Emergency medicine CESR Portfolio Guide

• Being an expert in assessing and managing all adult patients attending the ED. These capabilities will apply to patients attending with both physical and psychological ill health

ACCS LO 2. Make safe clinical decisions, appropriate to level of experience, knowing when and how to seek effective support

• An ability to support the pre-hospital, medical, nursing, and administrative team in answering clinical questions and in making safe decisions for discharge, with appropriate advice for management beyond the ED.
• Awareness of when it is appropriate to review patients remotely or directly and able to teach these principles to others.
• understanding how to apply clinical guidelines.
• understanding how to use diagnostic tests in ruling out key pathology, and be able to describe a safe management plan, including discharge where appropriate, knowing when help is required
• being aware of the human factors at play in clinical decision making and their impact on patient safety

• providing airway management & ventilatory support to critically ill patients
• being an expert in fluid management and circulatory support in critically ill patients (will need training)
• managing all life-threatening conditions including peri-arrest & arrest situations in the ED
• being an expert in caring for ED patients and their relatives and loved ones at the end of the patient’s life
• to effectively lead and support resuscitation teams
• Will be able to provide safe and effective care for critically ill patients across the spectrum of single or multiple organ failure
• Will be able to plan and communicate effectively with patients, relatives and the wider multi-professional team when attending to the clinical and holistic needs of patients.

• Being an expert in assessment, investigation and initial management of patients attending with all injuries, regardless of complexity
• providing expert leadership of the Major Trauma Team
• Pre-operatively assess, optimise and prepare patients for anaesthesia.
• Safely induce, maintain and support recovery from anaesthesia including recognition and management of complications.
• Providing urgent or emergency anaesthesia to ASA 1E and 2E patients requiring uncomplicated surgery including stabilization and transfer
• Providing safe procedural sedation for ASA 1E and 2E patients
• Provide evidence of IAC for anaesthesia

• Being an expert in assessing and managing all children and young adult patients attending the ED. These capabilities will apply to patients attending with both physical and psychological ill health and include concerning presentations that could be manifestations of abuse.
• Being able to lead a multidisciplinary paediatric resuscitation including trauma.
• Being able to assess and formulate a management plan for children and young adults who present with complex medical and social needs.

• the clinical knowledge to identify when key EM practical emergency skills are indicated.
• the knowledge and psychomotor skills to perform EM procedural skills safely and in a timely fashion
• Will be able to supervise and guide colleagues in delivering procedural skills.

• having expert communication skills to negotiate manage complicated or troubling interactions
• behaving professionally in dealings with colleagues and team members within the ED
• working professionally and effectively with those outside the ED

• Will provide support to ED staff of all levels and disciplines on the ED shift.
• Will be able to liaise with the rest of the acute / urgent care team and wider hospital as shift leader.
• Will maintain situational awareness throughout the shift to ensure safety is optimised.
• Will anticipate challenges, generate options, make decisions and communicate these effectively to the team as lead clinician.

• being able to undertake training and supervision of members of the ED team in the clinical environment.
• being able to prepare and deliver teaching sessions outside of the clinical environment, including simulation, small-group work and didactic teaching.
• being able to provide effective constructive feedback to colleagues, including debrief understand the principles necessary to mentor and appraise junior doctors.

• being able to appraise, synthesise, communicate and use research evidence to develop EM care.
• being able to actively participate in research.

• being able to provide clinical leadership on effective Quality Improvement work.
• being able to support and develop a culture of departmental safety and good clinical governance.

• having experience of handling a complaint, preparing a report for the coroner, preparing a report for the trust legal department, and be aware of the relevant medico-legal directives (elements not completed in intermediate)
• Being able to investigate a critical incident, participate and contribute effectively to department clinical governance activities and risk reduction projects.
• Being able to manage a complaint from the time it is received through to a resolution
• Being able to manage the staff rota, being aware of relevant employment law and recruitment activities including interviews and involvement in induction.
• Being able to effectively represent the ED at inter specialty meetings.

Currency Window

Evidence of skills or experience from the last six years of recent working practice (WTE, does not need to be consecutive) is acceptable. If you have worked less than full time (LTFT) or have had a break in practice in the last six years, evidence can be provided from additional years or whole-time equivalence (WTE). In this situation, you must clearly explain any gaps.

Evidence Volume

800-1000 pages of evidence – a maximum of 100 electronic uploads