ST 5-6 years
1x period of 12 months:
Consists of 3 areas:
- Paediatric ICM
- Neurological / neurosurgical ICM
- Cardiothroacics ICM
“The Faculty would expect this to typically involve a 3-month placement in each of these areas with the opportunity to either consolidate one or all of the trainee’s specialist ICM skills or their general intensive care medicine experience contributing to an indicative 12 months of training.”
2nd period of 12 months: “Special skills year”
- Develop a specialist area of interest of use to the speciality
- Research
- QI projects and education
- Echo
- ECMO
Progression from Stage 2 require completion of the above and completion of the FFICM exam
Skills provided on the CICU relevant to the Stage 2 curriculum:
Diagnosis and management of cardiac tamponade
- Referral and opportunity to witness pericardiocentesis
- Echo diagnosis of tamponade
- Physiological derangement associated with classical and atypical tamponade
Transoesophageal echo
- Cardiac output assessment
- LV and RV functional assessment
- Review for cardiac tamponade
- Valvular assessment
- fTOE qualified consultant and EACVI qualified consultants on the unit + regular echo teaching and interesting case reviews
Lung ultrasound
- Likely highest incidence of pneumothorax outside of respiratory medicine
- Assessment of pleural effusion volume and criteria for drainage
- FUSIC accredited consultant with potential to acquire cases / gain accreditation
Mechanical circulatory support
- IABP (approximately 30-50 cases per year)
- Impella device being reviewed for introduction in the next 12-18 months.
- Teaching from perfusion team available
Advanced cardiac output monitoring
- PA-catheter (intermittent)
- PICCO
- Vigileo
- Bedside echo
Management of right ventricular impairment
- Echo diagnosis and severity assessment
- Pulmonary hypertension severity assessment and management
- Nebulised epoprostenol, milrinone, IV sildenafil
- Indications for referral to tertiary centers
Epicardial pacing
Transvenous pacing (post TAVI or in emergency situations
[Teaching] - Heart transplant / lung transplant discussion with consultants who have experience with these (ZB currently still anaesthetising for these cases in Prague)
[Teaching] ECMO (VA/VV)
- Multiple consultants with extensive experience on these modalities
- Occasional cases commenced on VA ECMO support pending transfer to tertiary center