Knowledge guides

LG16: Acute care presentations and conditions

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

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Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

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Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

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For each presentation and condition, Advanced Trainees will know how to:

Synthesise
  • recognise the clinical presentation
  • identify relevant epidemiology, pathophysiology, and clinical science
  • take a relevant clinical history
  • conduct an appropriate examination
  • establish a differential diagnosis
  • plan and arrange appropriate investigation
  • consider the impact of illness and disease on patients and families, and their quality of life
Manage
  • provide evidence-based management
  • for less common or more complex presentations and conditions the trainee must also seek expert opinions
  • prescribe therapies tailored to patients’ needs and conditions
  • recognise potential complications of disease and its management, and initiate preventative strategies
  • involve multidisciplinary teams
Consider other factors
  • identify individual and social factors and the impact of these on diagnosis and management
  • Basic toxicology
  • Clinical pharmacology
  • Nutritional requirements of critically ill patients
  • Oxygen delivery, including evidence-based use of humified high-flow oxygen and non-invasive ventilation
  • Pathophysiology of cardiovascular failure, coma, respiratory failure, and shock
  • Physiology of acid-base and electrolyte disturbances
  • Procedural anxiety, pain management, and sedation:
    • non-pharmacological
    • pharmacological
  • Resuscitation and advanced life support
Procedures (required)
  • Airway stabilisation procedures
  • Blood product transfusion
  • Indwelling urinary catheter insertion
  • Intravenous cannulation
  • Puncture:*
    • arterial (arterial blood gas sampling)
    • lumbar
  • Ventilation:
    • high-flow oxygen therapy
    • manual
    • non-invasive ventilation:
      • bilevel positive airway pressure (BiPAP)
      • continuous positive pressure ventilation (CPAP)
Procedures (optional)
  • Arterial catheter insertion*
  • Ascitic aspirate / paracentesis
  • Aspiration:*
    • bone marrow
    • joint
    • pleurocentesis
  • Bedside ultrasound
  • Biopsy:*
    • liver
    • skin
  • Bronchoscopy
  • Central venous catheter insertion
  • Endoscopy
  • Endotracheal intubation
  • Intercostal catheter insertion
  • Mechanical ventilation
  • Nasogastric tube insertion
  • Percutaneous long line (PICC)
  • Point-of-care ultrasound (POCUS)
  • Procedural sedation

* Highly recommended for trainees in rural, regional, and remote settings.

  • Advanced life support algorithms
  • Assessment of capacity / functional limitations, such as driving
  • Consideration of clinical indications to determine patients’ needs, including comorbidities, and the most appropriate approach to investigations and care
  • Consideration of the patient holistically, including cultural background, ethnicity, family and psychosocial support, geographic location, and socioeconomic status, and the considerations when managing and following up these patients, such as community-based decision making and travel from rural to metropolitan areas
  • Cost, implications, and scope of healthcare-related adverse outcomes
  • Crisis resource management principles
  • Ethical and legal issues, including assessing decision-making capacity and identifying proxy decision makers
  • Family violence awareness and screening
  • Grief and bereavement
  • Informed consent in acute and emergency care
  • Management of patients with cognitive impairment / delirium
  • Principles of trauma-informed, patient-centred care
  • Relationship between primary care and specialist health services
  • Sexual assault
  • Tailoring treatment and management to the setting in which care is being provided, such as clinical and workforce resources