Syllabus – MD Emergency Medicine

Clinical skills for MD - Emergency Medicine

  1. Clinical history taking and examination; ability to analyze different clinical symptoms and signs; interpret their significance
  2. Interpretation of laboratory data
  3. Interpretation of pulmonary function tests, ECG, ECHO and other investigations
  4. Interpretation of chest roentgenography
  5. Oxygen therapy
  6. Nebulisation therapy
  7. Mechanical ventilation – indications and applications

SYLLABUS - ACCIDENT AND EMERGENCY MEDICINE

The orientation of training in Accident & Emergency Medicine shall encompass the following:

APrinciples of Emergency Care – Patient centred

  • Organisational issues and quality standards
  • Resuscitation, recognition of threats to life/limb
  • Triage of the emergency department patient
  • Understanding of "timeliness" and documentation
  • Therapeutics and pain control
  • Patient dignity and privacy
  • Ethical issues and confidentiality

Training is based on the acquisition of knowledge, skills and professional attributes and can be broadly outlined as follows:

ICardiovascular Diseases

ACardiopulmonary Resuscitation

  1. One and two-rescuer CPR
  2. Choking victim
  3. Adult/Child/Infant CPR

BAdvanced Cardiac Life Support (certification is expected)

  1. Recognition of ventricular fibrillation/ventricular tachycardia/asystole / pulseless electrical activity/bradyarrhythmias
  2. Protocols drugs and pacing
  3. Resuscitation team leadership

CCardiac Chest pain

  1. Acute coronary syndromes (Angina pectoris, myocardial infarction)
  2. Thrombolysis, glycoprotein inhibitors, angioplasty
  3. Pulmonary embolism
  4. Aortic dissection

DHeart failure and pulmonary oedema

ENarrow/Broad complex tachycardias

FHypertensive emergencies

GCardiac pacemaker function/failure

HPeripheral vascular disease

IITrauma

AAdvanced Trauma Life Support (certification is expected)

  1. Primary survey/resuscitation
  2. Secondary survey
  3. Definitive care
  4. Transfer arrangements

BHead and facial trauma

CChest and cardiac trauma

  1. Blunt/penetrating
  2. Tension pneumothorax
  3. Cardiac tamponade
  4. Massive haemothorax
  5. Open chest wound
  6. Ruptured aorta
  7. Blast injury
  8. Flail chest/lung contusion

DAbdominal trauma

  1. Blunt/penetrating
  2. Special investigations (DPL, US, CT)

EGenito-urinary trauma

FExtremity trauma

  1. Hand injuries
  2. Skeletal trauma
  3. Vascular trauma
  4. Soft tissue injury

GSpinal trauma - Immobilisation/Extrication/Logrolling techniques

HPaediatric trauma

ITrauma in pregnancy

JTrauma in the elderly

IIIAnaesthesia

APrinciples of airway management

BRapid sequence induction

CPain relief

DGeneral, regional, local anaesthesia

EInterface with Intensive Care

IVShock

AClinical findings and differential diagnosis

BFluid resuscitation

CBlood/blood products

VPulmonary Emergencies

A AAcute respiratory failure

BAsthma

CChronic obstructive airways disease

DForeign body

EPneumothorax

FChest infection

GThermal/chemical injury

HEvaluation of dyspnoea

IHaemoptysis

VIGastrointestinal Conditions

AAcute GI bleed

BVomiting, diarrhoea, dehydration

CAbdominal pain evaluation

DForeign body ingestion

VIIOphthalmology

AThe red eye

Conjunctivitis

Acute glaucoma

Uveitis

BTrauma

  1. Foreign Body/corneal abrasion
  2. Chemical burns
  3. Hyphaema and blow-out fracture

CCauses of visual impairment

DOrbital cellulitis

VIIIMetabolic Emergencies

AHypoglycaemia

BKetoacidosis / Hyperosmolar coma

CElectrolyte abnormalities

DAcid-base abnormalities

IXGynaecology & Obstetrics

AEctopic pregnancy

BPelvic inflammatory disease/lower abdominal pain

CAntenatal bleeding/Miscarriage

D Pre-eclampsia / Eclampsia

XGenito-urinary Medicine

ASexually transmitted diseases

BEpididymitis / Orchitis / Prostatitis

CTesticular torsion

DSexual assault

ENephrolithiasis

FUrinary Tract Infections

GHaematuria

XIInfectious Diseases

AHepatitis

BHIV/AIDS

CTuberculosis

DMalaria

EChildhood illnesses

FPyrexia of undetermined origin

GHerpes

HNeedlestick injury

XIIToxicological emergencies

ARecognition of clinical syndromes

BInitial treatment of poisoning

CAgent-specific therapy

DRole of poison centres/databases

EDecontamination facilities/procedures (including radio-activity)

XIIIChildhood Emergencies

AAdvanced Paediatric Life Support (certification is expected)

BDevelopmental paediatrics

CCroup/epiglottitis

DAsthma

EFever

FDehydration/gastrointestinal disorders

GMeningitis/septicaemia

HSeizures

ICongenital/inherited illness

JPain relief

KParasuicide in adolescents

LNon-accidental injury and child sexual abuse

MCommon injuries

NSurgical emergencies

OUrinary tract infections

PLinks with community care (GP, HV, social services)

XIVEnvironmental Emergencies

ABurns

  1. Grading/resuscitation
  2. Smoke inhalation
  3. Outpatient treatment

BHeat illness

CHypothermia

DNear drowning

EElectrical injury (including lightning)

FBites

  1. Snake/dog/cat/human/arthropod
  2. Rabies/tetanus prophylaxis

GAnaphylaxis

XVENT Conditions

AUpper airway obstruction

BEpistaxis / septal haematoma

CForeign bodies

DInfections

XVINeurological Emergencies

AComa

BHeadache / Subarachnoid haemorrhage

CMeningitis

DSeizures

EStroke

F Collapse

XVIIMusculo-Skeletal Conditions

AOrthopaedic & neurovascular extremity examination

BStrains/sprains/fractures

CDislocations

DSeptic joint

ESoft tissue injury/infection

FCompartment syndrome

GBack pain

HRheumatological disorders

XVIII Behavioural Emergencies

AMental state examination

BOrganic illness manifest as behavioural disorders

CAcute psychosis

DDeliberate Self-Harm

Suicidal and homicidal evaluation

FDrug and alcohol misuse

XIXGeriatric Emergencies

APsycho-social assessment

BMental state examination

CMobility assessment

DMulti-system pathology

XXMaxillo-facial conditions

ADental emergencies

BFacial fractures/dislocations

XXIDermatology

ACommon rashes

BAtopy

XXIISocial Emergencies

AOverall care of the patient

BFrequent attenders

CHomelessness

DHospital hopper / Munchausen’s

XXIHaematological Emergencies

AHaemoglobinopathies

BHaemophilia

XXIILegislation/Statutory Circulars

AConsent, competence and confidentiality

BChildren Act

CMental Health Act

DHealth and Safety at Work Act

ERoad Traffic Act

FData Protection Act

GAccess to Health Records Act

HPatients' Charter

INHS and Community Care Act

JRole of the Coroner

KOrgan/Tissue Donation

LHospital Complaint Procedure Act

MEqual Opportunities

NHuman Rights Act

OGood Medical Practice

CLINICAL SKILLS

IWound Management

ATypes of wounds/extremity examination

BWound preparation

CWound closure techniques

DForeign bodies

EExtensor tendon repair

FIncision of abscesses and pulp space infections

GFlexor tendon sheath infections (including palmar spaces)

HFinger tip injuries

IDressing techniques

JPlaster and immobilisation techniques

KJoint aspiration, soft tissue injection

LAnaesthetic techniques

IICardiopulmonary Resuscitation Training

ACardioversion/Carotid sinus massage

BECG interpretation

IIIMajor Trauma Management and team leader function

IVAirway (C-spine control)

ABasic airway management

BAdvanced airway management (tracheal intubation/alternatives)

CSurgical airway

VBreathing

ANeedle/tube thoracostomy

BVentilation techniques (including noninvasive)

VICirculation

ACentral venous access

BArterial access

CCut down techniques

DFemoral vessel cannulation

EPericardiocentesis

FIntra-osseous access

GCVP monitoring

VIISplinting/Immobilisation

ASpinal immobilisation

BLimb splinting/Traction splints

CLogrolling

VIIIENT

AIndirect laryngoscopy

BNasal packing

IXMaxillo-facial

ADental anaesthesia

BDental socket suture

CPlastic surgery techniques

XReduction of Fractures/Dislocations (Local and regional anaesthetic Techniques/pain relief)

XIGastric Lavage/Activated charcoal

XIISlit Lamp

XIIIInterpretation of laboratory investigations

XIVImaging interpretation (Ultrasound/CT/MRI included)

XVTransportation of Patients

COMMUNICATION SKILLS

IProfessional Relationships

APatients and relatives

BColleagues/team working

COther staff

II Consultation Skills

IIRecord keeping

IIIBereavement Care

ABreaking bad news

BReferral for counselling

MANAGERIAL SKILLS

IPolicies/procedures ( Hospital, Departmental)

IIStaff management (planning, recruitment, appraisal)

IIIEquipment (choosing to ordering, medical physics)

IVResource management/clinical budgeting

VContracting/standards setting, quality monitoring

VIInformation technology/Health informatics

VIIClinical governance/audit, risk management

VIIICompliments/complaints

IXMedico-legal statements/Woolfe reforms

XCommittee Work

XILiaising with other agencies (e.g. police, coroner)

XIIPublic Relations/media

XIIIMajor Incident planning/exercises

TEACHING SKILLS

ILecture preparation

IISmall Group techniques

IIIPresentation techniques

IVTeaching critique

VDepartmental teaching programme

VIProfessional Development (self-directed learning)

VIITeaching certificate expected

RESEARCH SKILLS

ILiterature survey

IIScientific study design

IIIData evaluation/Statistics

IVPreparing publications

PROFESSIONAL ATTRIBUTES

ILeadership

IIReliability

IIITeamwork

IVSelf-motivation (prioritisation, project completion)

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