ClinicalSyllabus

Learningstrategies/ Technique/Skills
Topics TechniquetoOBSERVE
Execution (MUSTKNOW)

Managementofcriticallyillpatients. Independentlearning: Clinicalskills Insertionof:

1.Identifytheacutelydeterioratingpatient
(recognizethepatientwhoisatthelimitof
his/herabilitytocompensate)bydemonstrating
understandingofthephysiologicalandclinical Independentreading
implicationsofderangementsof:
Airwaycontrol
Gasexchange
Bloodpressure
Heartrateandrhythm
Respiratoryrate
Endorganperfusion:consciousness,urine
outputandskinperfusion
2.Assessmentoftheseverityoforgan
dysfunctionbyintegratingdatafrommultiple
sources(history,physicalfindingsatbedside,
bloodbiochemistryandradiological
investigations)
3.Principlesoftheearlymanagementofthe
acutelydeterioratingpatient,including,butnot
limitedto:
goalsofmanagementistissueoxygen
deliverytosustainlifebyopeningthe
airway,restorationofadequategas
exchangeandrestorationofcardiacoutput
andorganperfusion
recognizingoneslimitationsinmanaging
suchpatients
prioritizationtheorderof(simultaneous)
assessmentandmanagement
Independentactivelearninginclinicalareas. 1. Arterialcatheter
1. Generalexamination:
2. Centralvenouscatheters
assessingthecriticallyill
patient Emergencyintubation(student
2. Preventingharm: mustfollowcrash)
1. PhysiologicalBasisofAcuteCare.Drs.Chan Infectioncontrol
Changeofendotracheal/
YooKuen&NgKweePeng(eds)Publishers precautions,ventilator tracheostomytubes
Elsevier,Singapore2012ISBN978981272 carebundle,CVcare
9637 bundle Transportacriticallyillpatient
(studentmustaccompany
2. PharmacologicalBasisofAcuteCareDrs. 3. Monitoringapatient patient)
ChanYooKuen,NgKweePeng,DebraSiSim requiringmultiorgan
Mui(eds)PublishersSpringerInternational support
PublishingSwitzerland2015ISBN9783319
103853
Proceduralskills
Seeairwaymanagement
skills
Guidedlearning:
Evaluationskills
Minilectures:
Evaluateseverityoforgan
dysfunctionandadequacyof
1. Lifecentredcare
supportbydataintegration
2. Managingtheacutelydeterioratingpatient
Clinicalreasoningsessions:
1. Thedeterioratingpatient
2. Thepatientwithallergies
3. Endoflifecare
 describethemultiprofessionalteam
approachtothecareofthepatientwithmulti
organfailureintheintensivecareunit
4.Principlesofmanagementofthepatientand
relativesinthesituationwherefurtheractive
therapyisdeemedfutile(discussendoflife
issues)*
5.Transportingacriticallyillpatient
6.Managingapatientinanaphylaxis

Independentlearning: Clinicalskills: 1. Endotrachealintubation

Independentactivelearninginclinicalareas. 1. Generalexamination 2. Tracheostomy
Oxygentherapyanddelivery
Independentreading 2. Respiratoryexamination
1. Indicationsofoxygentherapy
2. Choosingtherighttoolstoadministeroxygen 1. PhysiologicalBasisofAcuteCare.Drs.Chan Proceduralskills:
YooKuen&NgKweePeng(eds)Publishers 1. Choosingtheappropriate
3. Monitoringapatientinrespiratoryfailure Elsevier,Singapore2012ISBN978981272 modeofoxygentherapy
clinically,withpulseoximetryandby 9637 (CSU,recovery)
measurementofarterialbloodgases.

2. Maintainapatentairway
inanunconsciousbutnot
Guidedlearning: intubatedpatient(CSU&
OT)

Airwaymanagement 3. Bagmaskventilation
MiniLecture
4. Insertionofsupraglottic
1. Maintainapatentairwayinanunconscious
1. ProvidingOxygenTherapy airway(OT&CSU)
patient
5. Endotrachealintubation
2. Bagmaskventilation
(CSU)
3. Insertionofasupraglotticairway Evaluationskills:
4. Endotrachealintubation
1. Evaluationofarterial
bloodgas
Independentlearning: Clinicalskills: 1. Airwayassessment
Independentactivelearninginclinicalareas. 1. Assessmentofpatients 2. Anaesthesiaconsent
Independentonlinereading generalstatus:threatto
Preparingthepreoperativepatient
life
1. Evaluateandoptimizeapatientforsurgerywith 1. RecommendationsonPreanaesthetic 2. Implementfasting
Assessment(revised2014)byCollegeof
regardsto: guidelines
 theroleofthepreanaesthetic/preoperative Malaysia,incollaborationwithMalaysian
clinicinelectivesurgery SocietyofAnaesthesiologists
determiningrelevantpreoperativetestsand 2. RecommendationsforPatientSafetyand Evaluationskills:
consultationswithotherspecialists, MinimalMonitoringStandardsduring
accordingtopatientandsurgicalrisk AnaesthesiaandRecovery,4thEdition(revised 1. Evaluatingtheeffectsof
factorsi.e.premorbidities,medicationsand 2013)byCollegeofAnaesthesiologists, patientscomorbidities
typeofsurgery AcademyofMedicineofMalaysiain ontheircurrentstatus
collaborationwithMalaysianSocietyof
theeffectsofpatientspremorbiditiesand
Anaesthesiologists
preoperativemedicationsonanaesthesia,
Guidedlearning:
surgeryandtheperioperativeperiod
Minilecture:
fastingguidelines
informedconsent 1. Preparingthepreoperativepatient
Clinicalreasoningsession:

1. Preparingthesickpatientforanaesthesia

Independentlearning: Clinicalskills: 1. Epiduralcatheterinsertionand

Independentactivelearning: care
1. Assessmentofseverity
Managementofpatientsinpain 1. Dailypainrounds,recovery,labourward ofpain 2. Regionalanalgesia
Independentreading 3. Transitionofparenteraltooral
1. Assessmentofpain(includingseverityusing analgesics
appropriatetools) 1. R.Vijayan.Thepatientinpain.In:
2. Choosingappropriatedrugsaccordingtothe PharmacologicalBasisofAcuteCare.Pg163
analgesicladder 166

3. Demonstratetheappropriaterouteofanalgesic Guidedlearning:
administration Miniworkshop:

1. Managingapatientinpain
Clinicalbedsideteaching(painrounds)

Anaesthesiacare Independentlearning: Proceduralskills: 1. Safesurgerysaveslives

checks
1. Definethethreestagesofgeneralanaesthesia, Independentactivelearninginoperationtheatres. 1. Pretransfusionchecks
andlistthecommondrugsusedinthesethree
Independentreading 2. Performvenipunctureand
stages intravenouscannulation.
1. PhysiologicalBasisofAcuteCare.Drs.Chan
2. Outlinetheprinciplesofairwaymanagementin 3. Setupafluidgivingset
YooKuen&NgKweePeng(eds)Publishers
anunconsciouspatient
Elsevier,Singapore2012ISBN978981272
3. Defineregionalandlocalanaesthesia,andlist 9637
 additives
4. Managingthepatientsphysiologyduring
anaesthesiacare(includinggasexchange,fluids
management,paincontrol)
5. Relatethereadingsofstandardanaesthesia
monitoringtothepatientsmostlikely
physiologicalstatus
2. PharmacologicalBasisofAcuteCareDrs.
ChanYooKuen,NgKweePeng,DebraSiSim
Mui(eds)PublishersSpringerInternational
PublishingSwitzerland2015ISBN9783319
103853
3. WHO:safesurgerysaveslivescampaign
(http://www.who.int/patientsafety/safesurgery)

6. Explainthemechanismsofkeepingpatients Guidedlearning:
safeduringanaesthesiaandsurgery:WHOSafe Clinicalbedsideteaching(inOperatingTheatre)
surgerysaveslivescampaign,transfusion

checklists,infectioncontrol

Independentlearning: Advancedlifesupport Chesttubeinsertion

Independentactivelearning Clinicalskills: Needlecricothyrodotomy
1. AdvancedCardiovascularLifeSupport 1. Clinicalassessment FASTscan

2. AdvancedTraumaLifeSupportStudentCourse 2. Rhythmrecognition Pericardiocentesis

Manual9thEdition 3. Recognitionofreversible Intraosseouscannulation
Guidedlearning: conditions
Minilectures Proceduralskills:
Simulation 1. Cardiopulmonary
resuscitation

2. Defibrillation
3. Synchronised
Resuscitation cardioversion
1.BasicLifeSupport 4. transcutaneouspacing
2.AdvancedLifeSupport 5. Deliveringresuscitation
drugs
Pulselessarrest
Advancedtraumalife
Tachyarrythmias support
Bradyarrythmias Clinicalskill:
3.TraumaLifeSupport 1.Primarysurvey

Initialassessmentandmanagement Airway
Shock Breathing
Thoracictrauma Circulation
 headtrauma
spineandspinalcordtrauma
musculoskeletaltrauma
paediatricstrauma
geriatricstrauma
traumainpregnancy
Lifethreateningevents(systembased)
1.Cardiovascularemergencies
Ischaemicevent
Dysrhythmias
Dysfunction
2.Respiratoryemergencies
Upperandlowerairwaypathologies
Parenchymallungdiseases
3.Gastrointestinalemergencies
Acuteabdomen
4.Renalemergencies
Renalfailure
Exposure
2.Secondarysurvey
AMPLEhistory
Headtotoeexamination
Logroll
Proceduralskills:
Airwaymaneuvres
Airwayadjuncts
Cervicalimmobilisation
Intubation(RSI)
Needlethoracocentesis
Threewayocclusive
dressing
Pelvicbinder
Limbimmobilization
Directandindirect
compression
Logroll
Independentlearning: Clinicalskills: 1. Endotrachealintubation
1. Clinicalpracticeguidelinesonmanagementof 1. Targetedhistory 2. Lumbarpuncture
unstableangina/nonSTelevationmyocardial 2. Focusedphysical 3. Mechanicalventilation
infarction examination
4. FAST
2. Clinicalpracticeguidelinesonmanagementof 3. Resuscitation
acuteSTelevationmyocardialinfarction
5. Chesttube
4. Analysingbedside 6. Centralvenouscannulation
3. Clinicalpracticeguidelinesonmanagementof investigations
acuteischaemicstroke
Proceduralskill:
4. Globalinitiativeforasthmaguidelines
1. Oxygensupplementation
5. Globalinitiativeforchronicobstructivelung
diseaseguidelines 2. Attachingresuscitation
monitoringdevices
6. JointBritishDiabetesSocietiesguidelinefor
themanagementofdiabeticketoacidosis 3. PerformingECG
recording
7. Clinicalpracticeguidelinesonmanagementof
5.Acidbaseandelectrolyte 8. GuidetotheEssentialsinEmergency 5. Takingbloodandother
imbalances Medicine specimens,blood
9. Independentactivelearninginclinicalareas cultures
Acidosis
Guidedlearning: 6. Insertingbladderdrainage
Alkalosis
Clinicalreasoningsessions 7. Insertingnasogastric
Sodium
tube
Potassium 1. Generalapproachtotheundifferentiatedpatient
presentingtotheemergencydepartment
Calcium
6.Sepsis 2. Generalapproachtothepatientpresentingto
theemergencydepartmentwithchestpain
Pneumonia 3. Generalapproachtothepatientpresentingto
UTI theemergencydepartmentwithshortnessof
breath
Meningitis
Dengue
4. Generalapproachtothepatientpresentingto
theemergencydepartmentwithacuteabdomen
Musculoskeletal
5. Generalapproachtothepatientpresentingto
7.Neurologicalemergencies
theemergencydepartmentwithshock
Ischaemic/haemorrhagic 6. Generalapproachtothepatientpresentingto
Epilepsy theemergencydepartmentwithalteredmental
8.Endocrineemergencies status
7. Generalapproachtothepatientpresentingto
Hyper/hypoglycaemicemergencies theemergencydepartmentwithsepsis
Hyper/hypothyroidstates
Adrenalemergencies
9.Substanceabuse,overdose&
poisoning

Paracetamol
Opioid
Benzodiazepine
Carbonmonoxide
Organophosphate
Salicylate
10.Environmentalemergencies

Burns
 Explosion
Massemergencyevents Guidedlearning:

1. Masscasualtyincident Wholeclasslectures

2. Disasterpreparedness
Independentlearning: Clinicalskill: 1. Radiocommunication
Clinicalareateaching 1. Clinicalassessment
Prehospitalcare Proceduralskill:
1. Ambulanceservices Guidedlearning: 1. Intravenousaccess
2. Firstaid Wholeclasslectures 2. Immobilisation
3. Splintandimmobilisation triangularbandage,spinal
andextremities,cervical
collar
3. BLS
Independentlearning: Clinicalskills:
Clinicalareateaching 1. Identificationaspertriage
Triage protocol

Guidedlearning:
Wholeclasslectures

Disposition Independentlearning: Clinicalskills:

1. Referrals Clinicalareateaching Identifyingprimaryteam

2. Patienttransfer
1.PhysiologicalBasisofAcuteCare.Drs.ChanYooKuen&NgKweePeng(eds)PublishersElsevier,Singapore2012ISBN9789812729637

2.PharmacologicalBasisofAcuteCareDrs.ChanYooKuen,NgKweePeng,DebraSiSimMui(eds)PublishersSpringerInternationalPublishingSwitzerland2015ISBN
9783319103853