CCT in Anaesthetics - Core Level Training

Published: 15/08/2019

Physics and Clinical Measurement

Demonstrates knowledge of:

Competence

Description

Assessment

Methods

GMP

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Mathematical concepts: relationships and graphs

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1

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Exponential functions including wash-in, wash-out, tear-away

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1

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Logarithms

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1

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Area under the curve [integration] and rate of change [differentiation]

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1

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Basic measurement concepts relevant to understanding of monitoring in anaesthesia: 

  • linearity
  • drift
  • hysteresis
  • signal to noise ratio
  • static and dynamic response

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1

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Electrolyte solutions [also drug doses]: conversion between units e.g. molar, mg/ml, %

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1

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SI Units: fundamental units and derived units

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1

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Other non SI units relevant to anaesthesia: including mmHg, bar, atmospheres, cm H2O, psi

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1

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Simple mechanics: mass, force, work, energy, power

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1

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Heat: including temperature, absolute zero

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1

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Heat transfer and loss: conduction, convection, radiation, evaporation

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1

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Temperature measurement: including Hg, alcohol, infrared, thermistor, thermocouple, Bourdon gauge, liquid crystal.

Anatomical sites used for measurement

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1

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Latent heats, triple point of water

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1

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Patient warming systems: principles

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1

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Warming equipment for intravenous fluids: principles

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1

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Laws of thermodynamics; mechanical equivalent of heat

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1

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Humidity, absolute and relative; including measurement 

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1

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Colligative properties: osmolarity, osmolality, osmometry, diffusion

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1

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Physics of gases. Gas Laws: kinetic theory of gases, Boyles, Henry’s, Dalton, Charles, Gay-Lussac

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1

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Critical temperature, critical pressure 

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1

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Physics of vapours 

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1

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Pressure: absolute and relative pressure; gauge pressure

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1

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Manufacture and storage of gases and vapours, safety

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1

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Cylinders and pipelines, Bourdon gauge

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1

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Suction devices

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1

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Scavenging devices

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1

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Measurement of lung volumes and diffusion

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1

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Density and viscosity of gases

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1

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Laminar and turbulent flow: Hagen-Poiseuille equation, Reynold’s number, examples including helium

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1

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Measurement of volume and flow in gases and liquids, including pneumotachograph and other respirometers

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1

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Bernoulli principle

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1

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Venturi effect and entrainment devices

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1

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Vapour pressure: saturated vapour pressure

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1

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Vaporisation: process of vaporisation

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1

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Vaporisers: principles, including plenum and draw-over, temperature compensation, concentration

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1

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Principles of surface tension

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1

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Basic concepts of electricity and magnetism

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1

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Electrical voltage, AC and DC current, resistance, impedance

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1

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Electrical circuits: series and parallel

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1

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Symbols of basic components of electrical circuits

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1

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Capacitance, inductance

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1

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Wheatstone bridge: principles, uses

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1

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Electrical hazards: causes and prevention

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1

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Electrocution: including microshock, earth faults, leakage

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1

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Electrical equipment safety: domestic and medical, classification/types of equipment, symbols

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1

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Circuit breakers, fuses

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1

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Transformers, inductance 

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1

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Transistors, diodes

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1

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Amplifiers: band width, low pass, high pass, band pass filters

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1

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ECG: principles including electrodes and electrode placement

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1

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Fourier analysis

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1

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Amplification of biological signals: including ECG, EMG, EEG, BIS, CFM, CFAM

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1

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Piezo-electric devices

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1

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Electrical interference: sources, methods of reduction

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1

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Processing, storage, display of physiological measurements

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1

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Transducers and strain gauges

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1

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Lasers: basic principles and safety

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1

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Ultrasound: basic principles of ultrasound

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1

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Demonstrates knowledge of the physics relevant to optical fibres

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1

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Doppler effect, principle and clinical application

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1

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Cardiac pacemakers: principles and classification

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1

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Defibrillators and defibrillation: principles, including thoracic impedance, monophasic, multiphasic, implantable devices

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1

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Diathermy: monopolar, bipolar; safety and uses

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1

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Pressure transducers

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1

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Resonance, damping, frequency response

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1

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Plenum systems: warming blankets, theatre and anaesthetic room ventilation

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1

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Breathing systems: Maplesons’ classification, coaxial systems, circle systems, T-piece; resuscitation breathing devices

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1

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Ventilators: principles, including pressure and flow generators, cycling, minute volume dividers, jet and oscillator ventilators 

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1

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Disconnection: monitoring of patient ventilatory disconnection

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1

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CO2 absorption: chemistry, complications

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1

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Capnography

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1

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Pulse oximetry

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1

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Fires and explosions: risks and prevention

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1

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Measurement of gas pressures

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1

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Blood pressure: direct and indirect measurement

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1

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Pulmonary artery pressure measurement

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1

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Cardiac output: principles of measurement

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1

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Measurement of gas and vapour concentrations: e.g. infra-red, paramagnetic, fuel cell, oxygen electrode, mass spectrometry

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1

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Measurement of pH, PCO2, PO2,  electrolytes

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1

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Derived blood gas variables, e.g. HCO3a, HCO3s, BE.    Siggaard-Andersen nomogram

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1

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Measurement of CO2 production, oxygen consumption, respiratory quotient

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1

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Simple tests of pulmonary function: peak flow rate, spirometry 

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1

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Measurement of perfusion: coronary, cerebral, splanchnic, renal

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1

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Assessment of neuromuscular blockade

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1

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Infusion pumps and syringe drivers; including PCA drivers and epidural infusion devices: principles, use, safety, and relevant drug infusion calculations

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1

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Environmental monitoring: contamination by anaesthetic gases and vapours

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1

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Minimum monitoring standards

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Understanding the limits of monitoring equipment

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1

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Principles of calibration of monitoring equipment

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Principles of hygiene, including cleaning and sterilisation of equipment

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1