MMO Determination Competency Form

MMO Competency Assessment Form

Discipline: Anaesthetics

DATE ______

NAME ______

MAILING ADDRESS ______

CONTACT NUMBER(S) ______

COMPETENCY TICK THE APPROPRIATE LEVEL

A. EXPERIENCE

1. Up to 6 months full – time (or part time equivalent) general anaesthetic experience at SRMO or registrar level - LEVEL 1

2. Greater than 12 months full-time (or its PT equivalent) general anaesthetic experience at SRMO or Registrar level - LEVEL 2

3. At least one year of anaesthesia at Registrar level including adequate experience in paediatric and obstetric anaesthesia to allow you to function on the over-time roster (including nights) with the IAHS – LEVEL 3

B. DIAGNOSTIC

Please report your ability to Interpret results of the following in order to perform competent pre-op assessment, anaesthetic and post op assessment in particular in the recovery room

FURTHER DEVELOPMENT WITHOUT REQUIRED (LEVEL 1) ASSISTANCE (LEVEL 2 & 3) History Physical examination Pathology ECG Radiological investigations

C. MANAGEMENT FURTHER ACHIEVED DEVELOPMENT REQUIRED RESUSCITATION

Level 1 – Basic CPR

Bag/mask ventilation Peripheral venous access ECG interpretation/recognition of arrhythmias Emergency cardioversions (unconscious pt) Use of first line anti – arrhythmics

Level 2 – all items in level 1

Establish the uncomplicated airway and manually ventilate Large bore peripheral venous cannula Intraosseus cannula Simple use of fluid and blood products Intercostal catheter

Level 3 – all items in level 1 & 2

Maintainence if the established uncomplicated airway Ability to recognise the complicated airway and to possess an appropriate complicated airway drill Use of mechanical ventilation Complicated use of fluid and blood products Cardioversion of the conscious pt Use of second line anti-arrhythmics Use of transcutaneous pacemaker

D. PROCEDURAL SKILLS

Competence in the following implies a knowledge of indications, contraindications plus complications and their management (not just technical proficiency)

FURTHER ACHIEVED DEVELOPMENT REQUIRED

Level 1

May possess limited skills at entry but is rapidly acquiring those necessary for progression to high grades

Level 2 & 3

Competence in the following implies a knowledge of indications, contraindications plus complications and their management (not just technical proficiency)

Venous Access – peripheral (adult and paediatric including intra- osseous insertions) - central (subclavian, cubital fossa long line internal jugular line in central venous access) - Venous cut down (in peripheral access) Insertion of arterial line Airway management: mouth-mask, bag-mask ventilation use of oral & nasal airways Laryngeal mask ventilation Endo-tracheal intubation – oral & nasal Needle & Surgical cricothyroidotomy Use of mechanical ventilation Failed intubation drill Recognition of oesophageal intubation Oral/ Nasal gastric tube insertion Intercostal needle/chest drain insertion Urethral Catherisation Regional anaesthesia – spinal blockade - axillary & Biers blockade - digital & ring blockade - epidural blockade - femoral nerve block

General Anaesthetic Techniques – Intra-Venous Incl. Raid Sequence Induction

Nasogastric tube insertion Inhalations Self ventilation anaesthetic – bag mask - Laryngeal mask Mechanical ventilation Neurolept analgesia

FURTHER ACHIEVED E. GENERAL DEVELOPMENT REQUIRED

Level 1

Possesses limited knowledge of the Management of Anaesthetic presentations

Level 2 & 3

Possess the diagnostic skills to perform a competent pre-op assessment

Understanding of the impact of age, pregnancy, obesity, disease states in particular renal, hepatic, diabetic, cardiovascular and respiratory disease on anaesthesia Familiarity with different gas delivery systems and machines Fluid and electrolyte therapy including blood and component therapy, familiarity with monitoring during anaesthesia in particular cardiac monitoring blood pressure, O2 saturation’s capnography and ET CO2 temperature, central venous and respiratory pressures and peripheral nerve stimulator. Recognise and initially manage deviations from normal FURTHER ACHIEVED DEVELOPMENT REQUIRED Familiarity with a wide range of drugs in particular; IV induction agents-thiopentone, propofol, ketamine, muscle relaxants – depolarising and non-depolarising; inhalation agents-oxygen, nitrous oxide, halothane, sevflurane, isoflurance, local anaesthetics, reversal agents plus, a wide array of drugs such as narcotics, anti-metrics. B Blockers, adrenaline and other inotropes, ephedrine, metaraminol, salbutamol, dantrolene Diagnose and initially manage life threatening emergencies such as anaphylaxis, laryngeal spasm, aspiration, high spinal or epidural blockade, malignant hyperthermis, cardiac & respiratory failure Diagnose and initially manage post anaesthetic problems especially recovery at failure to emerge from anaesthesia, inadequate neuro – muscular reversal, the confused patient, respiratory distress, pain control, cardiovascular problems such as hypo and hypertension, chest pain control, cardiac dysthythmias Transport critically ill patients to ICU Liaise and co-ordinate with VMO’s nursing and ward staff and communicate with family members as required Formal certification such as EMST., ELS courses and Dip. Of Anaesthetics (UK) will be looked on favourably but the minimum experience component is considered essential for anaesthetics Assessment will largely depend on the supervising report and log book.

COMMENTS/RECOMMENDATIONS

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NAME & SIGNATURE OF SUPERVISOR

NAME & SIGNATURE OF MMO