Download CCU - Rotation Description and Objectives

CCU ROTATION
OBJECTIVES OF TRAINING
Demonstrate knowledge of:
 The methods and application of “Advanced Cardiac Life Support” techniques The principles of invasive and noninvasive hemodynamic monitoring
 The management of unstable angina and acute myocardial infarction and its complications including ischemic
ventricular septal defect (VSD), cardiac rupture and mitral insufficiency.
 The pathophysiology and treatment of cardiac failure, including the pharmacology of drugs used to treat these
entities basic and complex cardiac arrhythmias (also electrical therapies), management shock syndromes, with
emphasis on the pathophysiological events leading to and resulting from the shock state
 Heart-lung interactions
 The medical and surgical management of chronic coronary insufficiency including indications, timing and outcomes
for revascularization
 The pharmacological and non-pharmacological management of patient with congestive heart failure
 The role of primary and secondary prevention; current recommendations.
Specific Objectives:
At the completion of the cardiology rotation for the non cardiology resident, the resident will have acquired the following
competencies and will function effectively as a:
Medical Expert/Clinical Decision-maker
General Requirements:
 Demonstrate diagnostic and therapeutic skills for ethical and effective patient care.
 Access and apply relevant information to clinical practice
 Demonstrate effective consultation services with respect to patient care, education and legal opinions.
Specific Requirements:
Knowledge
 Principles of management of patients with ischemic heart disease.
 Principles of management of congestive heart failure, cardiomyopathies, valvular heart disease
 Principles of normal and abnormal cardiac physiology
 Principles of hemodynamic and neurohormonal abnormalities in heart
failure
 Anatomy and physiology of coronary circulation and effects of obstruction.
 Pathophysiology of atherosclerosis and acute ischemic syndromes.
 Principles and use of imaging techniques for investigation of cardiac patients including electrocardiography (EKG),
stress tests, coronary angiography, nuclear medicine scans, echocardiography MRI
Clinical Skills
 Recognize and manage acute and chronic coronary ischemia
 Recognize and recommend treatment for complications of coronary ischemia including low cardiac output,
ischemic VSD, mitral insufficiency.
 Recognize the systemic and non-cardiac complications in the critically ill cardiac patient Recognize and manage
congestive heart failure, cardiomyopathies, valvular heart disease Understand the hemodynamics of normal and
abnormal systemic and pulmonary circulation
 Understand the indications, principles of management of ventilation in patients with acute cardiac illness
 Understand the pharmacology of inotropes, vasopressors, vasodilators
 Understand the principles of non-pharmacologic, mechanical support devices in the critically ill cardiac patient
 Understand and the etiology, prognosis, and natural history of congestive heart failure
 Understand the pharmacology of medications commonly used in patients with congestive heart failure
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Understand the non-pharmacologic management options for the treatment of congestive heart failure
Use and interpret appropriate tests for the investigation of myocardial and valvular function
Use and interpret appropriate tests of myocardial ischemia and viability including differentiation of
stunned/hibernating myocardium from necrotic/scar tissue
Recommend appropriate timing of alternative treatment strategies including interventional and surgical therapies
Provide appropriate risk reduction recommendations and therapies
Communicator
General Requirements:
• Establish a professional relationship with patients and families.
• Obtain and collate relevant history from patients, and families.
• Listen effectively.
• Discuss appropriate information with patients and families and other members of the health care team.
Specific Requirements:
• Demonstrate consideration and compassion in communicating with patients and families.
• Provide accurate information appropriate to the clinical situation.
• Communicate effectively with medical colleagues, nurses, and paramedical personnel in inpatient, outpatient,
and operating room environments.
• Demonstrate appropriate oral and written communication skills.
Collaborator
General Requirements:
• Consult effectively with other physicians and health care professionals.
• Contribute effectively to other interdisciplinary team activities.
Specific Requirements:
• Demonstrate ability to function in the clinical environment using the full abilities of all team members.
Manager
General Requirements:
• Utilize personal resources effectively in order to balance patient care, continuing education, and personal activities.
• Allocate finite health care resources wisely.
• Work effectively and efficiently in a health care organization.
• Utilize information technology to optimize patient care, and lifelong learning.
Specific Requirements:
• Demonstrate knowledge of the management of acutely and chronically ill cardiac patient.
• Demonstrate knowledge of expenditures for investigation and management of cardiac patients
• Demonstrate knowledge of the guidelines concerning investigation and management of cardiac patients
• Demonstrate principles of quality assurance, and be able to conduct morbidity and mortality reviews.
Health Advocate
General Requirements:
• Identify the important determinants of health affecting patients.
• Contribute effectively to improved health of patients and communities.
• Recognize and respond to those issues where advocacy is appropriate.
Specific Requirements:
• Provide direction to hospital administrators regarding compliance with national practice guidelines
• Recognize the opportunities to advocate for resources for management of cardiac patients
Scholar
General Requirements:
• Develop, implement, and monitor a personal continuing education strategy.
• Critically appraise sources of medical information.
• Facilitate learning of patients, students, and other health professionals.
• Contribute to the development of new knowledge.
Specific Requirements:
Develop criteria for evaluating the literature.
Critically assess the literature using these criteria.
Describe the principles of good research.
Using these principles, judge whether a research project is properly designed.
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Professional
General Requirements:
• Deliver highest quality care with integrity, honesty and compassion.
• Exhibit appropriate personal and interpersonal professional behaviours.
• Practice medicine ethically consistent with the obligations of a physician.
Specific Requirements:
• Periodically review his/her own personal and professional performance against national standards.
• Include the patient in discussions concerning appropriate diagnostic and management procedures.
• Respect the opinions of fellow consultants and referring physicians in the management of patient problems and be
willing to provide means whereby differences of opinion can be discussed and resolved.
• Show recognition of limits of personal skill and knowledge by appropriately consulting other physicians and
paramedical personnel when caring for the patient.
• Establish a pattern of continuing development of personal clinical skills and knowledge through medical
education.
ROUNDS
 Our Rounds are as follows
 CIC Rounds- Monday Mornings 8-9.00am
 Grand Rounds- Tuesday Mornings 8-9.00am
 Journal Club- Thursday Mornings 8-9.00am
CALL EXPECTATIONS
Call Shifts are dependent on the resident numbers in each specific block, we require two residents per call shift.