The Critical Illness Attachment (CIA) is a 4 week rotation for junior doctors taking part in the Clinical Phase 3 (CP3) course at the University of Nottingham Medical School.

The rotation consists of time with our Anaesthetic, Critical Care and Emergency Medicine teams and includes clinical exposure, practical skills, small group teaching and simulation.

Overview

 

With QMC’s busy Emergency Department seeing between 500 and 600 patients a day, this is an excellent chance to experience the whole spectrum of critical illness. 

The emphasis of this rotation is on the time critical assessment, management and escalation of an acutely unwell patient.

CIA Simulation

This module also contains your compulsory Simulation Day and Intermediate Life Support (ILS) Day.

Your induction will be supported by DREEAM (Department of Research & Education – Emergency Medicine, Acute Medicine and Major Trauma). DREEAM supports the whole of the CIA rotation and leads on Emergency and Major Trauma aspects

DREEAM is a self-contained area located on the corridor behind ED, near to the west block lifts and will also be the main site for your small group teaching and simulation 

Timetable

This is a example timetable. You will have received your personal timetable prior to attending the induction. If not please contact a member of the (Undergraduate Medical Education Centre) UMEC team, who are based in south block on A-Floor.

Teaching Sessions

During your rotation in the Emergency Department ( see draft timetable), you will have bedside teaching with clinical fellows, registrar classroom small group teaching and consultant teaching sessions. Most of the learning objectives have contents on your CP3 Moodle page and here you will find links to further reading for the topics stated. 

Where it says 'Login to Moodle', it will direct you to the university page and signpost you to the further reading materials on there. We avoid duplication of content across the pages but help you organize your study better while on this rotation. 

The 4 sessions are:

  • Trauma I  (ABC)  -   Primary Survey
  • Trauma II (DE)     -   Head/Spine/Limbs
  • The Unconscious Patient
  • Mental Health in the ED
  • Cardiac Arrhythmias

For your preparation for the bedside teaching session, please review the CHAMPS History pages of your CIA handbook. 

Trauma: ABC

Pre-Reading:

Major Trauma- 2-part video

 

Trauma: Head and Neck Injuries/ Spine/ Limbs

Follow this Link on your Moodle Page: (Sign-in required) 

Dashboard > Modules > Clinical Phase 3 - Advanced Clinical Experience (MEDS4021 UNUK) (FYR1 21-22) >Critical Illness  > Head Injuries

The Unconscious Patient

Consultant's small group teaching: 

Login to Moodle: (Sign-in required) 

Dashboard > Modules > Clinical Phase 3 - Advanced Clinical Experience (MEDS4021 UNUK) (FYR1 21-22) >Critical Illness  > Critical Illness Case 3 - Unconscious on Arrival

Topics Include: ( and the Link to follow when you login to your Moodle Pages). Check under the following headlines. Sample of some resources can be downloaded here (pdf). 

 

Stroke : Medicine > Neurology > Stroke for CP3

Meningitis : Medicine > Neurology > CNS Infections

Seizures:Medicine> Neurology  > Status Epilepticus

Diabetic Emergencies: Medicine > Endocrine > Diabetes

 

Mental Health in ED

Overdose / Self Harm / Capacity /  Ethics 

Login to Moodle: (Sign-in required)

Dashboard > Modules > Clinical Phase 3 - Advanced Clinical Experience (MEDS4021 UNUK) (FYR1 21-22) >Critical Illness > Ethical Challenges in Critical Illness

 

Cardiac Arrhythmias

 

Concept Maps

Concept maps has helped the students:

·      To develop a good list of differentials when approaching a symptom in a patient

·      To identify critical pieces of information in the patient's presentation and use them as branch points to distinguish between groups of diagnoses

·      To shape a more targeted approach in history 

·      To serve as a brief guide in reading up on various conditions with overlapping features 

·      To translate the basic medical sciences they learnt in pre-clinical years into clinical context

·      To form conceptual links between topics covered in different modules/rotations in medical school

·      To complement the knowledge of individual disease conditions

·      To develop a systematic and functional way to approach patients

·      To use as revision tool

·      To improve Clinical reasoning 

 

It is not recommended that students to memorise these concept maps because none of them could be perfect and different clinician can create their concept maps differently. 

Concept maps presentations links is attached.

Sample of  youtube video also available  and presentation is uploaded per week so please keep an eye on the YouTube channel of Dr Swe Khin-Htun.