CCT in Anaesthetics - Intermediate Level Training
Transfer medicine
Learning outcome:
- Build on the knowledge, understanding and skills obtained in Basic Level training, so developing greater confidence and ability to provide clinical care to patients requiring transfer, including those for inter-hospital transfer
Core clinical learning outcomes:
- To deliver safe and efficient transfer [with distant supervision] of:
- Complex patients for intra-hospital including retrieving a newly referred ITU patient from A&E or the wards
- An uncomplicated ventilated patient for inter-hospital transfer by land [Less than 4 hours]
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 |
|---|
|
Competence |
Description |
Assessment methods |
GMP |
|---|---|---|---|
|
TF_IK_01 |
Explains the risks/benefits of Interhospital patient transfer |
C,E |
1,2,3,4 |
|
TF_IK_02 |
Explains the concept of primary/secondary/tertiary transfer |
C |
|
|
TF_IK_03 |
Outlines the hazards associated with Interhospital transfer, including but not limited to physical, psychological and organisational |
C,E |
1,2,3,4 |
|
TF_IK_04 |
Describes the increased risks to critically ill patients of transfer and the reasons for these risks |
C,E |
1,2 |
|
TF_IK_05 |
Outlines strategies to minimise risk during Interhospital transfer, including but not limited to:
|
C,E |
1,2,3,4 |
|
TF_IK_06 |
Explains how critical illness affects the risk of transfer |
C,E |
1 |
|
TF_IK_07 |
Explains how time-critical elements may influence risks to the patient and transfer personnel and how these should be managed to reduce them |
C,E |
1,2,3 |
|
TF_IK_08 |
Understands the increased risk of interventions during Interhospital transfer |
C,E |
1,2,3 |
|
TF_IK_09 |
Outlines the specific considerations for transfer of patients with specific clinical conditions, including but not limited to: o head, spinal, thoracic and pelvic injuries o critically ill medical patients o burns o children o pregnant women |
C,E |
1,2 |
|
TF_IK_10 |
Lists and explains the critical care equipment used during transfer including but not exclusively:
|
C,E |
1,2 |
|
TF_IK_11 |
Lists the different modes of ventilation and explains the selection of appropriate parameters in e.g. Asthma/COPD and ARDS |
C,E |
1 |
|
TF_IK_12 |
Outlines the different modes of transport available for inter-hospital transfer, including risks/benefits |
C,E |
1,2 |
|
TF_IK_13 |
Understand the safety implications of electrical and hydraulic equipment that may be used during patient transfer |
C,E |
1,2 |
|
TF_IK_14 |
Recalls/describes the physiological effects of transport including the effects of acceleration and deceleration, including Newton’s laws of motion |
C,E |
1 |
|
TF_IK_15 |
Understands the effects of high ambient noise on patients and alarm status |
C,E |
1,2 |
|
TF_IK_16 |
Recalls/discusses the reasons for patients becoming unstable during transfer and strategies for management |
C,E |
1 |
|
TF_IK_17 |
Recalls/describes how to manage patients who develop sudden airway difficulties whilst in transit [both in the intubated and un-intubated patient] |
C,E |
1,2 |
|
TF_IK_18 |
Outlines the ethical issues related to patient transfer, including the need to brief patients and their relatives |
C,E |
3,4 |
|
TF_IK_19 |
Awareness of the laws relating to deaths in transit |
C,E |
1 |
|
TF_IK_20 |
Outlines how to find and use the national register of critical care beds |
C,E |
1 |
|
TF_IK_21 |
Outlines the regional protocols for organising transfers between units |
C,E |
1 |
|
TF_IK_22 |
Outlines the importance of maintaining communications between the transfer team and the base/receiving units |
C,E |
1,2,3 |
|
TF_IK_23 |
Outlines the roles and responsibilities of all staff accompanying the patient during transfer including the ambulance technicians and paramedics |
C,E |
1,2 |
|
TF_IK_24 |
Describes the personal equipment needed when leading a transfer, especially when a prolonged journey is anticipated |
C,E |
1,2 |
|
TF_IK_25 |
Discusses the importance of auditing practice and reporting critical incidents that arise during Interhospital transfer and the need for appropriate research |
C,E |
1,2,3,4 |
| Skills |
|---|
|
Competence |
Description |
Assessment methods |
GMP |
|---|---|---|---|
|
TF_IS_01 |
Demonstrates ability to determine when patients are in their optimum clinical condition for transfer |
A,D |
1,2,3,4 |
|
TF_IS_02 |
Demonstrates the ability to optimally package a patient for Interhospital transfer to minimise risks |
A,D |
1,2,3,4 |
|
TF_IS_03 |
Demonstrates the ability to establish appropriate ventilation and monitoring required of a critically ill patient for interhospital transfer |
A,D |
1,2,3 |
|
TF_IS_04 |
Demonstrates the ability to safely sedate a patient for interhospital transfer |
A,D |
1,2 |
|
TF_IS_05 |
Demonstrates ability to know when the patient’s needs exceed the local resources available/that specific expertise is required |
A,C |
1,2,3,4 |
|
TF_IS_06 |
Demonstrates the need to integrate patient diagnosis with the physiological effects of transport |
A,C,S |
1,2 |
|
TF_IS_07 |
Demonstrates the ability to manage sudden loss of airway control, vascular access and monitoring in patients during transfer [S] |
D,S |
1 |
|
TF_IS_08 |
Demonstrates the necessary organisational and communication skills in managing inter-hospital transfers safely and effectively, recognising the importance of maintaining contact with base/receiving units if necessary whilst on transfer |
D,M |
3,4 |
|
TF_IS_09 |
Demonstrates appropriate situational awareness |
D,A,S |
2,3 |