Intensive Care

Draft proposed by Dr NC Fong
Reviewed by Dr Sabrina Tsao

Essential Skills

Domain 1 Professional Values & Behaviour
Domain 2 Communication

  1. Communication skill with parents and relatives of critically ill patients

Domain 3 Procedural Skills

  1. Intubation and CPR
  2. Intra-osseous infusion
  3. Set up of arterial lines for monitoring
  4. Thoracocentesis and chest drain insertion
  5. Use ultrasound to rule out pericardial effusion or pleural effusion, to assist vascular access, and to use bladder scan.

Domain 4 Patient Management

Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises.

Download Syllabus (28 November 2023)
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Basic Training

Resuscitation

Basic concepts in paediatric cardiopulmonary resuscitation.

Basic principle of mechanical ventilation

Knowledge of ventilator setting, short- and long-term complications of ventilation, appropriate use of oxygen, interpretation of blood gas.

Basic pharmacology and drug interaction
  • Use of inotropes, analgesic, sedative, neuromuscular blocking agents, anticonvulsants
  • Toxicology & poisoning
Shock

Knowledge of different types of shock and its basic management.

Acute management of congestive heart failure and common arrhythmia
  • Common causes
  • Common manifestations
  • Use of common cardiac drugs
Respiratory intensive care
  • Recognition of respiratory failure
  • Medications for status asthmaticus
  • Use of invasive and noninvasive respiratory support
  • Emergency treatment of pleural effusion and pneumothorax
  • Upper airway obstruction: croup, anaphylaxis
Neurological intensive care
  • Management of severe meningitis
  • Presentation of brain tumors and intracranial bleeding
  • Knowledge of raised ICP
  • Status epilepticus and treatment
  • Comatose patients
  • GBS, Transverse myelitis
Endocrine intensive care
  • DKA, hypoglycemia, CAH
  • Thyrotoxic storm, Cerebral DI, IEM emergency
Renal intensive care and electrolytes abnormality
  • Recognition of types of renal failure
  • Basic management of acute renal failure
  • Management of Hypo/Hyper Na, K, Ca, acid-base balance
Haematology and oncology intensive care
  • Severe anaemia and bleeding tendency
  • Various emergency presentation of malignancy
  • Tumor lysis syndrome, Neutropenic fever
  • Use of blood products
Infection in intensive care
  • Rational use of antibiotics
  • Prevention of hospital acquired infection
  • Infection control routines
Gastrointestinal intensive care
  • Severe GI bleeding
  • Pancreatitis
  • Liver failure
Nutritional support

Enteral and parenteral nutrition in critically ill patients.

Trauma
  • Management of multiple injuries
  • Management of head injury
Post-operative care
  • General surgery
  • Neurosurgery
  • Cardiac surgery (optional)
Psychological support and Bereavement
  • Psychological response of patients and their relatives towards PICU admission, morbidity and mortality
  • Counselling
Desirable Skill

Basic ventilator setting

 

Higher Training

Cardiology Intensive Care

Cardiogenic shock, malignant hypertension, arrhythmia, basic echocardiography, ECMO (optional).

Respiratory Intesive Care

Basic bronchoscopy, ARDS, advanced ventilation, ECMO (optional).

Renal Intensive Care

Knowledge of CRRT.

Transport of PICU patients

Stabilization of sick children during interhospital transport.

Palliative care in PICU
  • Ethical and legal issues related to withdrawal of
  • Support and organ donation
  • Understand the principle of diagnosing brain death
Medical audit
  • Use of standards and protocols in PICU
  • Quality assurance programmes
Desirable skills

1. Vascular access for central venous pressure
2. Basic echocardiography & POCT Ultrasound
3. Basic bronchoscopy
4. CRRT and plasmapheresis
5. Understanding the different modes of ventilation

 

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