Welsh School of Anaesthesia – welshschool.co.uk Trainee Name ……………………………………
Core Level Critical Incident Log Book
This is a curriculum based critical incident log book for core level training. Trainees and simulation trainers should use this log book to identify training requirements (as trainees move between hospitals).
The log book does not dictate in what order critical incidents should be taught - critical incidents 13 to 30 (advanced) can precede critical incidents 1 to 12 (basic). Managing these scenarios can be assessed with CEX or CBD.
6 critical incident skills which can be assessed using DOPS (or CEX or CBD) are also included.
The use of simulation for teaching and assessment is expected to cover many of the scenarios as trainees may not come across them during the course of clinical practice.
Critical incidents encountered within clinical practice should have a reflective e-portfolio entry. This is not necessary if the incident is encountered during simulation training.
Evidence of critical incident training experience also includes: Resus course certificates (ALS / ATLS / APLS / MEPA / CRISP / other). Presentations of critical incidents at quality and safety meetings. Evidence of submitting serious incident reports. Producing or contributing to clinical risk guidelines. Teaching on relevant courses.
Revision date: This log book should be revised in response to syllabus or training changes.
Revision history
Version 1 October 2016. Version 2 August 2017 Version 3 October 2017
1 Welsh School of Anaesthesia – welshschool.co.uk Trainee Name …………………………………… Guidance for completion
All core trainees need to complete the critical incident module
1. Trainees are required to complete at least one DOPS,CEX and CBD for the module sign off on eporfolio.
2. Trainees are required to show evidence of completion of the Welsh School of Anaesthesia critical incident logbook at ARCP (as per checklist)
The logbook is designed as a personal record/reflection of critical incidents and can be signed and completed by trainees :
Management of critical incident (1-30)
Tick the experience of critical incident e.g. clinical, informal discussion, simulation, meeting, incident report or other relevant setting. Trainee date and sign entry. Tick CBD, DOPS or CEX if completed and add to eportfolio. Trainee should add detail to each incident eg reflection of incident, course attended, teaching, risk meeting etc….
Critical incident skill
This section focuses on generic skills eg non technical, situational awareness. Tick the experience, add detail/reflection and date and sign. Tick CBD, CEX or DOPS if completed and add to eportfolio. This section lends itself to having been on courses eg simulation or resus where all of these skills can be demonstrated together in practice. Reflect on the courses.
The document is designed to help trainees cumulatively log their critical incidents. Trainees should aim to add to it during their training and complete each section by completion of core training.
2 Welsh School of Anaesthesia – welshschool.co.uk Trainee Name …………………………………… Core Level Critical Incident Logbook
Management of Critical Incident Experience ePortfolio (Basic) (tick) (tick if required) Simulation training CBD 1.Cardiac and/or respiratory Clinical experience Date ……………………. CEX arrest Informal discussion M&M meeting Signature Reflection Critical incident report …………….. Simulation training CBD 2.Unexpected fall in SpO2 with Clinical experience Date ……………………. CEX or without cyanosis Informal discussion M&M meeting Signature Reflection …………….. Critical incident report Simulation training CBD 3.Unexpected increase in peak Clinical experience Date ……………………. CEX airway pressure Informal discussion M&M meeting Signature Reflection Critical incident report …………….. Simulation training CBD 4.Progressive fall in minute Clinical experience Date ……………………. CEX volume during spontaneous Informal discussion Signature Reflection respiration or IPPV M&M meeting Critical incident report …………….. Simulation training CBD 5.Fall in end tidal CO2 Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature Reflection Critical incident report …………….. Simulation training CBD 6.Rise in end tidal CO2 Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature Reflection Critical incident report …………….. Simulation training CBD 7.Rise in inspired CO2 Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature Reflection Critical incident report …………….. Simulation training CBD 8.Unexpected hypotension Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature Reflection Critical incident report …………….. Simulation training CBD 9.Unexpected hypertension Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature Reflection …………….. Critical incident report Simulation training CBD 10. Sinus tachycardia Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature Reflection …………….. Critical incident report Simulation training CBD 11. Arrhythmias: Clinical experience Date ……………………. CEX Informal discussion ST segment changes M&M meeting Reflection sudden tachyarrythmias Critical incident report Signature sudden bradycardia …………….. ventricular ectopics broad complex tachycardia ventricular fibrillation
Simulation training CBD 12. Convulsions Clinical experience Date ……………………. CEX Informal discussion M&M meeting Reflection 3 Welsh School of Anaesthesia – welshschool.co.uk Trainee Name …………………………………… Critical incident report Signature ……………..
4 Welsh School of Anaesthesia – welshschool.co.uk Trainee Name ……………………………………
Management of Critical Incident Experience ePortfolio (Advanced) (tick) (tick if required) Simulation training 13. Difficult/failed mask CBD Clinical experience Date ……………………. CEX ventilation Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 14. Failed intubation CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 15. Can’t intubate, can’t ventilate CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 16. Regurgitation/Aspiration of CBD Clinical experience Date ……………………. CEX stomach contents Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 17. Laryngospasm CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 18. Difficulty with IPPV, sudden CBD Clinical experience Date ……………………. CEX or progressive loss of minute Informal discussion M&M meeting Signature …………….. Reflection volume Critical incident report
Simulation training 19. Bronchospasm CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 20. Pneumothorax and tension CBD Clinical experience Date ……………………. CEX pneumothorax Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 21. Gas / Fat/ Pulmonary CBD Clinical experience Date ……………………. CEX embolus Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 22. Adverse drug reactions CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 23. Anaphylaxis CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Signature …………….. Reflection Critical incident report Simulation training 24. Transfusion reactions, CBD Clinical experience Date ……………………. CEX transfusion of mis-matched Informal discussion M&M meeting Signature …………….. Reflection blood or blood products Critical incident report
Simulation training 25. Inadvertent intra-arterial CBD Clinical experience Date ……………………. CEX 5 Welsh School of Anaesthesia – welshschool.co.uk Trainee Name …………………………………… Informal discussion Signature …………….. Reflection injection of irritant fluids M&M meeting Critical incident report Simulation training 26. High spinal block CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Reflection Critical incident report Signature …………….. Simulation training 27. Local anaesthetic toxicity CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Reflection Critical incident report Signature ……………..
Simulation training 28. Accidental decannulation of CBD Clinical experience Date ……………………. CEX tracheostomy or tracheal Informal discussion M&M meeting Reflection tube Critical incident report Signature ……………..
Simulation training 29. Coning due to increased CBD Clinical experience Date ……………………. CEX intracranial pressure Informal discussion M&M meeting Reflection Critical incident report Signature ……………..
Simulation training 30. Malignant hyperpyrexia CBD Clinical experience Date ……………………. CEX Informal discussion M&M meeting Reflection Critical incident report Signature ……………..
6 Welsh School of Anaesthesia – welshschool.co.uk Trainee Name ……………………………………
Critical Incident Skill Experience ePortfolio (tick) (tick if required) Simulation training CBD Demonstrates good non-technical Clinical experience Date ……………………. CEX skills: M&M meeting DOPS Signature …………….. effective communication Critical incident report Reflection team-working leadership decision-making high situation awareness Simulation training CBD Demonstrates the ability to recognise Clinical experience Date ……………………. CEX early a deteriorating situation by M&M meeting DOPS Signature …………….. careful monitoring. Critical incident report Reflection
Simulation training CBD Demonstrates the ability to respond Clinical experience Date ……………………. CEX appropriately to each incident listed M&M meeting DOPS Signature …………….. above. Critical incident report Reflection
Simulation training CBD Shows how to initiate management of Clinical experience Date ……………………. CEX each incident listed above. M&M meeting DOPS Signature …………….. Critical incident report Reflection Simulation training CBD Demonstrates ability to recognise Clinical experience Date ……………………. CEX when a crisis is occurring. M&M meeting DOPS Signature …………….. Critical incident report Reflection Simulation training CBD Demonstrates how to obtain the Clinical experience Date ……………………. CEX attention of others and obtain M&M meeting DOPS Signature …………….. appropriate help when a crisis is Critical incident report Reflection occurring.
7