FOD 1: Recognizing deteriorating and/or critically ill patients and initiating stabilization and management

Key Features

• This EPA focuses on recognizing when a patient requires timely intervention and/or an increased level of care, and initiating necessary interventions including pediatric basic life support and advanced life support, when needed.
• It includes identifying when further assistance is required and promptly seeking it.
• This EPA does not include the delivery room setting and does not include leading the resuscitation or ongoing management of the patient.
• This EPA may be observed in simulation.

Assessment Plan

Direct observation or case review by supervisor or senior resident

Use form 1. Form collects information on:

• Type of observation: direct; case review
• Age: neonate; infant; preschool; school age; adolescent
• Clinical presentation: decreased level of consciousness; fever; hypo/hypertension; hypoxemia; pain; seizure; tachy/bradycardia; tachy/bradypnea; other presentation (please specify)
• Setting: inpatient; outpatient; emergency department; community; simulation

Collect at least 5 observations of achievement

• At least 1 neonate
• At least 1 infant
• At least 1 preschool, school age or adolescent
• At least 3 different clinical presentations
• No more than 2 simulations
• At least 1 observation by a pediatrician
• At least 3 different observers

CanMEDS milestones

1. ME 2.2 Provide assessment and initial stabilization of ABCs
2. ME 2.1 Determine the acuity of the issue and the priorities for patient care
3. ME 3.4 Perform the sequence of resuscitation as per established protocols
4. ME 2.2 Select and/or interpret appropriate investigations
5. ME 2.4 Reassess clinical status and re-evaluate and adjust resuscitative and diagnostic efforts as appropriate
6. COL 1.3 Work effectively with other members of the health care team
7. ME 1.4 Recognize urgent problems that need the involvement of more experienced colleagues and seek their assistance