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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.	Syllabus	Resources
1.2 Manages cardiopulmonary resuscitation	Syllabus	Resources
1.3 Manages the patient post-resuscitation	Syllabus	Resources
1.4 Triages and prioritises patients appropriately, including timely admission to ICU	Syllabus	Resources
1.5 Assesses and provides initial management of the trauma patient	Syllabus	Resources
1.6 Assesses and provides initial management of the patient with burns	Syllabus	Resources
1.7 Describes the management of mass casualties	Syllabus	Resources

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

View the complete syllabus for Domain 1

View all Resources for Domain 1

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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