperwork” • 6 DOPS • 3 Mini Cex • 4 CBD • 1 MSF • FICM documentation • Educational Supervisor Report

  18. Intensive Care Medicine Single/Dual CCT’s: • Entry routes: Anaesthetics, CMT, EM ACCS • Primary exam • Primary FICM exam not running yet (2014?)

  19. Intensive Care Medicine Single CCT: • Competitive entry at ST3 level • Primary exam in entry specialty • Annual interviews in ICM • National interview process • Soon: applications for ACCS ICM possible

  20. Intensive Care Medicine Stage 1 ICM training: • Appointments into ST3 and ST4 ICM training • At the end of ST4 every trainee will have had: 1 year Anaesthetics 1 year ICM 1 year AM

  21. Intensive Care Medicine Stage 2 ICM training: • ST 5 year with specialty experience (cardiac, neuro, paeds plus other) • ST 6 special interest • Compulsory FICM exam: ST 5/ ST6 level

  22. Intensive Care Medicine Stage 3 ICM training: • 1 year of advanced ICM training

  23. Intensive Care Medicine Dual CCT’s: • CT of 2nd specialty • 2 Applications (within 18 months) • Additional 18 months of training needed • Overlap of competencies

  24. Intensive Care Medicine Why dual CCT? • Broadens working opportunities • Increasing demand for ICM consultants • Anaesthetics: “peri-operative physician” • AM/EM: close links

  25. Thank you!

  26. Questions?

More Related