The ASCERT course recognizes that, whatever your specialty and career aspirations, you will be faced with acutely unwell patients, whose morbidity and mortality are reliant on your initial assessment and management of their clinical care. Our intention is to offer you the opportunity to consolidate your knowledge and to develop and practice some of the essential skills inherent in achieving an optimal outcome for your patients.
Doctors must be FY2 or above to attend ASCERT
The ASCERT course has been designed by a group of like-minded specialists who have a particular interest in education and a strong desire to establish high quality clinical performance. It has been overseen and edited by an internationally recognised clinical educator and it is intended to try and encourage learning. The ASCERT course involves
- Interactive presentations
- Small group workshops
- Practical skills stations
- Clinical simulations
- Communication and Human Factors
- Assessment
Acute deterioration in clinical condition can occur in any patient, in any setting and, potentially, in any way. Major acute illnesses may represent:-
- an acute exacerbation of an underlying chronic illness, such as coronary artery disease, diabetes
- the presentation of a new or previously undiagnosed or unrecognised condition eg epilepsy
- a complication of intervention eg contrast imaging and anaphylaxis, post-operative sepsis or acute kidney injury
- a complication of a physiological condition such as pregnancy
Severity of acute illness can range from relatively minor and easily reversible through a whole spectrum to life-threatening or fatal. Appreciation of severity can be complex at outset and a low threshold of suspicion is advocated in ASCERT.
The fundamental ethos of ASCERT is to achieve early recognition of acute illness, assure its organised effective assessment and the institute appropriate early management – these functions are vital and have direct influence on the patient’s definitive care and outcome ie on both their morbidity and their mortality. It has been recognised by many institutions and organisations including the King’s Fund, NICE, the Society for Acute Medicine UK (SAMUK) and the Resuscitation Council UK (RCUK) that the application of generic response and treatment skills to the acute clinical arena is of proven benefit, positively influencing patient illness trend and trajectory. Markers of this benefit include earlier patient recovery linked to more rapid re-acquisition of acceptable physiological stability, reduced length of hospital stay with concomitant reduction in inferred risk and both the avoidance of the need for unplanned Intensive Care Unit admission and reduction in the rate of unexpected cardiorespiratory arrest. An important by-product in ASCERT is the experience gained of enhanced personal confidence, self-esteem and job satisfaction, which further directly influences good patient care.
ASCERT is permeating out to a number of course centres. There is a continuing need to train and recruit suitable faculty for ASCERT. Faculty should be at ST3 or equivalent grade and above, they should hold the relevant postgraduate examination and should have completed an instructor course (this could be Generic Instructor Course, ATLS instructor course or the 1-day ASCERT instructor course).
| Initial assessment of the critically ill medical patient | |||
| Demonstration of assessment scheme | |||
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Interactive tutorials & lectures
Breathing Shock GI emergencies |
ACS and heart failure Sepsis Acute neurology |
AKI Poisoning
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Practical workshops Airway Vascular access |
NIV CVC and IO |
Thoracocentesis LP | |
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Data interpretation practical workshops ECG + arrhythm Electrolytes Transfusion |
CXR Metabolic Pain |
Oxygen Fluid balance Transfer |
ABG
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Scenarios | |||
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Long case assessments | |||
| Communication skills |
