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Domain 4 : Therapeutic interventions / Organ system support in single or multiple organ failure
Skilled organ-system support including appropriate therapeutic interventions is the 'housekeeping' of intensive care practice, a necessary - but in itself insufficient - requirement for promoting survival from critical illness. The practical procedures associated with organ system support are considered in the next section.


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

4.1 Prescribes drugs and therapies safely
4.2 Manages antimicrobial drug therapy
4.3 Administers blood and blood products safely
4.4 Uses fluids and vasoactive / inotropic drugs to support the circulation
4.5 Describes the use of mechanical assist devices to support the circulation
4.6 Initiates, manages, and weans patients from invasive and non-invasive ventilatory support
4.7 Initiates, manages and weans patients from renal replacement therapy
4.8 Recognises and manages electrolyte, glucose and acid-base disturbances
4.9 Co-ordinates and provides nutritional assessment and support

Features of competent performance

  • Awareness of relevant applied anatomy, physiology and pharmacology
  • Consider indications & contraindications of therapeutic intervention
  • Consider alternative modes, methods and techniques
  • Safe use of equipment / device / drugs
  • Complications: prevention; identification; management; awareness of interactions between different forms of organ system support
  • Clearly defined therapeutic strategy / care plan & goals of therapy
  • Evaluation & modification of therapy according to clinical response
  • Appropriate referral / consultation
  • Appropriate referral / consultation / further investigation
  • 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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