CCT in Anaesthetics - Intermediate Level Training

Published: 05/09/2019

Paediatrics

Paediatric anaesthesia is best learned in an exclusively paediatric environment, although it is recognised that this is not always possible. Some competencies may be acquired quickly but confidence comes with experience and a minimum period of one month up to a maximum of three months in practical paediatric anaesthesia is recommended. Whenever possible such training is best delivered in blocks of at least one month duration [Reference section on minimum recommended training sessions] and trainers should spend not less than the equivalent of one full operating session per week in paediatric anaesthetic practice

Learning outcomes:

Build on the knowledge and skills gained during Basic Level training
Develop in-depth knowledge and understanding of the anaesthetic needs of children and neonates
Understand the potential hazards associated with paediatric anaesthesia and have obtained practical skills in the management of such events

Core clinical learning outcome:

Deliver safe perioperative anaesthetic care to ASA 1 and 2 children aged 5 years and over for minor elective and emergency surgery (e.g. inguinal hernia repair, orchidopexy, circumcision, superficial plastic surgery, grommets, manipulation of fractures, appendicectomy) with distant supervision

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Final examination identified in the FRCA examination blueprint section.

Knowledge:

General

Competence	Description	Assessment Method	GMP
PA_IK_01	Recalls/explains the relevance of the knowledge of applied basic sciences to all age groups including neonates	A,C,E	1
PA_IK_02	Recalls/explains the implications of paediatric medical and surgical problems including major congenital abnormalities (eg tracheoesophageal fistula, diaphragmatic hernia,) congenital heart disease and syndromes eg Down’s for anaesthesia	A,C,E	1,2,3,4
PA_IK_03	Recalls/explains the adverse effects of starvation and hypoglycaemia in neonates and children	A,C,E	1,2
PA_IK_04	Recalls the specific factors in preoperative assessment and preparation of neonates for surgery	A,C,E	1,2,3,4
PA_IK_05	Describes special anaesthetic techniques for neonates	C,E	1,2
PA_IK_06	Explains the difficulty of thermoregulation in the newborn and the measure required to prevent hypothermia	C,E	1,2
PA_IK_07	Explains the law as relates to children in respect of Consent, Restraint and Research and the concept of ‘Gillick competence’	C,E	1,2,3,4
PA_IK_08	Describes the anaesthetic management of neonates and infants for minor operations, major elective and emergency surgery	A,C,E	1,2,3,4
PA_IK_09	Calculates the analgesic requirements of neonates and infants	C,E	1,2
PA_IK_10	Describes the specific anaesthetic and monitoring equipment required for neonates	C,E	1,2
PA_IK_11	Lists common anaesthetic problems in the neonatal period and explains their perioperative anaesthetic management [e.g. inguinal hernia, intestinal obstruction, pyloric stenosis]	C,E	1,2,3,4
PA_IK_12	Describes the special problems of the premature and ex-premature neonate	C,E	1,2,3,4
PA_IK_13	Explains the importance of a comprehensive knowledge of Child Protection and how to be responsible for taking appropriate action when non-accidental injury is suspected	C,E,S	1,2,3,4

Immediate Care

Competence	Description	Assessment Method	GMP
PA_IK_14	Recalls/explains how to recognise the critically ill child with e.g. sepsis, trauma, convulsions, diabetic emergencies and describes their timely management	C,E,S	1,2,3,4
PA_IK_15	Explains the principles of stabilisation and safe transport of critically ill children and babies	C,E,S	1,2,3,4

Competence

Description

Assessment

Method

GMP

PA_IK_14

Recalls/explains how to recognise the critically ill child with e.g. sepsis, trauma, convulsions, diabetic emergencies and describes their timely management

C,E,S

1,2,3,4

PA_IK_15

Explains the principles of stabilisation and safe transport of critically ill children and babies

C,E,S

1,2,3,4

Skills:

Children and Infants

Competence	Description	Assessment Method	GMP
PA_IS_01	Demonstrates the ability to resuscitate all ages, both basic and advanced [BLS and ALS]	S	1
PA_IS_02	Demonstrates correct preoperative assessment in all ages down to 1 year	A,D	1,3,4
PA_IS_03	Demonstrates the ability to use the correct technique for induction, maintenance and monitoring for elective and emergency anaesthesia	A,D	1,2,3,4
PA_IS_04	Demonstrates correct selection, management and monitoring of children requiring diagnostic and therapeutic procedures carried out under sedation	A,C,D	1,2,3,4
PA_IS_05	Demonstrates ability to maintain perioperative physiology [e.g. glucose, fluids and temperature] in children down to 5 years of age	A,C,D	1,2
PA_IS_06	Demonstrates strategies for, and the practical management of, anaesthetic emergencies in children [e.g. loss of airway, laryngospasm, failed venous access, anaphylaxis including latex allergy]	A,C,D,S	1,2
PA_IS_07	Demonstrates correct postoperative pain management, including the use of regional and local anaesthetic techniques, simple analgesics, NSAIDs and opioids	A,C,D	1,2,3,4
PA_IS_08	Demonstrates the ability to communicate clearly with children & young people, parents and carers. including those with cognitive, communication or behavioural problems	A,D,M	1,2,3,4