Training activity information
Details
Perform three cardiac output measurements using invasive and/or minimally invasive techniques
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- Equipment set up
- Preparation of area
- Patient centred care and support
- Communication with patients, relatives and the clinical team
- Connection to patient
- Contraindications
- Troubleshooting
- Risk management
- Drug prescriptions
- Infection control
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What knowledge do you need regarding the principles of the specific invasive and/or minimally invasive techniques you will be using (e.g., thermodilution, pulse contour analysis)?
- What knowledge is required about the correct setup and calibration procedures for the equipment?
- What do you need to know about patient preparation for these procedures?
- What factors can affect the accuracy of the measurements and how can these be minimised?
- Do you understand the safety procedures and risk management associated with performing these measurements, particularly with invasive techniques?
- What do you need to know about recording and communicating the results to the clinical team?
- What specific practical skills in setting up equipment, preparing the patient, and performing the measurements do you hope to develop?
- What insights do you anticipate gaining into the advantages and disadvantages of different cardiac output monitoring techniques?
- How do you expect this activity to enhance your ability to obtain accurate and reliable cardiac output data?
- What do you hope to learn about troubleshooting common issues that arise during measurement?
- Discuss with your training officer which specific techniques (invasive/minimally invasive) you will be focusing on and review the associated protocols.
- Review resources and equipment manuals for the specific monitoring systems you will be using.
- Practice the steps for equipment setup and calibration if possible. Consider potential challenges such as technical difficulties, arrhythmias affecting measurements, or patient movement, and think about how you might handle them.
- Reflect on your current understanding of haemodynamics and different monitoring technologies.
In action
- Pay attention to your actions. What are the steps you are taking to perform the cardiac output measurements. Why are you following this particular procedure?
- What decisions are you making during the measurement process? For example, how are you ensuring accurate readings or troubleshooting any technical difficulties?
- What aspects of the procedure feel natural, and what requires more deliberate attention? Are you confidently operating the equipment, or are you needing to focus intently on each step?
- How effective are your actions in obtaining reliable cardiac output measurements?
- Are you getting consistent and plausible results?
- What challenges are you facing while performing these measurements? Are there issues with equipment calibration, patient factors affecting readings, or your technique?
- What are you learning about the process of cardiac output measurement as you perform it? Are you gaining a better understanding of potential pitfalls or the nuances of different techniques?
- How does this activity build upon your existing knowledge of haemodynamic monitoring? Are you connecting the practical steps to the underlying physiological principles?
- If you encounter difficulties, what alternative approaches could you consider to obtain a cardiac output measurement?
- Are you thinking about different troubleshooting steps? When would it be appropriate to ask for assistance or a second opinion during this procedure?
- Are you aware of when to seek help? Are you performing the measurements according to established protocols and within your ability?
On action
- Describe the process of performing the cardiac output measurements. What techniques did you use?
- What were the readings obtained, and what factors might have influenced them?
- What challenges did you encounter with the equipment or the procedure itself?
- What were your observations about the patient’s response to the measurements?
- What skills in performing cardiac output measurements did you develop or refine?
- Were there any surprising findings or obstacles during the measurements? What did you learn from these?
- How did your real-time adjustments (reflect-in-action) during the procedure affect the outcome of the measurements?
- How does this experience relate to the interpretation of cardiac output data in clinical practice?
- What aspects of performing cardiac output measurements require further practice or understanding?
- How will you apply your learning from this activity to future cardiac output measurements?
- What next steps will you take to consolidate your skills in performing these measurements?
- What support or resources would be beneficial for your continued development in this area?
Beyond action
- Reflect on your experience of performing cardiac output measurements. With the benefit of hindsight and further training, are there any aspects of the procedure or the interpretation of the results that you now view differently?
- Have you observed more experienced colleagues performing cardiac output measurements? How did their approach compare to your own? What techniques or practices have you since incorporated?
- Review your initial notes on this DTA. What additional learning points can you now identify regarding the practical aspects or the clinical significance of cardiac output measurements? What further actions might you take to improve your skills?
- Have you discussed challenges you faced during these measurements with colleagues? Did these discussions offer any new strategies or insights?
- How has the practical experience of performing cardiac output measurements contributed to your overall understanding of haemodynamic monitoring in critical care? Have the skills you developed (e.g., technical proficiency, attention to detail, interpretation of numerical data) been transferable to other procedures or monitoring techniques?
- Since performing these measurements, have you been involved in situations where you have needed to interpret cardiac output data? How has your understanding and ability to apply this knowledge evolved?
- How might this hands-on experience of performing cardiac output measurements aid you in preparing for practical assessments or case discussions related to haemodynamic monitoring?
- What transferable skills (e.g., practical skills with medical devices, data acquisition and interpretation) did you develop or enhance through this DTA?
- What are your plans for continued development in the area of performing and interpreting cardiac output measurements?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Apply techniques to manage and monitor cardiac conditions. |
| # 5 |
Outcome
Communicate effectively with the patient and the multi-disciplinary team. |
| # 6 |
Outcome
Practice safely, managing risk in all elements of patient care. |