Libro blanco de las ACES Pediátricas 2024

Libro Blanco de las ACES Pediátricas 2024 484 ❚ 10 4. CONTENT TABLE 4.1 Core neonatal skills and competences Trainees will be expected to have acquired extensive skills and competences in the below domains 4.2.1 Practical procedures: Stabilisation and resuscitation of the newborn with particular regard to maintenance of temperature, timing of cord clamping, airway management, facemask ventilation, tracheal intubation, laryngeal mask airway (LMA) insertion and techniques of artificial ventilation, oxygen supplementation and physiologic monitoring. Insertion of arterial catheters (umbilical and peripheral), establishment of intravenous infusion and percutaneous insertion of long intravenous lines. Indication, prescription and monitoring of blood component transfusions. Ultrasound guided techniques: arterial puncture, needle aspiration and pleural drainage of pneumothorax, suprapubic aspiration of urine, lumbar and ventricular puncture. 4.2.2 Diagnosis: Ordering and interpretation of common laboratory and micro-biological investigations, including blood gas analysis and metabolic tests. Interpretation of neonatal X-Ray examinations, such as standard chest and abdominal radiological investigations. Role and indication of specialised investigations, e.g. MRI, CT. Experience in performing and interpreting cranial ultrasound examination of the nervous system, focussing on the identification of major intracranial abnormalities and haemorrhages, as well as the abdominal organs, and of congenital hip dysplasia is expected. Use and interpretation of the results of EEG, cortical evoked responses and neuromuscular electro-physiological tests. Application of neuro-monitoring devices such as amplitude-integrated electroencephalography /multichannel EEG and near infrared spectroscopy (NIRS) cerebral tissue oximeters. 4.2.3 Clinical practice: Clinical examination of sick and healthy newborn baby, recognition of specific neonatal problems including deformation and malformation, assessment of gestational age. Developmental and neurological assessment of the older infant and child and the assessment of disability. 4.2.4 Structured clinical hand over: For clinical hand over of patients, a clear structure should be trained and followed. The SBAR format (Situation, Background, Assessment, Recommendation) is advised as the gold standard for clinical handovers. 4.2.5 Communication: Counselling and communication skills including appropriate approach to distressed and bereaved parents, disclosure of “bad news”, handling of autopsy reports. Staff support and team dynamics, including resuscitation team debriefing. Co-operation and consultation with other medical specialists. 4.2.6 Technology: The neonatologist will be expected to understand basic mechanical and electrical function of radiant heaters, incubators, ventilators, and monitoring equipment. 4.2.7 Teaching: The neonatologist should be trained and involved in teaching activities including teaching programmes for doctors and nurses. 4.2.8 Ethics: The trainee should be educated in the ethics around end-of-life decisions in accordance to the national laws, including respecting parental wishes, providing family guidance, specifics of tailored pharmacotherapy, utilising hospice facilities and palliative care specialists, etc. 4.2 Additional skills (including non-technical skills) The neonatal specialist role includes leadership within the clinical team and many neonatologists