Libro blanco de las ACES Pediátricas 2024

Libro Blanco de las ACES Pediátricas 2024 584 ❚ European Curriculum Recommendations Syllabus items Knowledge Skills Attitude and behaviour Level of competence Minimumclinical exposure Assessment tools* Sample clinical situation 1) Pathophysiology of chronic respiratory failure • Pathophysiology of chronic respiratory failure • Diseases of the lung, airway, chest wall, respiratory muscles and control of breathing that may cause respiratory failure 3 2) Home oxygen therapy including control inves- tigations and weaning strategies • Current national and international guidelines in the long-termuse of home oxygen in children • Locally available protocols of prescribing and delivering home oxygen • Performance and inter- pretation of an overnight recording of oximetry • Organising and prescrib- ing home oxygen for a child •Willingness to discuss the need for home oxygen with parents and child in an ap- propriatemanner 3 • Manage 10 patients • CbD • MiniCEX • Set up a baby with chronic neonatal lung disease on home oxy- gen, andmonitor and manage the ongoing care for 3months 3) Invasive and nonin- vasive home ventilatory support including con- trol investigations and weaning strategies • Different forms of ventilatory support, including pressure and volume-controlled ven- tilators, and different trigger modalities • Leading and working in amultidisciplinary team to set up andmanage an ap- propriate package of care for a child requiring home ventilation • Willingness to discuss themanagement in view of the child’s condition and prognosis •Willingness to collaborate with a palliative care team 3 • Manage 10 patients with invasive and noninvasive home ventilatory support • DOPS • Set up andmanage the ongoing care of a child with aneuromus- cular problemwho needs overnight non- invasive ventilation 4) Tracheostomy management including control investigations and weaning strategies • Different types of tracheosto- my tubes and their advantages and disadvantages • Advantages and disadvan- tages of speaking valves • Tracheostomy tube re- placement in emergencies • Preliminary assessment of problems with tracheos- tomies •Willingness to involve and work with amultidisciplinary team in tracheostomy man- agement 2 • Comanage 6 patients with tracheostomy • DOPS 5) Basic technical understanding of equip- ment • Advantages and disadvan- tages of available technolo- gies and strategies for home ventilatory support • Settings adjustment on ventilators in common use in the local centre 3 6) Airway clearance techniques (physi- otherapy, intermittent pressure breathing, insufflator–exsufflator) • Different techniques avail- able for clearing secretions in children on ventilation includ- ing evidence for each •Willingness to work with a physiotherapist in training parents to use appropriate se- cretion clearance techniques 2 • Experience airway clearance with five patients • DOPS 7)Recognition of associ- ated problems, setting up and coordinating a MDT • Associatedmedical and social problems likely to be encoun- tered in a child in need of home respiratory support • Leading amultidiscipli- nary teamwhere necessary •Willingness to explore proactively with the child and family any non-respiratory problems encountered •Willingness to work as part of amultidiscplinary team in addressing these problems 3 • Experience five cases with a multidisciplinary team • CbD * all items can be assessed using MCQ in a written knowledge-based examination; refer to assessment toolbox for suggestedmethods P) TECHNOLOGY-DEPENDENT CHILDREN Mandatory