Overview

Topics may include:

Procedural sedation and analgesia including; Risk/benefit assessment

Respiratory Support including; Arterial or capillary blood gas interpretation and use to guide ventilation decisions Respiratory management failure and indications for ECMO Relevant anatomy, physiology and pathology underpinning the history and examination of the respiratory system Indications for oxygen therapy Knowledge of oxygen delivery devices Interpretation of P/V loops, FV loops and other ventilator data Lung protective strategies and management of acute lung injury/ARDS

Neurological assessment

Gastrointestinal support including; Indications for and use of terlipressin Awareness of nutritional considerations during transfer

Metabolic support including; Electrolyte interpretation including acid/base balance Understanding of common poisons, mechanisms of harm and antidotes

Sepsis management including; Rationale for approach to sepsis management Pharmacology and use of antibiotics Understanding of common pathogens and sources Understanding of hospital-acquired and multi-resistant pathogens

General Management of multiorgan failure states

Ventilator setup: all ages, all modes Non-invasive ventilation setup and management (Biphasic; CPAP including neonatal)

Open thoracostomy including chest drain insertion and management NG tube insertion and management (all age groups)

Cadrivascular support including; Invasive monitoring/transducer setup Arterial line insertion and management Assistance with central vascular access Setup and management of infusions of vasoactive substances Arrythmia management including pacing

Renal Support including; Renal (dialysis) line management and safety Identification and support of renal failure

Gastrointestinal support including; Insertion of nasogastric tubes for gastric decompression in all ages groups. Maintaining safety of intestinal tubes (NG, OG, percutaneous) for transfer including feeding tubes Maintaining safety of indwelling devices (eg drains) during transfer Insertion and management of Sengstaken tubes

Adverse events in ventilation

Transfer of the ventilated, inotrope-dependent patient.

Assessment Strategy

-threshold -Basic understanding of the facts and principles specific to the topics covered in this module. Students will be required to achieve a minimum of C- grade in the assignment to pass the theory component of the module. -good -Very good understanding of the facts and principles specific to the topics covered in this module. Good understanding of professional accountability issues. This equates to a minimum mark of Grade B- in the Grading Criteria. -excellent - Excellent understanding of the facts and principles specific to the topics covered in this module and evidence of additional evidence gained by the student. Very good understanding of professional accountability issues. This equates to a minimum mark of Grade A- in the Grading Criteria

Learning Outcomes

• Critically review the aetiology, physiology and pathophysiology of key body systems relevant to the module.

• A critical understanding of decision making theory used to make clinical decisions in critical care management.

• Analyse the pharmacology of the key drugs / agents used in the critical care management of patients and special patient groups and evaluate their effectiveness.

• Critically evaluate advanced assessment and management plans for a wide variety of critically ill or injured patients, encountered within a pre-hospital environment.

• Critically evaluate information from and about critical care patients in order to determine timely interventions and appropriate care pathways.

• Develop comprehensive and systematic knowledge and skills in key aspects of advanced prehospital critical care, retrieval and transportation