Date: / / MULTISKILLED MEDICAL OFFICER (MMO) DETERMINATION

MACARTHUR HEALTH SERVICE

Date: ……../……../…….. MULTISKILLED MEDICAL OFFICER (MMO) DETERMINATION

ICU SKILL LEVEL CLASSIFICATION

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ICU – LEVEL 1 /

ICU – LEVEL 2

ICU – LEVEL 3

Description /

Descriiption

/ Description
Training level – involves / Competently functions in ICU unsupervised though / Competently functions independently in the ICU sphere.
intensive period of training and / May still be required to consult for the diagnosis and / Able to supervise more junior staff.
skills acquisition. Implies little / Management of some presentations / Comments:
or no previous experience in ICU / Comments:
Comments:
Experience /

Experience

/ Experience
Insufficient ICU or other / Greater than 12 months full-time (or part-time / Greater than 24 months full time (or its part time
relevant experience to meet / equivalent) ICU experience at SRMO or registrar level / equivalent) ICU experience at SRMO or Registrar level
the requirements of higher / OR / OR
levels / Greater than 6 months full time (or part time equivalent) / More than 12 months full time (or its part time
Comments: / ICU experience plus greater than 6 months full time (or / equivalent) ICU experience plus more than 8 months full
part time equivalent) anaesthetic experience / time (or its part time equivalent) anaesthetic experience
Comments: / (NB total experience to exceed 2 years).
Comments:
Diagnostic / Diagnostic / Diagnostic
May possess limited / Able to / Able to
diagnostic skills at entry / a)Interpret results of history, physical examination, / a)Interpret results of history, physical examination,
pathology, radiological and ECG investigations in / pathology, radiological and ECG investigations in
order to maximise patient therapy / order to maximise patient therapy
b)Process information from a variety of sources / b)Process information from a variety of sources
- ICU flow charts, reports from nursing staff, / - ICU flow charts, reports from nursing staff,
ward rounds, monitoring equipment, etc. / ward rounds, monitoring equipment, etc.
c)Work as an integral member in a team / c)Work as an integral member in a team
approach to patient care / approach to patient care
Comments: / Comments: / Comments:

Management

Management/Procedures/Duties

Should have a sound knowledge and competence in the

Competence in the following : (implying a knowledge

following critical conditions:

of indications, contraindications, plus complications

and their management.

Cardiovascular

-Inotrope therapy

-Recognition and management of acute

arrhythmias

-Post operative management of vascular patients

-Management of shock

Respiratory

-Acute respiratory failure

-Acute asthma / CAL

-Severe pneumonia

-ARDS

-Tracheostomy care

Renal / Metabolic / Endocrine

-Acute renal failure and oliguria

-Dialysis

-Perenteral / enteral nutrition

-Diabetes mellitus, especially hyperosmolar

non-ketotic coma and ketoacidosis

Neurological

-Head injury management

-Management of raised intracranial pressure

-Status epilepticus

-Subarachnoid haemorrhage

Gastrointestinal

-Gastrointestinal haemorrhage

-Hepatic failure

-Intra-abdominal sepsis

/ Intra-abdominal sepsis /

-Intra-abdominal sepsis

/ Intra-abdominal sepsis

-Pancreatitis

Trauma

-Acute management

-Complications

-Oxygen therapy

-Aspiration syndromes

-Pancreatitis

-Comatose patients

-Severe obstetric emergencies (eg PPH,eclampsia)

-Shock

*Hypovolaemic

*Anaphylactic

*Cardiogenic

*Septic

-Trauma

*Head

*Facio-maxillary / upper airway

*Spinal

*Chest

*Abdominal

*Pelvic

Comments:

Comments

Procedural Skills

May possess limited skills at / -Central venous catheterisation by / -Central venous catheterisation by
entry but is rapidly acquiring / subclavian route / subclavian route
those necessary for / -Arterial catheterisation / -Arterial catheterisation
progression to higher grades / -Arterial blood gases / -Arterial blood gases
-Intercostal catheter insertion / pleural tap / -Intercostal catheter insertion / pleural tap
-Use of bag and mask in airway management / / -Use of bag and mask in airway management /
manual ventilation / manual ventilation
-Establishing and maintaining CPAP / -Establishing and maintaining CPAP
-Defibrillation / cardioversion / -Defibrillation / cardioversion
-Lumbar puncture / -Lumbar puncture
-Insertion of indwelling catheter / -Insertion of indwelling catheter
-Insertion of naso-gastric tube / -Insertion of naso-gastric tube
-Simple endotracheal intubation / -Difficult endotracheal intubation
-Cricothyrotomy
-Tracheostomy
-Pericardiocentesis
-Central venous access (variety of approaches)
-Swan-Ganz catheter insertion
-Pleural biopsy
-Temporary pacemaker insertion
-Suprapubic catheter insertion
- Sengstaken-Blackmore tube insertion
-Blood component use
Post operative management / Post operative management
-Post operative analgesia / -Post operative analgesia
-Regional anaesthesia, especially epidural infusion / -Regional anaesthesia, especially epidural infusion
-Sedatives and analgesic agents / -Sedatives and analgesic agents
-Specific post operative complications / -Specific post operative complications
*Abdominal aortic aneurysm repair / *Abdominal aortic aneurysm repair
*Carotid endartectomy / *Carotid endartectomy
*Total cystectomy / *Total cystectomy
*Craniotomy / *Craniotomy
*Complicated or high risk gastrointestinal / *Complicated or high risk gastrointestinal
surgery. / surgery.

Patient monitoring and Physiology

-Haemodynamic monitoring / -Haemodynamic monitoring
-Intracranial pressure monitoring / -Intracranial pressure monitoring
-Respiratory physiology / -Respiratory physiology
-Acid-base balance / -Acid-base balance
-Ventilators and ventilator management / -Ventilators and ventilator management
-Fluid and electrolyte management / -Fluid and electrolyte management

General

Possesses only limited / -Communication with family members / -Communication with family members
knowledge of ICU / -Transport of critically ill patients / -Transport of critically ill patients
presentations / -Drug overdose management / -Drug overdose management
-Hypothermia / -Hypothermia
-Antibiotic therapy and sepsis / -Antibiotic therapy and sepsis
-Entering information into databases / -Entering information into databases
-Admission and discharge summaries, daily / -Admission and discharge summaries, daily
documentation in patients notes, and / documentation in patients notes, and
following up results of investigations. / following up results of investigations.

Pharmacology

-Paralysing agents
-Sedatives
-Analgesics
-Antiboitics
-Anti-arrhythmics
-Inotropes
-Anti-emetics
-Anti-convulsants
-Anti-hypertensives
-Anti-coagulants

Duties

-Retrievals
-Cardiac arrest team
-Assess admission/discharge suitability of patients
-Liaise with intensivist on duty

Resuscitation

-Basic CPR / -Basic CPR / -Basic CPR
-Bag/mask ventilation / -Bag/mask ventilation / -Bag/mask ventilation
-Peripheral venous access / -Peripheral venous access / -Peripheral venous access
-ECG interpretation/ / -ECG interpretation/recognition of arrhythmias / -ECG interpretation/recognition of arrhythmias
recognition of arrhythmias / -Emergency cardioversion (unconscious patient) / -Emergency cardioversion (unconscious patient)
-Emergency cardioversion / -Use of first line anti-arrhythmic / -Use of first line anti-arrhythmic
(unconscious patient) / -Establish the uncomplicated airway and / -Establish the uncomplicated airway and
-Use of first line / manually ventilate / manually ventilate
anti-arrhythmic / -Large bore peripheral venous cannula / -Large bore peripheral venous cannula
-Intraosseus cannula / -Intraosseus cannula
-Simple use of fluid and blood products / -Simple use of fluid and blood products
-Intercostal catheter / -Intercostal catheter
-Maintenance of the established uncomplicated
airway.
-Ability to recognise the complicated airway and to
possess an appropriate complicated airway drill.
-Use of mechanical ventilation
-Complicated venous access
-Complicated use of fluid and blood products
-Cardioversion of the conscious patient
-Use of second line anti-arrhythmic
-Use of transcutaneous pacemaker
Comments: / Comments: / Comments: