Adapted from the New England Journal of Medicine SI Unit Conversion Guide. Waltham, MA: Massachusetts Medical Society, 1992

aP plasma, S serum, U urine, WB whole blood, CSF cerebrospinal fluid, RBC red blood cell

Appendix D: Syllabus for ICU Training

Narendra Rungta and Arvind Kumar Baronia

1.General

(a)ICU infrastructure: building, equipments and manpower

(b)Organization of critical care services: models of intensive care and outreach services

(c)Critical care physiology (system-wise)

(d)Assessment of critically ill patients

(e)Monitoring in the ICU

(f)Principles of critical care pharmacology, Drug interactions and toxicity, Pharmacology of sedatives, hypnotic agents, analgesics and neuromuscular blocking agents

(g)Pain management

(h)Scoring system in the ICU

(i)Enteral and parenteral nutrition

(j)Care of ICU equipment-electrical safety, calibration, decontamination and maintenance

(k)Intra and inter-hospital transport of critically ill patients

(l)Basics of imaging modalities including ultrasound, x-ray, CT, MRI and Angiography in the ICU patients

(m)Systemic disorders in critical illness

(n)Obesity-hypoventilation syndrome and obstructive sleep apnea syndrome

2.Fluid and electrolytes

(a)Fluid requirements in critically ill patients

(b)Monitoring of fluid therapy and diagnosis of inappropriate fluid therapy i.e. fluid overload and hypovolemia

(c)Colloid versus crystalloid

(d)Electrolyte disturbances (calcium, magnesium, potassium, sodium and phosphorus) in ICU

(e)Hyperosmolar therapies-Hypertonic saline

(f)Acid-base disorders-Bicarbonate and Anion Gap, Base Deficit, Stewart approach

(g)Fluid therapy in children

3.Renal disorders

(a)Acute kidney injury

(b)Renal tubular acidosis

(c)Hepatorenal syndrome

(d)Peritoneal dialysis, plasmapheresis and apheresis

(e)Renal replacement therapy

(f)Drugs in renal failure

4.Nervous system

(a)Seizure disorders and status epileptics

(b)Cerebrovascular accident (CVA)

(c)Acute CNS infections

(d)Intra-arterial pressure: Physiology, Intracranial hypertension, ICP monitoring

(e)Coma

(f)Traumatic brain injury

(g)Neuromuscular diseases

(h)Acute Flaccid Paralysis-Guillain-Barré syndrome and other disorders

(i)Tetanus

(j)CNS drugs

(k)Brain death

(l)EEG in the ICU

5.Cardiovascular system

(a)Acute coronary syndrome

(b)Acute heart failure

(c)ACLS guidelines

(d)Rhythm disorders

(e)Basics of echocardiography in the ICU

(f)Valvular heart diseases

(g)Cardiomyopathies

(h)Postoperative cardiac care

(i)Cardiogenic shock

(j)Myocarditis

(k)Hypertensive emergencies

(l)Cardioversion

(m)Cardiac drugs

6.Environmental disorders

(a)Near-drowning

(b)Thermal injuries

(c)Biochemical hazards

(d)Radiation hazards

(e)Polytrauma

(f)Disaster management guidelines

(g)Envenomation

(h)Acute poisoning

7.Endocrinal disorders

(a)Thyroid storm and other thyroid disorder in critical care

(b)Diabetic ketoacidosis (DKA)

(c)Adrenal insufficiency

(d)Cerebral salt wasting

(e)Hyperglycemia and hypoglycemia in the ICU

8.Gastrointestinal disorders

(a)Upper gastrointestinal bleeding

(b)Lower gastrointestinal bleeding

(c)Acute liver failure

(d)Acute pancreatitis

(e)Acute abdomen-medical and surgical emergencies

(f)Stress ulcer prophylaxis

(g)Postoperative care

(h)Liver transplant: Basics

9.Respiratory disorders

(a)Oxygen therapy

(b)Airway adjuncts

(c)Basics of mechanical ventilation and applied physiology

(d)Disease-specific ventilation

(e)Ventilator-Graphics, monitoring and Troubleshooting

(f)High-frequency oscillation ventilation

(g)Acute respiratory distress syndrome

(h)Pulmonary thromboembolism

(i)Pneumonias

(j)Chronic obstructive pulmonary disease

(k)Noninvasive ventilation

(l)Chest physiotherapy

(m)Pulmonary function test (PFT)

(n)Extracorporeal membrane oxygenation (ECMO) + ECCO2 Elimination: Basics

10.Infections

(a)Hand hygiene

(b)Asepsis guidelines

(c)Sepsis syndrome: SIRS, sepsis, severe sepsis, septic shock and multiorgan dysfunction syndrome (MODS)

(d)Immunocompromised hosts

(e)HIV and AIDS

(f)Ventilator-associated pneumonia (VAP)

(g)New outset fever in the ICU

(h)Severe Tropical infections: Malaria, Typhoid, Scrub typhus and zoonosis

(i)Nosocomial infections

(j)Viral hemorrhagic fevers

(k)Endocarditis

(l)Opportunistic infections in the ICU

(m)Fungal infections

(n)Infection control measures in the ICU

(o)Antimicrobial therapy

(p)Prevention of Antibiotic Resistance in the ICU

(q)Antibiotic resistance and MDR pathogens

11.Obstetric disorders

(a)Pregnancy-induced hypertension

(b)Acute haemorrhage

(c)Trauma in pregnancy

(d)HELPP syndrome

(e)Cardiomyopathy in pregnancy

(f)Amniotic fluid embolism

12.Procedures

(a)Endotracheal Intubation

(b)Percutaneous tracheostomy

(c)Flexible bronchoscopy

(d)Intercostal drainage

(e)Intracranial pressure monitoring

(f)EEG interpretation

(g)Peritoneal dialysis

(h)Continuous renal replacement therapy

(i)Cardiac pacing

(j)ECG

(k)CPR

(l)Defibrillation

(m)Pericardiocentesis

(n)Central venous access

(o)Echo cardiography(ECHO)

(p)Emergency ultrasonography

(q)Emergency radiology

(r)Percutaneous endoscopic gastrostomy (PEG)

(s)Intra-abdominal pressure monitoring

13.Hematology

(a)Blood component therapy

(b)Thrombocytopenia in the ICU

(c)Oncology-related life threatening issues in critical care

(d)Laboratory tests: Interpretation

14.Research

(a)Basics-statistical definitions

(b)Sample size calculations, study designs, data collection

(c)Generation of research ideas and hypotheses

(d)Interpretation of results

(e)Understanding evidence-based medicine in critical care

15.Miscellaneous

(a)Do not attempt resuscitation (DNAR)

(b)Medical ethics

(c)Withholding and withdrawing care

(d)Organ donation

(e)Legal issues-Laws related to ICU

(f)Anxiety and stress management in health care providers in ICU

(g)Communication skills in acute care

(h)Critical Care nursing-education

(i)Quality care in the ICU-Bench marking

16.Skills

(a)Endotracheal intubation

(b)Difficult airway management

(c)Flexible bronchoscopy

(d)Surgical airway

(e)Percutaneous tracheostomy

(f)Needle thoracotomy

(g)Chest tube insertion

(h)Initiation of ventilation

(i)Care of equipment

(j)Central venous access

(k)Intra-arterial pressure monitoring

(l)Defibrillation

(m)Pacing

(n)Cardiac output measurement

(o)Gastric tonometry

(p)Peritoneal dialysis

(q)Continuous renal replacement therapy

(r)Intra-abdominal pressure monitoring

(s)Interpretation of ECG/arterial blood gas/Ventilator waveforms

(t)Chest physiotherapy

(u)Lumbar puncture

(v)Intracranial pressure monitoring

(w)Intraosseous insertion