Module information
Module details
- Title
- Ventilatory Control and Assessment
- Type
- Specialist
- Module code
- S-RS-S4
- Credits
- 10
- Phase
- 3
- Requirement
- Compulsory
Aim of this module
This module will provide trainees with the opportunity to assess patients for ventilatory failure by performing and interpreting a range of physiological measurements in Respiratory and Sleep Science.
Work-based content
Training activities
| # | Learning outcome | Training activity | Type | Action |
|---|---|---|---|---|
| # 1 | Learning outcome 1, 2, 3, 4, 5 |
Training activities
Undertake long-term oxygen therapy assessment in patients with type 1 respiratory failure and document a plan |
Type DTA | Action View |
| # 2 | Learning outcome 1, 2, 3, 4, 5 |
Training activities
Undertake long-term oxygen therapy assessment in patients with type 2 respiratory failure and document a plan |
Type DTA | Action View |
| # 3 | Learning outcome 1, 2, 5, 6, 7, 8 |
Training activities
Evaluate the need for domiciliary non-invasive ventilation in patients with known hypercapnic respiratory failure and document a plan |
Type DTA | Action View |
| # 4 | Learning outcome 5, 6 |
Training activities
Initiate and optimise non-invasive ventilation in patients with hypercapnic respiratory failure |
Type DTA | Action View |
| # 5 | Learning outcome 1, 2, 5, 6, 7, 8 |
Training activities
Evaluate patient’s responses to non-invasive ventilation, determining effectiveness and generating a plan for ongoing treatment and follow up |
Type DTA | Action View |
| # 6 | Learning outcome 3, 4, 5 |
Training activities
Undertake ambulatory oxygen assessment in patients with suspected exercise induced desaturation and document a plan |
Type DTA | Action View |
| # 7 | Learning outcome 5, 7 |
Training activities
Undertake consultations with patients who require non-invasive ventilation, communicating the requirement for ventilation and ensuring patients’ perspectives are considered |
Type DTA | Action View |
| # 8 | Learning outcome 1, 2, 3, 4, 5 |
Training activities
Undertake hypoxic challenge assessment with a patient who does not require ventilation and document a plan |
Type DTA | Action View |
| # 9 | Learning outcome 4, 5 |
Training activities
Prepare an order for supplemental home oxygen, including appropriate risk assessments |
Type DTA | Action View |
| # 10 | Learning outcome 7, 8 |
Training activities
Develop a patient pathway for domiciliary non-invasive ventilation from initial assessment through to withdrawal |
Type DTA | Action View |
Assessments
Complete 2 Case-Based Discussions
Complete 2 DOPS or OCEs
Direct Observation of Practical Skills Titles
- Interpret a set of blood gas results and make recommendations for treatment.
- Set up a ventilator for a patient including appropriate commencement settings and interfaces.
- Perform either an arterial or capillary blood gas measurement.
Observed Clinical Event Titles
- Explain investigation findings to a senior colleague and suggest an action plan.
- Describe to a patient the range of oxygen delivery devices available and discuss the appropriateness for them.
- Explain the dangers of over oxygenation to a patient with type 2 respiratory failure.
Learning outcomes
| # | Learning outcome |
|---|---|
| 1 | Interpret blood gas measurements in a range of patients. |
| 2 | Use the results of blood gas measurements, in conjunction with other physiological parameters and patient history, to effectively plan appropriate treatment and/or interventions. |
| 3 | Undertake supplementary oxygen assessments in patients who are hypoxemic at rest and/or on exertion and analyse the results to make effective decisions regarding treatment. |
| 4 | Perform a risk assessment for, and order, supplemental oxygen. |
| 5 | Employ effective communication skills and compassion with a range of patients enabling patients to understand their treatment pathway. |
| 6 | Assess a patient’s requirement for, initiate and evaluate effectiveness of, non-invasive ventilation therapy. |
| 7 | Appraise patient pathways from diagnosis to end of life care. |
| 8 | Practice effectively as part of a multidisciplinary team to interpret complex scientific and technical data which will form part of the diagnosis and management plan. |
Clinical experiences
Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.
Activities
- Attend a Consultant led outpatient clinic for patients with respiratory failure to appreciate the experience from the patient’s perspective.
- Spend time with a Home Oxygen Service Assessment and Review (HOS-AR) team.
- Attend a multidisciplinary team meeting.
- Spend time on a respiratory ward to experience patients with acute ventilatory failure and reflect on the impact of treatment on the patient.
- Attend a setting where you can observe the initial management of a patient presenting with acute respiratory failure e.g. A&E to appreciate the experience from the patient’s perspective.
- Attend and observe a service providing ongoing management of patient with ventilatory failure e.g. ITU to appreciate the experience from the patient’s perspective.
Academic content (MSc in Clinical Science)
Important information
The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.
Learning outcomes
On successful completion of this module the trainee will know and be able to:
- Demonstrate extended understanding of assessments of respiratory failure.
- Critically appraise the role of non-invasive ventilation in the treatment of acute and chronic respiratory failure in a range of disorders.
- Critically evaluate national and international guidelines for the use of oxygen therapy.
- Demonstrate a critical awareness of effective methods of communicating findings and outcomes to both patients and clinicians.
Indicative content
Respiratory failure:
- Assessment of respiratory failure and control
- Use of blood gas measurements to differentiate type 1 and type 2 respiratory failure
- Acute and chronic respiratory failure
- Underlying pathologies – e.g. obstructive/chest wall/neuro muscular disorders
- Metabolic disorders
- Treatment pathways for patients in respiratory failure
- Diagnostic procedures used in the assessment of patients with respiratory failure
Non-invasive ventilation:
- Role of non-invasive ventilation in the treatment of acute and chronic respiratory failure in a range of disorders
- Airway
- Chest wall
- Muscle disorders
- Clinical indications for NIV using national and international guidelines
- Acute
- Protocols for initiation and withdrawal
- Indications and contraindications
- Monitoring
- Requirements for invasive ventilation
- Chronic
- Assessment for domiciliary ventilation
- Indications and contraindications
- Nocturnal and diurnal monitoring of patients for domiciliary ventilation
- Long-term monitoring
- Modes of ventilation (positive and negative)
- Pressure support
- Volume support
- Spontaneous Intermittent mechanical ventilation
- Interfaces
- Operational parameters
- IPAP
- EPAP
- Respiratory rate
- Rise time
Risks – smoking, over oxygenation/CO2 retention, falls, hoarding and fire risks
Risk mitigation – oxygen alert cards, smoking and use of the multidisciplinary team
Blood gases – indications and contraindications, techniques, performance, interpretation, normal ranges, metabolic/respiratory, acid base balance, chronic/acute, benefits and drawbacks of sampling techniques and oximetry
Oxygen Therapy:
National and international guidelines, modalities, interfaces, use of LTOT, AOT, NOT, palliative oxygen therapy, evidence base, limitations, benefits, SOPs for supplemental oxygen assessments and guidelines for withdrawal
- Non-invasive – national and international guidelines, modalities, interfaces, modes, parameters, theoretical knowledge, evidence base, limitations, benefits, SOPs, indications and contraindications, domiciliary and acute ventilation
- Holistic assessment of the patient to include knowledge of physiological measurements, imaging results, social factors, psychological factors
- Appropriate patient groups for NIV therapy and how treatment varies with patient type
- Appropriate monitoring of patients – physiological, frequency, role of remote monitoring. When it is appropriate to withdraw, why you would withdraw, who to communicate with
- Guidelines for withdrawal
- EOL
Blood gas analysers – quality assurance and quality control
Patient – consent, education, effectively communicating results and treatment options and role of patient history
Pathology – knowledge and understanding of a range of conditions relevant to supplemental oxygen therapy and NIV to include, lung disease, neuromuscular disease, chest wall deformity, obesity hypoventilation, heart failure and cluster headaches
Communication – Effective hand over, use of handover tools,
- Communicating findings and outcomes effectively to both the patient and clinicians
- Escalation to the multidisciplinary team
- Requirement for urgent medical intervention
Module assigned to
Specialties
| Specialty code | Specialty title | Action |
|---|---|---|
| Specialty code SPS1-3-22 | Specialty title Respiratory & Sleep Science [2022] | Action View |
| Specialty code SPS1-3-23 | Specialty title Respiratory & Sleep Science [2023] | Action View |
| Specialty code SPS1-3-24 | Specialty title Respiratory & Sleep Science [2024] | Action View |