Educational content: CRITICAL CARE MEDICINE 2 WEEK REFRESHER COURSE

Clinical experiences in the management of a broad spectrum of critical care illnesses, including:

• Hemodynamic monitoring
  
  • Know the indications, contraindications, techniques, and potential complications for central venous catheterization
  • Know the indications, contraindications, techniques, and potential complications for arterial catheterization
  • Know the indications, contraindications, techniques, and potential complications for pulmonary arterial catheterization
  • Interpret hemodynamic data including waveform analysis, and interpretation of sets of hemodynamic data
    

  
  
• Endotracheal intubation, artificial airways, airway management
  
  • Know the indications, contraindications, techniques, and potential complications for oro-tracheal and nasotracheal intubation
  • Be familiar with the indications, contraindications, care, and potential complications of tracheostomy
  • Know the principles of airway management and emergency alternatives to endotracheal intubation
    

  
  
• Mechanical Ventilation
  
  • Understand the principles of positive pressure ventilation
  • Know the common ventilator modes, settings, alarms, and monitors
  • Know the principles of mechanical ventilation for ARDS and their rationale
  • Know the mechanisms, risk factors, recognition, and management of pneumothorax and barotrauma
  • Understand the principles of weaning from mechanical ventilation
  • Appreciate the indications, contraindications, techniques, and potential complications for noninvasive mechanical ventilation
    

  
  
• Arterial blood gas and pulse oximetry interpretation and Acid / base disturbances
  

  • Understand how blood gases are measured
  • Understand how oximetry is performed and the limitations of pulse oximetry
  • Know the principles of acid-base physiology and acid base disturbances
  • Interpret arterial blood gases and other laboratory measurements for various acid base disturbances
    

  
  
• Acute respiratory distress syndrome
  

  • Understand the defining characteristics, causes, and pathophysiology of ARDS
  • Know the management principles for ARDS
    
    
• Pneumonia in the ICU
  

  • Understand the pathophysiology, manifestations, prevention, diagnostic tests, and management of ventilator-associated pneumonia
  • Know the agents and antibiotics for severe community acquired pneumonia
    
    
• Shock
• Understand the various mechanisms of shock including hypovolemic, maldistributive, cardiogenic, and obstructive
• Know the principles of resuscitation from shock and monitoring of resuscitation
• Compare the characteristics and indications for common vasopressors and inotropic agents
  
  
• Myocardial infarction
• Know the diagnostic studies and basic management of cardiac ischemia and acute coronary syndrome
  
  
• Cardiac arrhythmias

  • Identify atrial and ventricular tachyarrhythmias, heart blocks, and ECG abnormalities associated with electrolyte disturbances.
  • Know the anti-arrhythmic agents, including indications, contraindications, potential adverse effects
    
    
• Acute renal failure
• Know the differential diagnosis for acute renal failure
• Know the management principles for acute renal failure, including indications for hemodialysis
  
  
• Fluid and electrolyte disorders

  • Understand the pathophysiology, manifestations, and management of the following electrolyte disorders
    • Hypokalemia/Hyperkalemia
    • Hyponatremia/Hypernatremia
    • Hyperosmolality
    • Hypocalcemia/Hypercalcemia
    • Hypomagnesemia/Hypermagnesemia
    • Hypophosphatemia
    • Understand the advantages and disadvantages of various forms of fluid administration (crystalloids / colloids)
      

  
  
• Endocrine disorders in the ICU

  • Know the manifestations, diagnostic tests, and management of adrenal insufficiency
  • Know the manifestations, diagnostic tests, and management of thyroid storm
  • Know the manifestations, diagnostic tests, and management of hypothyroidism
    
    
• Nutrition

  • Know the principles of enteral nutrition
  • Know the principles of parenteral nutrition
    
    
• Gastrointestinal disorders

  • Know the differential diagnosis, evaluation and management of upper GI bleeding
  • Know the differential diagnosis, evaluation and management of lower GI bleeding
  • Know the evaluation and management of acute pancreatitis
  • Know the evaluation and management of fulminant hepatic failure
  • Know the complications, and their management, of cirrhosis
    
    
• Hematology / Oncology disorders

  • Know the causes and management of bleeding disorders, including blood products
  • Know the principles of management of the neutropenic and immunocompromised patient
  • Know the complications, and their management, of bone marrow transplantation
    
    
• Miscellaneous Critical Care Topics

  • Understand the principles for evaluation of poisoning and drug overdose
  • Know the primary manifestations, evaluation, and management of common drug overdoses, including tylenol, salicylate, tricyclic antidepressant, benzodiazepine
  • Understand disorders of temperature control such as hypothermia and hyperthermia, including evaluation and management
  • Appreciate issues surrounding ICU management, billing and documentation, admission / discharge
    
    
• Clinical competencies in the following technical skills:
  

  1. Mechanical ventilation, including volume -cycled, pressure-cycled, time-cycled, and flow-cycled ventilation.
  2. Non-invasive mechanical ventilation.
  3. Respiratory care, including the oxygen delivery systems, continuous positive airway pressure, nebulizer therapy.
  4. Management of pneumothorax, with needle insertion or chest tube drainage techniques
  5. Diagnostic and therapeutic procedures, including thoracentesis, pleural biopsy, flexible fiberoptic bronchoscopy.
  6. Pulmonary function testing, to assess respiratory mechanics
  7. Includes spirometry, flow volume studies, lung volumes, diffusion capacity, arterial blood gas analysis
  8. Management of circulation:
  9. Arterial puncture and line placement.
  10. Insertion of central venous or pulmonary artery balloon floatation catheters.
  11. Basic and advanced cardiopulmonary resuscitation.
  12. Cardioversion
  13. Calibration and operation of hemodynamic monitoring systems.
  14. Examination and interpretation of sputum, bronchopulmonary secretions, pleural fluid or lung tissue for infectious agents, cytology or histopathology.