Short Session Objectives

Topic / Objectives: Suggested areas to be covered: / FICM syllabus areas
Airway management in ICU: what is different? /
  • NAP 54 summary for ICU
  • Factors leading to increased risk in ICU
  • Contents of difficult airway trolley and bronchoscope
  • Difficult airway management guidelines
/ 1.1, 3.1, 5.2, 5.3. 5.4
Tracheostomy management (to be accompanied by in-situ simulation) /
  • Indications for tracheostomy and evidence base for when/why/how
  • Percutaneous vs surgical
  • Tracheostomy care and decanulation
  • Management of displaced trache (re-enforced by SIM
/ 5.2, 5.3, 5.4, 5.6
Ventilation modes in ICU and common scenarios /
  • Description of different ventilator modes available
  • Description of safe ventilation (ARDS-net)
  • Common scenarios in ICU (examples)
/ 1.1, 2.7, 4.6, 5.1
Advanced ventilator modes and rescue techniques /
  • Recruitment maneouvers and ‘optimum peep’
  • Ventilator strategies for hypoxia and hypercarbia
  • Reverse I:E rations and APRV
  • Ventilator strategies for bronchospasm
  • Rescue strategies for ventilation failure including, proning, paralysis, ECMO
/ 1.1, 3.1, 3.2, 3.6, 2.7, 4.6
Ventilator weaning strategies /
  • Recognition of readiness to wean
  • Methods of reducing ventilator support
  • Spontaneous breathing trial
  • Safe extubation
  • Facilitating weaning (use of NIV or optiflow)
  • Strategies to manage long term weaning
/ 2.7, 4.6
Acute heart failure and coronary syndromes /
  • Classification of cardiac ischaemia
  • Classification of ACS, diagnosis and management
  • Management of coronary ischaemia in ICU
  • Management of heart failure in ICU
/ 1.1, 2.3, 3.1, 3.3
Cardiac arrest and prognostication /
  • Management of post-cardiac arrest (evidence base)
  • Methods of prognostification including how, when and with what.
/ 1.3
Intravenous fluid therapy and cardiac output monitoring /
  • Preparations of IV fluid available, pros and cons of each.
  • Complications of fluid administation
  • Methods of fluid titration (CO monitoring, SV optimisation, SVV)
/ 1.1, 3.1, 4.4, 4.4, 4.8
Delirium and sedation /
  • Definition of delirium in ICU
  • Recognition of pain and delirium in ICU
  • Management of pain and delirium in ICU
  • Complications of sedation and methods to reduce these
/ 1.1, 3.6, 2.7, 4.1, 5.16, 7.2, 7.3
Critical illness weakness /
  • Pathophysiology of critical illness weakness
  • Causes and risk factors
  • Physical diagnosis
  • Tests available
  • Management and prognosis
/ 3.2, 7.1
Acute, acute on chronic and chronic liver failure /
  • Pathophysiology and definition of the spectrum of liver disease
  • Common presenting features of liver disease in ICU (UGI bleed, encephalopathy, sepsis, renal failure)
  • Criteria for liver transplant services
/ 3.1, 3.5, 6.4
Management of seizures and status epilepticus /
  • Classification and definition of seizures and status
  • Management of status epilepticus
  • Causes and specific management strategies
  • Basic EEG interpretation
/ 1.1, 3.1, 3.2
Disorders of coagulation /
  • Physiology of the coagulation cascade
  • Disorders of coagulation and presentation
  • Anticoagulants
  • Diagnostic tests available for coagulation abnormalities, including platelet mapping and TEG
/ 1.1, 2.2, 3.1, 4.1
Blood products – what’s available? Transfusion guidelines /
  • Summary of available blood products, contents and indications
  • Management of anaemia in different groups of ICU patients
  • Blood transfusion for haematological disease
  • Complications of blood transfusion
  • Blood conservation strategies
/ 3.2, 4.3
Management of massive haemorrhage /
  • Definition of massive haemorrhage
  • Management guidelines (evidence base)
  • Complications of massive transfusion
/ 3.1
Haematological disease: neutropenic sepsis, ITP, TTP, HUS and plasmapharesis /
  • Description of spectrum of haematological disease in ICU, presenting features and specific challenges
  • Definition and management of neutropenic sepsis
  • Management of invasive lines in neutropenic patients with sepsis
  • Plasmapharesis indications and process
/ 3.2, 3.9
Gut failure: physiology, causes, management /
  • Signs and symptoms of gut failure
  • Differential diagnosis and investigations
  • Management of gut failure
/ 4.9, 5.19
Nutritional support on ICU, Malnutrition and re-feeding syndrome /
  • Nutritional requirements for patients in ICU
  • Methods of feeding
  • When, what, how? Brief discussion of evidence base/guidelines
  • Malnutrition and re-feeding syndrome
/ 4.9, 5.19
Endocrine emergences in ICU /
  • Common presentations of thyroid disease, adrenal disease and diabetic emergencies
  • Discussion of phaeochromacytoma and carcinoid syndrome
  • Management of above
/ 3.1, 3.2, 4.1, 4.8
Skin conditions in ICU /
  • Dermatological emergencies in ICU
  • Prognostication and management
  • Pressure sore physiology and management
  • Skin infections and invasive lines
  • Burns and management
/ 1.6, 3.1, 3.2
Antibiotic resistance and stewardship /
  • Common classification of antibiotics
  • Methods of action
  • Mechanisms of antibiotic resistance
  • Principles of antibiotic stewardship
/ 1.2, 2.4, 4.2
Disorders of electrolytes /
  • Fluid compartments within the body and electrolyte contents
  • Abnormalities of sodium, potassium, magnesium, phosphate, calcium overview
/ 3.1, 4.8