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Transcript
PAEDIATRIC INFECTION AND IMMUNOLOGY SPIN APPLICATION – additional information
Please complete the grid below indicating which of the modules you wish to complete in order to complete the SPIN. You are required to
achieve 30 points to successfully complete the programme of which a maximum of 30% can be from courses attended. To be awarded
the points from the module all competencies in that module must be completed. Once you have completed the table, please ask the
person who supervised you (for retrospective components) and/or the person agreeing to supervise you (prospective components) to
sign the form and return it to the college.
Evidence
Provided
2.2 Specific Competences
2.2.1 Prescribing and Therapeutics – Module points
Understand the mode of action and pharmacokinetics / pharmodynamic properties of antimicrobial drugs in children
1.
and infants
Understand and be able to use appropriate antimicrobial prophylaxis and treatment in the immunocompromised
2.
child in liaison with a tertiary specialist
Have knowledge and experience of the principles and practice of immunoglobulin treatment including the use of
3.
intravenous and subcutaneous treatment routes
4. Have knowledge of the local antibiotic resistance patterns and how to implement them for antibiotic policies
Anti-microbial stewardship, the provision of outpatient parenteral antimicrobial therapy (OPAT) and the
5.
development of paediatric hospital antibiotic policies and the evidence underpinning these, including drug resistance
2.2.2 Immunology
NB 4 points may be gained by completion of the Imperial College Immunology Short Course – Module Points
Be familiar with the functioning of the immune system including the complement system, phagocytic system, humoral
1.
and cellular immunity
2. Know and understand the classification of immune deficiencies
Be able to work with specialists from other disciplines such as genetics and obstetrics to facilitate prenatal diagnosis
3.
of primary immunodeficiency disorders
Understand the basis of secondary immune‐deficiencies including those induced by infections, other disease and drug
4.
treatments
5. Know how to investigate recurrent infections
Supervisor Proposed Maximum
Signature Points
Points
8
15
Evidence
Provided
6. Understand the basis of hereditary angioedema and its management
Understand the basis of immune function testing and be aware of the molecular genetic tests available for the
7.
diagnosis of primary immunodeficiency disorders
2.2.3 Infectious Diseases – Module points
Understand the basics of nomenclature, epidemiology, incubation periods, clinical presentations, pathogenesis,
1. diagnostic tests, host response, infection prevention and control issues and treatment for the different families of
micro‐organisms listed below
2. Understand the likely pattern of infecting organisms in different clinical situations
Understand the presentation and management of common zoonoses in different situations and be able to treat
3.
appropriately for the most likely infections
Bacteria
Understand the nature, consequences and treatment of infections with Gram positive organisms e.g.: staphylococci,
1.
streptococci, diphtheria, tuberculosis and other mycobacteria
Understand the nature, consequences and treatment of infections with Gram negative organisms including:
2. enterobacteriaceae, salmonella, and other important pathogens such as Neisseria meningitidis and Haemophilus
influenzae
3 Be aware of mechanisms of resistance in e.g. ESBL, CRE and MRSA
Viruses
Understand the nature, consequences and treatment of infections with viruses such as herpes virus, adenovirus,
1.
enterovirus and RSV
Fungi
1. Understand the nature, consequences and treatment of infections with fungi including Aspergillus and Candida
Parasites
Understand the nature, consequences and treatment of infections with different human parasites including the
1.
protozoa such as malaria, toxoplasmosis and cryptosporidiosis
Lower respiratory tract infections
Be able to investigate and manage infectious complications of chronic lung diseases such as cystic fibrosis and
1.
bronchiectasis
Central nervous system infections
Supervisor Proposed Maximum
Signature Points
Points
8
4
2
2
2
4
Evidence
Provided
1. Be able to investigate and manage tuberculous meningitis
Be able to identify and manage the possible complications of meningitis, including effusions and empyema, and of
2.
encephalitis
Be able to manage “post‐infectious” complications in the CNS such as Guillain‐Barre syndrome, acute demyelinating
3.
encephalomyelitis and cerebellitis in liaison with tertiary specialists
Cardiovascular system infections
1. Be able to investigate and manage infective endocarditis, myocarditis and pericarditis
Be able to arrange investigations for and treat acute rheumatic heart disease and manage the long term follow up of
2.
such patients in liaison with the cardiologist and tertiary infectious disease specialist
3. Be able to diagnose and treat other vascular infections that may be secondary to intravenous devices
Genitourinary tract infections
1. Be able to manage UTIs in children with unusual or resistant organisms
Be able to diagnose and manage sexually transmitted infections in children and adolescents (jointly with
2.
genitourinary specialist)
Gastro‐intestinal tract infections
Be able to initiate the appropriate contact and control of infection measures for diarrhoeal illnesses and understand
1.
the importance of contact tracing for some diarrhoeal illnesses
2. Understand the epidemiology, diagnosis and management of Clostridium difficile infection
Be able to diagnose and manage infective hepatitides and liaise with the hepatology and/or tertiary ID team where
3.
appropriate
Musculoskeletal and skin infections
Be able to investigate and manage infections of the bones and joints, recognising the problems of antibiotic
1.
penetration into bone, in liaison with the orthopaedic team
Be able to diagnose and manage bacterial myositis as well as necrotising fasciitis and liaise with the surgeons to
2.
prevent its complications
Systemic infections/inflammations
Be able to give antibiotic advice for the individual and for prophylaxis, if appropriate, of other family members e.g.
1.
meningococcal disease, asplenia, sickle cell
2. Be able to diagnose and manage toxic shock syndrome with antibiotics and immune modulation
Supervisor Proposed Maximum
Signature Points
Points
2
2
2
2
3
Evidence
Provided
Be able to diagnose, investigate and manage diagnosis of a fever of unknown origin (including liaison with tertiary
3. specialists where appropriate) and be able to recognise when the fever is not due to infection but to another
inflammatory or malignant condition
Tuberculosis
1. Be able to investigate and manage pulmonary tuberculosis in children
2. Be aware of the investigation and management of non-pulmonary forms of TB
Understand the process of screening children who have come into contact with cases of active TB and the
3.
management of latent TB
4. Understand the use of investigations in possible TB, including Mantoux testing and gamma interferon assays
5. Be aware of drug resistance and management of multi-drug resistant TB, including use of DOT
HIV
NB 6 points may be gained by completion of the PENTA HIV Course
Understand the classification of HIV disease in children, the modes of presentation of HIV and the management of
1.
opportunistic infections
2. Have knowledge of antiretroviral treatment of HIV in children
Have some knowledge of the development of resistance to antiretroviral drugs, the short and long term side effects of
3.
these drugs and particular problems of administering these drugs to children
4. Have experience of multi‐disciplinary care meetings for families with HIV
Have experience of working with adolescents with HIV and be able to recognise the complex issue surrounding their
5.
care
Be aware of the UK national study of HIV in Pregnancy and Childhood (NSHPC) and the Collaborative HIV Paediatric
6.
Study (CHIPS)
Have experience of attendance at meetings of British HIV Association (BHIVA) and Children’s HIV Association
7.
(CHIVA) and have contributed to HIV treatment trials
Have an understanding of the appropriate interventions to reduce mother to child transmission of HIV and of the
8.
multi‐disciplinary perinatal management of mothers and infants to reduce transmission of HIV
9. Understand post-exposure prophylaxis after exposure to infection such as HIV and sexually transmitted infections
Infections of the fetus and newborn
Be able to support the obstetrician and neonatologists in the diagnosis and treatment of congenital infections such as
1.
cytomegalovirus, syphilis and toxoplasmosis
Supervisor Proposed Maximum
Signature Points
Points
6
10
3
Evidence
Provided
Be able to support the neonatologists in the diagnosis and treatment of severe viral, fungal and bacterial infections of
the neonate, such as disseminated herpes simplex, neonatal varicella zoster exposure or bacterial meningitis
Infections in the immune‐compromised child
1. Recognise the atypical manifestations of common infection
2. Be aware of the range of atypical organisms causing infection in the immunocompromised child
3. Be aware of non-infectious presentations of immune deficiency e.g. autoimmunity
Infections in the returning traveller
NB 3 points may be gained by completion of the Diploma of Tropical Medicine and Hygiene
1. Be able to diagnose and treat the different presentations of the commoner tropical infections such as malaria, typhoid
Be able to provide pre-travel advice for travellers, including immunisation and anti- malarials and non2.
pharmacological measures
3. Know where to seek advice on management of rarer tropical diseases
Infection prevention and control
Know about infection control in the community and how to liaise with the public health team including the
1.
management of outbreaks, statutory notification of diseases, disease surveillance and contact tracing
2. Know about contact tracing for infectious diseases (excluding TB which is covered above)
Know when to report infections which have implications for public health, whether vaccine preventable tropical or
3.
highly infectious
2.2.4 Non-infectious conditions, including unclassified diseases and inflammatory diseases
1. Be able to manage complex or relapsing Kawasaki’s disease, with liaison with tertiary specialists
2. Be able to recognise rare cases of vasculitis or other inflammatory disorders and liaise
with the rheumatologist for their best management
3. Be able to recognise and manage cases of periodic fever, in conjunction with tertiary specialists
4. Recognise complex presentations such as chronic urticaria/angioedema and refer to appropriate specialists
2.2.5 Vaccination
1. Know when passive vaccination may be appropriately given, such as for prophylaxis of hepatitis or diphtheria
Know how to advise regarding
2.
Supervisor Proposed Maximum
Signature Points
Points
2.
4
6
3
3
2
Evidence
Provided
1.
Supervisor Proposed Maximum
Signature Points
Points
Catch up immunisations for children
not vaccinated according to the
current UK schedule
2.
Recommended additional
immunisations in children with primary or secondary immunodeficiencies (e.g. pneumococcal and influenza
vaccines)
Total points gained from Specific Competences
Signature of educational supervisor (retrospective):
Name of Educational Supervisor (retrospective):
Signature of educational supervisor (prospective):
Name of Educational Supervisor (prospective):
44