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GENERAL CLINICAL MANAGEMENT

  • Patient selection - indications, contraindications and potential complications of procedures / interventions.

  • Universal precautions and preventative infection control techniques.

  • Principles of aseptic technique and aseptic handling of invasive medical devices.

  • Methods and routes of insertion - associated indications and complications.

  • Appropriate use of critical care drugs.

  • Detection of potential physiological alterations during procedures.

  • Indications for specific monitoring to ensure patient safety during an interventions / procedures.

  • Complications of techniques, how to prevent/recognise them and initiate appropriate treatment.

  • Methods of sterilisation and cleaning or disposal of equipment.

  • Management and use of the device once in situ necessary to minimise the risks of complications.

  • Indications and techniques for removal devices.

 

RESPIRATORY

  • Administer oxygen using a variety of administration devices.

  • Emergency airway management.

  • Insert and check correct placement of laryngeal mask airway.

  • Intubation and verify correct placement of tube.

  • Change an orotracheal tube.

  • Manage and minimise cardiovascular and respiratory changes during and after intubation.

  • Apply an end-tidal CO2 detector post-intubation and interpret a capnograph trace.

  • Rapid sequence induction of anaesthesia / cricoid pressure.

  • Extubation and management of difficult or failed extubation.

  • Emergency relief of tension pneumothorax.

  • Thoracocentesis.

  • Aseptic insertion of an intrapleural chest drain and connection to a one-way seal device.

  • Fibreoptic laryngoscopy.

  • Fibreoptic bronchoscopy and BAL in the intubated patient.

  • Percutaneous tracheostomy.

 

CARDIOVASCULAR

  • Insert peripheral cannulae via different routes.

  • Arterial catheterisation.

  • Ultrasound techniques for vascular localization.

  • Ecocardiography.

  • Central venous catheterisation.

  • Defibrillation and cardioversión.

  • Cardiac pacing (transvenous or transthoracic).

  • Pericardiocentesis.

 

CENTRAL NERVOUS SYSTEM

  • Lumbar puncture (intradural / 'spinal').

  • Epidural anesthesia.

  • Administration of analgesia via an epidural catheter.

  • Intracraneal Pressure Monitoring.

  • Intracraneal Doppler Ultrasonography.

  • Cooling/preservation techniques.

 

GASTROINTESTINAL

  • Nasogastric tube placement.

  • Abdominal paracentesis.

  • Sengstaken tube (or equivalent) placement.

  • Enteral and parentheral nutrition.

  • Alternative routes for enteral feeding: indications, contraindications and complications of post-pyloric and percutaneous feeding tube placement.

 

RENAL/GENITOURINARY

  • Urinary catheterisation.

  • Vesical puncture – suprapuvic drain.

  • Continuous Extracorporeal Blood Therapies.

 

GENERAL SURGERY

  • Cutaneous/subcutaneous suture.

  • Vascular emergency suture/management.

  • Management of wounds.

 

BIOETHICS

  • Recognises personal limitations, seeks and accepts assistance or supervision (knows how, when and who to ask).

  • Considers patient comfort during procedures / investigations.

  • Desire to minimise patient distress.

  • Accepts personal responsibility for the prevention of cross infection and self infection.

  • Supports other staff in the correct use of devices.

  • Respect for patient privacy, dignity and confidentiality.

  • Limitation of Vital Supporting Therapies.

 

 

LABORATORY SKILLS

GENERAL LABORATORY

  • Clinical Biochemistry.

  • Microbiology.

  • Histopathology.

  • Hematology.

 

LABORATORY INPATINENT CLINIC EXPERIENCE

  • Internal Medicine.

  • Endocrinology.

  • Nephrology.

  • Lipidology.

  • Paediatrics.

  • Metabolic medicine.

 

TECHNIQUES

  • Standardization and calibration.

  • Common method interferences.

  • Use of pipettes.

  • Preparation and storage of reagents.

  • Use and maintenance of centrifuges.

  • Spectrometric methods.

  • Osmometry.

  • Electrometric methods.

  • Enzymology.

  • Immunochemical techniques.

  • Electrophoresis.

  • Chromatography.

  • Point of care testing

  • Solid/dry phase chemistry

  • Automated Analyzers (Abbot, IMX,…)

  • DNA/RNA/chromosomal (Analyses, PCR, Southern)

  • Interpretation of results.

  • Pathology reception of samples.

  • Urine Collections and Preparations.

 

IT AND COMMUNICATION

  • Computing within the laboratory.

  • Databases.

  • Spreadsheets.

 

QUALITY CONTROL

  • External Quality Assurance

  • National External Quality Assurance Service

 

OUTPATIENT CLINIC EXPERIENCE

  • Diagnosis of Biochemical/metabolic features of diseases and their abnormal findings in the laboratory.

  •  Advise on the differential diagnosis and initial management of common chemical pathology disorders.

 

 

TEACHING SKILLS

  • Develop an effective medical educational environment and help Clinical Fellows and Undergraduates to learn within that environment.

  • Write objectives for a teaching session.

  • Design and use a session plan.

  • Recognise the risk and complications of critical patients teaching and identify how to improve clinical practice.

  • Discuss good practice in teaching and learning evaluation.

  • Plan and undertake an evaluation of a teaching session.

  • Develop an effective training for nurses, physiotherapists and speach and language therapists in tracheostomy management.

RESEARCH SKILLS

  • Strong analytical management of databases.

  • Intermediate - Advanced user of Excel and SPSS.

  • Advanced user of literature databases for research.

  • Peer-review of journals. 

  • Knowledge of experimental - invitro laboratory management.

MANAGEMENT SKILLS

  • Strong analytical management of databases.

  • Intermediate - Advanced user of Excel and SPSS.

  • Advanced user of literature databases for research.

  • Peer-review of journals. 

  • Knowledge of experimental - invitro laboratory management.

AUDITS

2016 Evaluation and Assessment of Tracheostomy Management.  Through the Tracheostomy Report stablished we created a minimum data for the patients with tracheostomy in the Trust.  Training of doctors and nurses was evaluated and a new program was designed.

 

2016 Procalcitonin Test in Intensive Care Unit.  Assessment of Procalcitonin Test in critical care, evaluation of strength of test, results and efficiency in critical care patients.

 

2016 Conventional dialysis for hypertriglyceridaemic Pancreatitis.  Novel therapy ideated by me to treat hypertriglyceridaemic pancreatitis in a patient with this type of recurrence.

 

2015 High Flow Oxygen Therapy; Optiflow.  In collaboration with Respiratory Medicine, evaluation of treatment provided with High Flow Oxygen Therapy.  Development of guidelines and teaching in Newham University Hospital.

 

2014 Assessment of the Management of the Tracheostomy Service. Newham University Hospital. Audit presented in the Tracheostomy Working Group.  November 2014.

 

2013 Cardio - Respiratory Resuscitations Trolleys.  Newham University Hospital.  Audit presented in the monthly Staff Meeting February 2014.

 

2009 - 2013 Yearly audit in Sepsis in colaboration with the Spanish Intensive Care Society, in the program ENVIN.

 

2012 - 2013 Audit for the multicentric study ARIAM in Myocardial Infarction.  Spanish Intensive Care Society.

CRITICAL CARE SKILLS

AS A TEACHER / LECTURER

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  • Ultrasound Guided Percutaneous Tracheostomy.  Course: Tracheostomy.  Northwick Park Hospital. London. June 2019.

​​

  • Lumbar Puncture. Course: Postgraduate Doctors. 

       Educational SIM. Newham University Hospital. 2018, 2019

 

  • Ultrasound Guided Percutaneous Tracheostomy.  Course: Tracheostomy.  Northwick Park Hospital. London. June 2016.

​

  • Infection in the Intensive Care Unit.  Course: Infectious Diseases.  Barts Health Trust. London, May 2016.

​

  • Update of viral infections in the Intensive Care Unit.  Teaching sesion: Anaesthesia Department.  Barts Health Trust. London, May 2016.

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  • Fluid Management.  Course: Fluid Management in Intensive Care.  QMU – Newham Hospital. London.  February 2014, September 2015.

​

  • Bioethics in Intensive Care.  Course: The Rights of the Terminal Patient.  Zaragoza. Nov 22nd 2016.

​

  • Bioethics in Intensive Care.  Course: The Rights of the Terminal Patient.  Zaragoza. Nov 22nd 2011.

 

  • II Course of Electronic Patient Record.  Course: Development of a New EPR in Quiron Madrid Hospital.  Cantabria Nov 20-21st 2007.

 

  • Summer Course Alcalá University.  Course: Cardiovascular Risk and Metabolic Syndrome. June 28-29th 2004.

 

  • Summer Course Alcalá University.  Course: Cardiovascular Risk and Metabolic Syndrome.  Inflammatory Markers of Cardiovascular Risk in Obesity and Insulin Resistance. Madrid. June 28-29th 2004.

 

  • Doctorate Course Alcalá University.  Course: Pharmacocinetics and Immunosupressors.  Course 2003-2004.

 

  • Doctorate Course Alcalá University.  Course: Pharmacocinetics and Immunosupressors.  Course 2003-2004.

 

  • I Course of Histology. University School Cuellar. Course 1995-1996.

 

 

ATTENDANCE TO COURSES

 

  • London Organ Donation Collaborative. Blood and Transplant NHS. The Law Society, London.  7th November 2016.

  • Train the Trainers.  Newham University Hospital.  Alan Nftalin Centre for Educaton.  10/11th February 2016. 10 CPD.

  • Incident Management and Governance.  Newham University Hospital.  Barts Health Trust.  July 7th 2015.

  • Advanced Life Support Course.  Wipps Cross Hospital.  UK Resuscitation Council. April 30th 2015.

  • Enhanced Appraiser Certificate.  Training and Education Course.  Barts Health NHS Trust.  November 2014. 5 hours.

  • Advanced Tracheostomy Management.  Whipps Cross Hospital.  Barts Health NHS Trust.  September 26th 2014.  6 hours.

  • Induction for Clinical Fellows.  Newham University Hospital. Barths Health NHS Trust.  July 15 - 18th 2013.

  • Induction Training for Consultants.  King´s College Hospital.  January 17th 2013.

  • Induction Training for Junior Doctors.  King´s College Hospital.  January 17th 2013.

  • Organ Donation Coordination.  National Organ Donation Association.  Barcelona. Spain. 2012 (20 hours).

  • Echography in Intensive Care.  Continuous Physical Activities.  AGEDEC. Madrid. 2012.

    • Echocardiography. 12h

    • Thoracic Echography. 12h.

    • Abdominal Echography 12h.

    • Vascular Echography 12h.

  • Actualization and Experience in Haemostasis.  Continuous Physical Activities (3,9). La Paz Hospital. Madrid. July 11th 2011.

  • Nosocomial Infection Course in Intensive Care.  Continuous Physical Activities.  Madrid. June 13th 2011.

  • Bioethics in Intensive Care.  University of Zaragoza.  2011 – 2012.  10 hours.

  • Instruments for Diagnosis and Treatment in Intensive Care (III).  Intensive Care Society.  Valencia. May 2011 (20h).

  • Surgical Infection Course in Intensive Care.  Continuous Physical Activities.  AGEDEC. October 21 – 25th 2010.

  • Actualization in Gram positive Infections. Continuous Physical Activities.  Ministry of Health.  October 2010. (60h).

  • Instruments for Diagnosis and Treatment in Intensive Care (II).  Intensive Care Society.  Valencia. May 2010 (20h).

  • Advanced Life Support.  Intensive Care and Anesthesia Departments.  Lozano Blesa Clinical University Hospital.  March 2nd. 2011. (Revalidation April 30th 2015).

  • Instruments for Diagnosis and Treatment in Intensive Care (I).  Intensive Care Society.  Valencia. May 2009 (20h).

  • Patient Clinical Record and Clinical History.  Lozano Blesa Clinical University Hospital.  May 22-24th 2008.

  • Management Practical Course: “Metodology and Management in Quality Assurance in a Hospital”.  March 15-16-22-23 2004.  20 hours.

  • Specialized Course in Clinical Management. Clinical Biochemistry Module.  170 hours. 17 CPD.  June 2001 - April 2003.

  • Laboratory Informatic System OPENLABÒ.  Ramón y Cajal Hospital. Madrid. December 2002. 4 hours.

  • Statistics: Introduction to Methodology in Clinical Research.  Madrid.  May – June 2003; 34 hours.

  • Practical use of High Pressure Liquid Chromatography (HPLC) and LC/MS. Ramón y Cajal Hospital. April 8th 2003. 4,5 hours.

  • Accurate Correction. Madrid Medical Council.  April 28th 2003.  4 hours.

  • How to Create and Maintain Teams. Madrid Medical Council.  May 13th 2003.  4 hours.

  • Engineering in Decision Making. Madrid Medical Council.  May 12th 2003.  4 hours.

  • Direction of Directors. Madrid Medical Council.  May 19th 2003.  4 hours.

  • Communication in Management. Madrid Medical Council.  June 17th 2003.  4 hours.

  • How to Speak in Public Audiences. Madrid Medical Council.  May 2nd 2003.  4 hours.

  • Motivation. Madrid Medical Council.  May 3rd 2003.  4 hours.

  • Logistic Regression.  Statistics Department.  Ramón y Cajal Hospital.  May 2002.

  • Doctorate Courses.  Alcalá University.  Madrid. January – June 2002.

    • Hydroelectrolites alterations and AB (5 CPD).

    • Advances in Pneumology (5 CPD).

    • Avances en Neumología (5 CPD).

    • Molecular Biology in Cancer. (5 CPD).

    • Bioethics in Clinical Practice (4 CPD).

    • Actualization in Cystic Fibrosis. (3 CPD).

  • Radiology, Antibiotheraphy and A&E Medicine for Junior Doctors.  Ramón y Cajal Hospital. Madrid 2001.

  • Induction Course for Residents.  Ramón y Cajal Hospital. Madrid. July 2001.

  • Practical Course of Clinical Biochemisty in A&E. Ramón y Cajal Hospital, Madrid, agosto-septiembre del 2001. 8 weeks.

  • Training Course in Axsym Laboratory System. AbbotÒ Científica S.A, Madrid. October 2001. 24 hours.

  • Training Course in Aeroset Laboratory System. AbbotÒ Científica S.A, Madrid. October 2001. 24 hours.

  • Bioethics in a Multicultural Society. Josefa Segovia y La Salle University College.  Zaragoza. 1997. 15 hours.

  • Bioethics: To die with Dignity.  Health Science Fundation.

CASE PRESENTATIONS

 

  • Advanced Life Support MCQ. March 2018

      Newham University Hospital

 

  • Nasal High Flow Oxygen. Grand Round Meeting. 

      Newham University Hospital. February 2017

 

  • Acute Fatty Liver Disease of Pregnancy. Gran Round Meeting.  Newham University Hospital. March 10th 2015.

 

  • Effective Treatmet with Octreotide in the Acute Roux Stasis Syndrome.  M&M Meeting.  Newham University Hospital. December 4th 2014.

 

  • Severe Head Injury.  Intensive Care Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. March 19th 2013.

 

  • Brain Death.  Intensive Care Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. March 22th 2013.

 

  • Limitation of Care.  Intensive Care Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. March 13th 2012.

 

  • Supraventricular Arrythmias.  Intensive Care Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. April 17th 2012.

 

  • Thrombopathy in Pregnancy.  Intensive Care Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. March 13th 2012.

 

  • Unknown Embolic Death.  Case Presentation.  Intensive Care Society. Feb 2011.

 

  • Diagnosis in Rheumatology.  Practical Presentation. Intensive Care Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. March 17th 2010.

 

  • Pancoast Syndrome.  Case Presentation. Internal Medicien Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. March 18th 2009.

 

  • Autolitic Attempt with Insulin.  Case Presentation. A&E Department.  Lozano Blesa Clinical University Hospital. Zaragoza. Spain. February 11th 2009.

 

  • Immunosuppressors in Liver Transplant.  Biochemistry Department.  Ramón y Cajal Hospital. Madrid. Spain. June 2004.

 

  • Biochemistry in the Art.  Biochemistry Department.  Ramón y Cajal Hospital. Madrid. Spain. November 2003.

 

  • Biochemical Interferences.  Biochemistry Department.  Ramón y Cajal Hospital. Madrid. Spain. February 2002.

COURSES

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