Domain 5 : Practical procedures
Practical procedures underpin all forms of organ system support. All these competencies will include, where relevant, attention to:
Respiratory:
By the end of specialist training, the trainee...
| 5.1 Administers oxygen using a variety of administration devices |
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| 5.2 Performs fibreoptic laryngoscopy under supervision |
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5.3 Performs emergency airway management
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5.4 Performs difficult and failed airway management according to local protocols
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5.5 Performs endotracheal suction
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5.6 Performs fibreoptic bronchoscopy and BAL in the intubated patient under supervision
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5.7 Performs percutaneous tracheostomy under supervision
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5.8 Performs thoracocentesis via a chest drain
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Cardiovascular:
By the end of specialist training, the trainee...
| 5.9 Performs peripheral venous catheterisation |
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| 5.10 Performs arterial catheterisation |
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5.11 Describes a method for surgical isolation of vein / artery
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5.12 Describes ultrasound techniques for vascular localisation
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5.13 Performs central venous catheterisation
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5.14 Performs defibrillation and cardioversion
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5.15 Performs cardiac pacing (transvenous or transthoracic)
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5.16 Describes how to perform pericardiocentesis
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5.17 Demonstrates a method for measuring cardiac output and derived haemodynamic variables
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Central Nervous System:
By the end of specialist training, the trainee...
| 5.18 Performs lumbar puncture (intradural / 'spinal') under supervision |
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| 5.19 Manages the administration of analgesia via an epidural catheter |
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Gastrointestinal:
By the end of specialist training, the trainee...
| 5.20 Performs nasogastric tube placement |
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| 5.21 Performs abdominal paracentesis |
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5.22 Describes Sengstaken tube (or equivalent) placement
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5.23 Describes indications for, and safe conduct of gastroscopy
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Renal / Genitourinary system:
By the end of specialist training, the trainee...
| 5.24 Performs urinary catheterisation |
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Features of competent performance
- Consider indications, contraindications & complications of the procedure
- Prior planning & preparation of patient (including consent), staff and equipment
- Prioritisation of tasks (patients and procedures)
- Consider comfort of the patient
- Awareness of relevant applied anatomy and physiology
- Correct placement / insertion technique - alternative modes and methods
- Attention to safety: safe use of equipment, infection control, confirmation of correct placement, prevention / management of complications
- Maintenance and safe use of devices - troubleshooting
- Consider duration of placement, discontinuation and removal
- Appropriate referral / consultation
- Recognition of limitations (self and others)
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