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Domain 1 : Resuscitation and initial management of the acutely ill patient
The point of first contact with an acutely ill, deteriorating, or collapsed patient requires clinicians to take action to prevent or correct physiological deterioration despite uncertainty about causation and the underlying diagnosis. Meeting this challenge - action in uncertainty - demands a structured approach to patient management, exemplified by the resuscitation algorithms, but less well developed for the non-arrested acutely ill patient.

By the end of specialist training, the trainee...

1.1 Adopts a structured and timely approach to the recognition, assessment and stabilisation of the acutely ill patient with disordered physiology
NB. Acutely disordered physiology may include for example: altered consciousness including acute confusional states and coma; acute seizures; dysrhythmias; hypo / hypertension; acute chest pain; hypoxaemia; dyspnoea; hypo / hyperthermia.
1.2 Manages cardiopulmonary resuscitation
1.3 Manages the patient post-resuscitation
1.4 Triages and prioritises patients appropriately, including timely admission to ICU
1.5 Assesses and provides initial management of the trauma patient
1.6 Assesses and provides initial management of the patient with burns
1.7 Describes the management of mass casualties


Features of competent performance

  • Recognition of presenting signs and symptoms
  • Identification and rapid response to life-threatening complications
  • Prioritise investigations and monitoring - appropriate; timely
  • Appropriate differential diagnosis
  • Clear decision making and immediate management strategies (including application of relevant protocols / guidelines / care bundles)
  • Effective team-working & leadership - clear communication & instructions
  • Appropriate referral / consultation
  • Recognition of limitations (self and others)
  • Attention to patient safety


All competencies
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Note that the "Resources" that are included in this page, have not been updated in the recent years. An updated collection of useful resources will be available soon as part of the ESICM Academy (for more details, see www.esicm.org).

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