Children with complex disability - RCPCH | The Royal ...



Special Interest Module in Paediatric Respiratory MedicineName:SPIN Educational Supervisor name:Training Programme Director name:Condition Specific CompetenciesAllergyCompetencyEvidence SubmittedWhere evidence can be found on Eportfolio(Please list type of event, date created and title)Be able to take an allergy history and differentiate different types of allergy and food intoleranceKnow when to order appropriate investigationsBe able to interpret allergy investigations, i.e. skinprick tests & specific IgE testingUnderstand when to perform a food challenge and be able to interpret itBe able to advise on allergy avoidance and the use of adrenaline autoinjectorsKnow the appropriate treatments for atopic eczema and allergic rhinitisES Comments:AsthmaUnderstand the pathophysiology of asthmaKnow the BTS /SIGN asthma guidelines including recent updates and understand the outpatient management of asthmaUnderstand the different wheezing phenotypes in young children and be able to advise on appropriate treatmentKnow the basicpharmacology for common asthma medications, and understand the step wise approach of therapy at different agesKnow and be able to demonstrate different inhaler devicesBe able to advise on non-pharmacological strategies including allergen avoidanceKnow the importance of written information for families, and be able to formulate asthma plans, including liaison with specialist nurses and other agencies e.g. schoolsBe able to manage acute severe asthma including the need for HDU or PICU when necessaryBe able to manage, and where necessary refer, children and young people with difficult to treat asthma to other servicesUnderstand dysfunctional breathing and how psychosocial aspects can influence symptomsES Comments:Children with complex disabilityKnow the range of respiratory problems associated with children who have complex disabilitiesUnderstand how to appropriately investigate children with complex disabilities for respiratory complicationsBe able to produce effective strategies for these children to improve their quality of life, including close liaison with their families, other members of the multi-professional team and other agenciesUnderstand the principles of palliative care and symptom control in children with complex disabilities, especially with respect to respiratory problemsES Comments:Chronic lung disease of prematurityUnderstand the pathophysiology of chronic lung disease of prematurityBe able to mange the common pulmonary sequelae of prematurityBe able to manage oxygen therapy in premature infants, including the use of oximetry studies and weaning protocolsES Comments:Congenital lung and airway problemsKnow the range of congenital lung and airway problems and their presentation at different agesKnow the associations between abnormalities in the respiratory tract and other non-pulmonary problemsBe able to manage the initial care of children who have common airway & lung congenital abnormalitiesBe able to manage the long term follow up of children and young people who have had congenital lung and airway problems, including knowing their long term complicationsES Comments:Cystic fibrosisUnderstand the basic molecular defect, genetics and pathophysiologyKnow the common presentations and be familiar with the UK screening protocolUnderstand the outpatient multidisciplinary management of children and young people with cystic fibrosisBe able to manage a respiratory exacerbation, including the indications for oral and intravenous antibiotics, and other respiratory treatmentsKnow how to diagnose allergic bronchopulmonary aspergillosis and how to manage an exacerbationUnderstand different respiratory physiotherapy techniquesKnow the antibiotic management of the common airway organismsUnderstand the management of the other common issues, including pancreatic enzyme replacement, monitoring of growth, microbiological surveillance, diabetic screening, vitamin supplementation, radiological surveillanceUnderstand the practicalities of managing a CF clinic, the annual review process and the requirements for data collectionUnderstand the evolving funding mechanismsES Comments:Primary ciliary dyskinesiaUnderstand the basic pathophysiologyKnow the common symptomatology and presentation of PCDKnow the diagnostic tests available, and the indications for testingKnow the principles of on-going managementRespiratory failure and long term ventilationKnow the presentations of respiratory failure at different ages and the indications for long term ventilationKnow the different interfaces available for long term ventilationBe aware of different ventilators and have some knowledge of how they work and how settings can be altered.Understand the process of safe discharge of children dependent on technology, and be involved in at least one child’s discharge to homeUnderstand the ethical complexities surrounding the provision of long term ventilation for children with very severe disabilityES Comments:Respiratory tract infectionBe able to manage viral and bacterial lower respiratory tract infectionsBe able to manage children and young people with chronic coughKnow when to refer children with severe infections for respiratory supportUnderstand the management of parapneumonic effusionsBe able to manage children with recurrent respiratory infection, including appropriate investigation for underlying conditionsKnow the principles of respiratory management of children and young people with immunodeficiency or other underlying predispositions to infection, e.g. bronchiectasisES Comments:Sleep disordered breathingUnderstand the basic physiology of sleep and the impact of disordered sleepKnow the indications for investigation of sleep disordered breathingBe able to interpret oximetry and capnography sleep studies, be aware of the indications for polysomonograpy, and know how these tests are performedBe able to diagnose obstructive sleep apnoea, including appropriate history taking, examination and investigation, and be able to manage it in conjunction with referral to otololarngology and/or respiratory supportBe aware of the other types of sleep disordered breathingES Comments:TuberculosisKnow the varied presentation of pulmonary tuberculosis at different agesBe able to initiate appropriate investigation for a child or young person with suspected tuberculosisKnow appropriate treatment strategiesUnderstand screening strategies and contact tracing protocolsES Comments:Practical procedures and investigationsLung function testingCompetencyEvidence SubmittedWhere evidence can be found on Eportfolio(Please list type of event, date created and title)Understand the physiological principles of spirometry in children and young people, including the use of reference dataBe able to perform spirometry with children and young peopleKnow how to interpret spirometry, including flow-volume loops, and bronchodilator response, with the ability to detect the common pathological abnormalitiesBe aware of the process of quality assurance of spirometry, and know its limitations as a diagnostic testBe aware of the other types of lung function testing in children and young people, and know when these are indicatedES Comments:Inhaler devices and deliveryKnow the range of inhaler devices including their relative advantages and their appropriateness for different agesBe able to demonstrate inhaler technique to parents, children and young peopleKnow the range of nebuliser devices and the differences between themBe able to train other staff to teach inhaler techniqueES Comments:ImagingBe able to interpret chest radiographsUnderstand the use of chest ultrasound, chest fluoroscopy, upper gastrointestinal contrast studies and bronchographyKnow the indications for thoracic CT and be able to identify the most common abnormalitiesES Comments:Percutaneous long line insertionBe able to insert percutaneous long lines in children and young people, including the use of safe conscious sedationBronchoscopyKnow the indications for flexible and rigid bronchoscopyUnderstand the process of flexible bronchoscopy, and be able to interpret results from bronchoalveolar lavage fluid (i.e. cytology and microbiology)Home oxygenUnderstand the process of home oxygen provisionBe involved with at least one provision of home oxygen therapyES Comments:Section 2 (To be completed by ES)Please note: Borderline implies some concerns but not clear failure to meet objectives.Has the trainee made adequate progress in demonstration of knowledge base?Yes / No / Borderline*Comments:Has the trainee made adequate progress in gaining clinical competencies?Yes / No / Borderline*Comments:Are the SPIN competencies completed thoroughly showing adequate assessments and reflective notes?Yes / No / Borderline*Comments:Has the trainee had a Multisource feedback in last 12 months? Yes / NoComments on MSF (any strengths weaknesses identified?):Are there any concerns about the training opportunities available? Yes / NoComments:Please comment on Academic progress (teaching and research activities):Please provide any other information relevant to the trainee SPIN training:Are there any concerns about the trainee’s progression through SPIN training?Declarations – all parts to be completedTo be signed by the Trainee I confirm that I have completed all the SPIN competencies.Signed: Dated:Print Name: To be signed by the Educational Supervisor. I confirm that all the information provided is correct and that the trainee has satisfied all the competencies of the SPIN module.Signed: Dated:Print Name: ................
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