Log Book Idccm

Indian College of Critical Care Medicine
Indian Society of Critical Care Medicine
LOG BOOK OF
IDCCM/CTCCM Trainee
NAME OF TRAINEE:
NAME OF COURSE:
REGISTRATION NO.:
(ISCCM Membership No.)
S
TRAINEE’S DETAILS
Passport photograph
Name:
Address:
Date of Birth:
Email:
Education:
MBBS
Name of the College Name of the University
Post-Graduation
Subject Name of the College/Hospital Name of the University

Sl. No DATE TOPIC NAME OF STAFF
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Sl. No DATE TOPIC NAME OF STAFF
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
Sl. No DATE TOPIC PRESENTOR MODERATOR
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.
100.
10
Sl. No DATE ARTICLE TITLE and NAME OF JOURNAL PRESENTOR MODERATOR
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
11
Sl. No DATE ARTICLE TITLE and NAME OF JOURNAL PRESENTOR MODERATOR
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
12
Sl. No DATE TOPIC PRESENTOR
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
13
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
14
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
15
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
16
Sl. No DATE PROCEDURE DETAILS SUPERVISOR
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
17
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
18
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
19
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
20
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.
100.
21
101.
102.
103.
104.
105.
106.
107.
108.
109.
110.
111.
112.
113.
114.
115.
116.
117.
118.
119.
120.
22
121.
122.
123.
124.
125.
126.
127.
128.
129.
130.
131.
132.
133.
134.
135.
136.
137.
138.
139.
140.
23
141.
142.
143.
144.
145.
146.
147.
148.
149.
150.
151.
152.
153.
154.
155.
156.
157.
158.
159.
160.
24
161.
162.
163.
164.
165.
166.
167.
168.
169.
170.
171.
172.
173.
174.
175.
176.
177.
178.
179.
180.
25
181.
182.
183.
184.
185.
186.
187.
188.
189.
190.
191.
192.
193.
194.
195.
196.
197.
198.
199.
200.
26
Sl. No DATE CASE DETAILS TYPE OF CALL
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
27
Sl. No DATE CASE DETAILS TYPE OF CALL
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
28
Sl. No DATE NAME OF CONFERENCE/CME PLACE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
29
Sl. No DATE WORKSHOP CONDUCTED BY PLACE
1.
BLS
2.
ACLS
3.
ATLS
4.
Difficult Airway
5.
Mechanical Ventilation
6.
Hemodynamic Monitoring
7.
4C
8.
9.
10.
11.
12.
30
DEPARTMENT FROM TO DURATION SUPERVISOR
CARDIAC CARE UNIT
NEURO ICU
NEPHROLOGY ICU
RADIOLOGY
MICROBIOLOGY
ECHOCARDIOGRAPHY
31
AUDIT FROM TO DURATION SUPERVISOR
32
JUDGEMENTS OF PERFORMANCE
Domain 1. Resuscitation and Initial management of the acutely ill patient

Yes/No
1.1 Adopts a structured and timely approach to the recognition, assessment and
stabilization of the acutely ill patient with disordered physiology
1.2 Manages cardiopulmonary resuscitation

1.3 Manages the patient post-resuscitation
Domain 2. Diagnosis: Assessment, Investigation, Monitoring and Data Interpretation

Yes/No
2.1 Obtains a history and performs an accurate clinical examination
2.2 Undertakes timely and appropriate investigations
2.3 Describes indications for echocardiography
2.4 Performs electrocardiography (ECG / EKG) and interprets the results
2.5 Obtains appropriate microbiological samples and interprets results
2.6 Obtains and interprets the results from blood gas samples
2.7 Interprets chest x-rays
2.8 Liaises with radiologists to organize and interpret clinical imaging
2.9 Monitors and responds to trends in physiological variables
2.10 Integrates clinical findings with laboratory investigations to form a DD
33
Yes/No
Acute Disease:
3.1 Manages the care of the critically ill patient with specific acute medical
conditions
Chronic Disease:
3.2 Identifies the implications of chronic and co-morbid disease in the acutely ill
patient
Organ System Failure:
3.3 Recognizes and manages the patient with circulatory failure
3.4 Recognizes and manages the patient with, or at risk of, acute renal failure
3.5 Recognizes and manages the patient with, or at risk of, acute liver failure
3.6 Recognizes and manages the patient with neurological impairment
3.7 Recognizes and manages the patient with acute gastrointestinal failure
3.8 Recognizes and manages the patient with acute lung injury syndromes (ARDS)
3.9 Recognizes and manages the septic patient
3.10 Recognizes and manages the patient following intoxication with drugs or
environmental toxins
3.11 Recognizes life-threatening maternal peripartum complications and manages

care under supervision
34
Yes/No
4.1 Prescribes drugs and therapies safely
4.2 Manages antimicrobial drug therapy
4.3 Administers blood and blood products safely
4.4 Uses fluids and vasoactive/inotropic drugs to support the circulation
4.5 Describes the use of mechanical assist devices to support the circulation
4.6 Initiates, manages, and weans patients from invasive and non-invasive
ventilation
4.7 Initiates, manages and weans patients from renal replacement therapy
4.8 Recognizes and manages electrolyte, glucose and acid-base disturbances
4.9 Co-ordinates and provides nutritional assessment and support
Domain 5. Practical procedures
Yes/No
Respiratory system:
5.1 Administers oxygen using a variety of administration devices
5.2 Performs fibreoptic laryngoscopy under supervision
5.3 Performs emergency airway management
5.4 Performs difficult and failed airway management according to local protocols
5.5 Performs endotracheal suction
5.6 Performs FOB and BAL in the intubated patient under supervision
5.7 Performs percutaneous tracheostomy under supervision
5.8 Performs thoracocentesis via a chest drain
35
Yes/No
Cardiovascular system:
5.9 Performs peripheral venous catheterisation
5.10 Performs arterial catheterization
5.11 Describes a method for surgical isolation of vein / artery
5.12 Describes ultrasound techniques for vascular localization
5.13 Performs central venous catheterisation
5.14 Performs defibrillation and cardioversion
5.15 Performs cardiac pacing (transvenous or transthoracic)
5.16 Describes how to perform pericardiocentesis
5.17 Demonstrates a method for measuring cardiac output and derived

haemodynamic variables
Central Nervous System:
5.18 Performs lumbar puncture under supervision
5.19 Manages the administration of analgesia via an epidural catheter
Gastrointestinal System:
5.20 Performs nasogastric tube placement
5.21 Performs abdominal paracentesis
5.22 Describes Sengstaken tube (or equivalent) placement
5.23 Describes indications for, and safe conduct of gastroscopy
Genitourinary system:
5.24 Performs urinary catheterization
36
Yes/No
6.1 Manages the pre- and post-operative care of the high risk surgical patient
6.2 Manages the care of the patient following cardiac surgery under supervision
6.3 Manages the care of the patient following craniotomy under supervision
6.4 Manages the care of the patient after organ transplantation under supervision
6.5 Manages the post-operative care of the trauma patient under supervision
Domain 7. Comfort and Recovery

Yes/No
7.1 Identifies and attempts to minimize the physical and psychosocial

consequences of critical illness for patients and families
7.2 Manages the assessment, prevention and treatment of pain and delirium
7.3 Manages sedation and neuromuscular blockade
7.4 Communicates the continuing care requirements of patients at ICU discharge

to health care professionals, patients and relatives
7.5 Manages the safe and timely discharge of patients from the ICU
Domain 8. End of life care

Yes/No
8.1 Manages the process of withholding or withdrawing treatment with the

multidisciplinary team
8.2 Discusses end of life care with patients and their families / surrogates
8.3 Manages palliative care of the critically ill patient
8.4 Performs brain-stem death testing
8.5 Manages the physiological support of the organ donor
37
Yes/No
Undertakes transport of the mechanically ventilated critically ill patient

9.1
outside the ICU
Domain 10. Patient safety and health systems management

Yes/No
10.1 Leads a daily multidisciplinary ward round
10.2 Complies with local infection control measures
10.3 Identifies environmental hazards and promotes safety for patients & staf
10.4 Identifies and minimizes risk of critical incidents and adverse events
10.5 Organizes a case conference
10.6 Critically appraises and applies guidelines, protocols and care bundles
10.7 Describes commonly used scoring systems for assessment of severity of illness
10.8 Demonstrates an understanding of the managerial & administrative

responsibilities of the ICM specialist
Domain 11. Professionalism

Yes/No
Communication Skills
11.1 Communicates effectively with patients and relatives
11.2 Communicates effectively with members of the health care team
11.3 Maintains accurate and legible records / documentation
Professional relationships with patients and relatives
11.4 Involves patients (or their surrogates) in decisions about care and treatment
11.5 Demonstrates respect of cultural and religious beliefs and an awareness of

their impact on decision making
Respects privacy, dignity, confidentiality and legal constraints on the use of
11.6
patient data
38
Professional relationships with members of the health care team
11.7 Collaborates and consults; promotes team-working
11.8 Ensures continuity of care through efective hand-over of clinical information
11.9 Supports clinical staf outside the ICU to enable the delivery of efective care
11.10 Appropriately supervises, and delegates to others, the delivery of patient care
Self governance
11.11 Takes responsibility for safe patient care
11.12 Formulates clinical decisions with respect for ethical and legal principles
11.13 Seeks learning opportunities and integrates knowledge into clinical practice
11.14 Participates in multidisciplinary teaching
11.15 Participates in research or audit under supervision
39

Log Book Idccm

Uploaded by

Copyright:

Available Formats

Log Book Idccm

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Log Book Idccm

Uploaded by

Copyright:

Available Formats

Indian College of Critical Care Medicine

Indian Society of Critical Care Medicine

Name of the College Name of the University

Subject Name of the College/Hospital Name of the University

CARDIAC CARE UNIT

Domain 1. Resuscitation and Initial management of the acutely ill patient

1.2 Manages cardiopulmonary resuscitation

Domain 2. Diagnosis: Assessment, Investigation, Monitoring and Data Interpretation

2.1 Obtains a history and performs an accurate clinical examination

2.2 Undertakes timely and appropriate investigations

2.3 Describes indications for echocardiography

2.4 Performs electrocardiography (ECG / EKG) and interprets the results

2.5 Obtains appropriate microbiological samples and interprets results

2.7 Interprets chest x-rays

2.8 Liaises with radiologists to organize and interpret clinical imaging

2.9 Monitors and responds to trends in physiological variables

2.10 Integrates clinical findings with laboratory investigations to form a DD

Organ System Failure:

3.3 Recognizes and manages the patient with circulatory failure

3.6 Recognizes and manages the patient with neurological impairment

3.9 Recognizes and manages the septic patient

3.11 Recognizes life-threatening maternal peripartum complications and manages

4.1 Prescribes drugs and therapies safely

4.2 Manages antimicrobial drug therapy

4.3 Administers blood and blood products safely

4.4 Uses fluids and vasoactive/inotropic drugs to support the circulation

4.8 Recognizes and manages electrolyte, glucose and acid-base disturbances

4.9 Co-ordinates and provides nutritional assessment and support

Domain 5. Practical procedures

5.1 Administers oxygen using a variety of administration devices

5.2 Performs fibreoptic laryngoscopy under supervision

5.3 Performs emergency airway management

5.5 Performs endotracheal suction

5.7 Performs percutaneous tracheostomy under supervision

5.8 Performs thoracocentesis via a chest drain

5.9 Performs peripheral venous catheterisation

5.10 Performs arterial catheterization

5.11 Describes a method for surgical isolation of vein / artery

5.12 Describes ultrasound techniques for vascular localization

5.13 Performs central venous catheterisation

5.14 Performs defibrillation and cardioversion

5.15 Performs cardiac pacing (transvenous or transthoracic)

5.16 Describes how to perform pericardiocentesis

5.17 Demonstrates a method for measuring cardiac output and derived

Central Nervous System:

5.18 Performs lumbar puncture under supervision

5.19 Manages the administration of analgesia via an epidural catheter

5.20 Performs nasogastric tube placement

5.21 Performs abdominal paracentesis

5.22 Describes Sengstaken tube (or equivalent) placement

5.23 Describes indications for, and safe conduct of gastroscopy

5.24 Performs urinary catheterization

Domain 7. Comfort and Recovery

7.1 Identifies and attempts to minimize the physical and psychosocial

7.3 Manages sedation and neuromuscular blockade

7.4 Communicates the continuing care requirements of patients at ICU discharge

Domain 8. End of life care

8.1 Manages the process of withholding or withdrawing treatment with the

8.3 Manages palliative care of the critically ill patient