The Advanced Practitioner in Acute, Emergency and Critical Care E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: Advanced Clinical Practice
• Sprache: Englisch

Seitenzahl: 971

Veröffentlichungsjahr: 2023

Beschreibung

The Advanced Practitioner in Acute, Emergency and Critical Care

Dedicated text for trainee and newly-qualified Advanced Practitioners specialising in acute, emergency and critical care

Aligned with the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC) regulatory body requirements, this formative text is the first of its kind, covering a variety of key topics for advanced practitioners working in acute, emergency and critical care.

Written by experienced advanced practitioners and academics closely involved in the delivery of both the clinical and academic components of advanced practice training programmes, The Advanced Practitioner in Acute, Emergency and Critical Care presents:

• Complex decision making, covering legal and ethical frameworks (including patient safety), communication skills and breaking bad news, and end of life care
• Diagnosis and management of patients, covering radiology, principles of point of care ultrasound (PoCUS), laboratory tests and prescribing
• Resuscitation and first stage management of the critically unwell, advanced resuscitation skills, shock, intra- and inter-hospital transfers, and organ donation
• History taking, physical examination, and consultation models
• Learning support with accreditation considerations boxes, clinical investigations, examination scenarios, pharmacology boxes, pathological and psychological considerations, social and cultural considerations, case studies, self-assessment questions, and more

Utilising a multi-professional and inclusive framework of advanced level practice, this is an essential resource for all trainee and newly-qualified advanced practitioners. The text also serves as an excellent classroom aid for lecturers teaching advanced practice courses.

Leseprobe

Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

About the Editors

Notes on Contributors

Preface

Acknowledgements

How to Use Your Text Book – Pedagogical Features Contained Within Your Textbook

UNIT 1: CONTINUOUS PROFESSIONAL DEVELOPMENT, APPRAISAL AND REVALIDATION

CHAPTER 1: Governance

INTRODUCTION

THE MULTI‐PROFESSIONAL FRAMEWORK (MPF)

GOVERNANCE

REGULATION STATEMENTS OF STANDARDS AND CODE OF CONDUCTS

NURSING AND MIDWIFERY COUNCIL (NMC)

HEALTH AND CARE PROFESSIONS COUNCIL (HCPC)

REFERENCES

CHAPTER 2: Continuous Profession Development (CPD), Appraisal and Revalidation

INTRODUCTION

PROFESSIONAL DEVELOPMENT AND TRANSITION IN ADVANCED PRACTICE

PERSONAL PROFESSIONAL DEVELOPMENT

CREDENTIALS, CAPABILITIES, OR COMPETENCIES

SUPERVISION

CONTINUING PROFESSIONAL DEVELOPMENT‐USING APPRAISALS EFFECTIVELY

ATTITUDES TO LEARNING

SUPPORTING PROFESSIONAL DEVELOPMENT WITHIN A TEAM

CONTRIBUTION TO BROADER DEVELOPMENT OF AP

WHAT NEXT?

REFERENCES

UNIT 2: COMPLEX DECISION MAKING

CHAPTER 3: Ethics and Legal Principles

INTRODUCTION

PATIENT SAFETY, ETHICS AND ADVANCED CLINICAL PRACTICE

CONSENT

TREATY OF OVIEDO ON HUMAN RIGHTS AND BIOMEDICINE

WRITTEN CONSENT

VERBAL (EXPLICIT) AND NON‐VERBAL (IMPLIED OR IMPLICIT) CONSENT

BEST INTERESTS PRINCIPLE IN EMERGENCY SITUATIONS

ELECTRONIC CONSENT (E‐CONSENT)

DUTY OF CANDOUR

DISCLOSURE PROCESS FOR NOTIFIABLE SAFETY INCIDENTS (STATUTORY DUTY OF CANDOUR)

WITHHOLDING AND WITHDRAWING TREATMENT

REFERENCES

SUGGESTED READING

CHAPTER 4: Communication Skills and Breaking Bad News

INTRODUCTION

VERBAL AND NON‐VERBAL COMMUNICATION

PATIENT‐CENTRED COMMUNICATION

‘GOALS OF CARE’ AND DIFFICULT CONVERSATIONS

HUMAN FACTORS

CONSIDERATIONS FOR PAEDIATRIC AND YOUNG PERSONS POPULATIONS

MENTAL HEALTH CONSIDERATIONS

CONSIDERATIONS FOR PERSONS WITH LEARNING DISABILITIES

REFERENCES

FURTHER READING

CHAPTER 5: Advanced Clinical Decision‐making and End‐of‐life Care

INTRODUCTION

ADVANCED DECISION‐MAKING

ADVANCED DECISION‐MAKING IN COMPLEX ENVIRONMENTS

END‐OF‐LIFE CARE

LEGAL AND ETHICAL CONSIDERATIONS

OPEN AND HONEST CONVERSATIONS

DECISIONS TO ESCALATE, LIMIT, OR WITHDRAW LIFE‐SUSTAINING TREATMENT

THE IMPORTANCE OF EFFECTIVE COMMUNICATION

PRACTICAL CONSIDERATIONS

MEDICINES MANAGEMENT

PALLIATIVE CARE IN CRITICAL ILLNESS

REFERENCES

FURTHER READING

UNIT 3: HISTORY TAKING AND PHYSICAL EXAMINATION SKILLS IN ACUTE, EMERGENCY, AND CRITICAL CARE

CHAPTER 6: Consultation Models and Diagnostic Reasoning

INTRODUCTION

CLASSIFICATION OF CONSULTATION MODELS

CALGARY‐CAMBRIDGE GUIDES TO THE MEDICAL INTERVIEW

MNEMONICS

THE CONE TECHNIQUE

THE PATIENT PERSPECTIVE OF CONSULTATION AND THE USE OF IDEAS, CONCERNS, AND EXPECTATIONS (ICE)

COMMUNICATION

KINESICS INTERVIEWING

EQUALITY, DIVERSITY, AND INCLUSIVITY CONSIDERATIONS

HISTORY‐TAKING FOR NEURODIVERSE AND NON‐VERBAL POPULATIONS

HISTORY TAKING FOR ETHNIC MINORITY POPULATIONS

TRIGGERS TO CONSULTATION

CONSULTATIONS WITH AN ALTERNATIVE AGENDA

CLINICAL REASONING AND THE CONSULTATION

COGNITIVE AND META‐COGNITIVE PROCESSES

DUAL PROCESS THEORY AND COGNITIVE BIAS IN DIAGNOSTIC REASONING

INTEGRATING THE CLINICAL REASONING PROCESS INTO THE CLINICAL CONSULTATION

EVIDENCE‐BASED DIAGNOSIS

BAYES' THEOREM

2 × 2 CONTINGENCY TABLE

THE INACCURACIES OF DIAGNOSTIC ACCURACY

REFERENCES

FURTHER READING

CHAPTER 7: Respiratory Presentations

INTRODUCTION

RESPIRATORY HISTORY‐TAKING

SOCIAL HISTORY

MEDICATION HISTORY

FAMILY HISTORY

OTHER QUESTIONS TO CONSIDER

ASTHMA

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

RESPIRATORY FAILURE

COMMUNITY ACQUIRED PNEUMONIA (CAP)

PULMONARY EMBOLISM

LUNG CANCER

REFERENCES

FURTHER READING

CHAPTER 8: Cardiac Presentations

INTRODUCTION

THE CARDIOVASCULAR SYSTEM

CARDIAC IMAGING

REFERENCES

CHAPTER 9: Neurological and Endocrine Presentations

INTRODUCTION

NEUROLOGICAL AND ENDOCRINOLOGICAL HISTORY‐TAKING

NEUROLOGICAL PRESENTATIONS

SEIZURES AND STATUS EPILEPTICUS

MENINGITIS AND ENCEPHALITIS

ENDOCRINE PRESENTATIONS

REFERENCES

FURTHER READING

CHAPTER 10: AECC Renal and Genitourinary Presentations

INTRODUCTION

RENAL FAILURE

RENAL CALCULI

SERUM ELECTROLYTES AND RENAL INSUFFICIENCY

REFERENCES

FURTHER READING

CHAPTER 11: Gastrointestinal and Hepato‐Pancreato‐Biliary

INTRODUCTION

ACUTE PANCREATITIS

CLINICAL FEATURES

AIRWAY AND BREATHING

REFERENCES

FURTHER READING

CHAPTER 12: Haematological and Oncological Presentations

INTRODUCTION

HAEMATOLOGIC EMERGENCIES

ACUTE PULMONARY EMBOLISM

BRAIN METASTASES

TUMOUR LYSIS SYNDROME

LEUKAEMIA

NEUTROPENIC SEPSIS

ANTIVIRAL IMMUNODEFICIENCY

PLATELET DISORDERS

DISSEMINATED INTRAVASCULAR COAGULATION

IMMUNOTHERAPY AND CHEMOTHERAPY

IMMUNOTHERAPY

CHECKPOINT INHIBITORS

BACILLUS CALMETTE‐GUERIN

VIRUS THERAPY TO TREAT CANCER

MONOCLONAL ANTIBODIES

CANCER VACCINES

ADOPTIVE CELL TRANSFER AND CAR‐T THERAPY

SIDE EFFECTS OF IMMUNOTHERAPY

CHEMOTHERAPY

RADIATION THERAPY

HAEMOSTASIS

SYSTEMIC BLEEDING DISORDERS

BLOOD DYSCRASIAS

ANAEMIA

HAEMOLYTIC ANAEMIAS

THALASSAEMIA

SICKLE CELL ANAEMIA

HUMAN IMMUNODEFICIENCY VIRUS

GRANULOCYTOPENIA

REFERENCES

FURTHER READING

CHAPTER 13: Rheumatological and Immunological Presentations

INTRODUCTION

RHEUMATOLOGICAL EMERGENCIES

IMMUNOLOGIC EMERGENCIES

AUTOIMMUNE DISORDERS

REFERENCES

FURTHER READING

CHAPTER 14: Mental Health Presentations

INTRODUCTION

PARITY OF ESTEEM

MENTAL HEALTH AND ETHNICITY

HOLISTIC ASSESSMENT IN MENTAL HEALTH

WHY?

WHAT?

WHERE?

WHO?

WHEN?

PHARMACOLOGICAL PRINCIPLES IN MENTAL HEALTH

LITHIUM TOXICITY

THINKING ABOUT ACUTE CARE

THINKING ABOUT EMERGENCY CARE

PSYCHOLOGICAL WELLBEING IN THE CRITICAL CARE ENVIRONMENT

POST‐TRAUMATIC STRESS DISORDER

POST‐INTENSIVE CARE SYNDROME

REFERENCES

UNIT 4: DIAGNOSIS AND MANAGEMENT IN ACUTE, EMERGENCY, AND CRITICAL CARE

CHAPTER 15: Radiology

INTRODUCTION

IONISING RADIATION (MEDICAL EXPOSURE) REGULATIONS (IR[ME]R) CONSIDERATIONS

GYNAECOLOGY

UROLOGY

VASCULAR

RESPIRATORY

LUNG ULTRASOUND

APPROACH TO PULMONARY EMBOLISM

SEVERE/ATYPICAL OR UNRESOLVING SYMPTOMS

NEUROLOGY

STROKE/TRANSIENT ISCHAEMIC ATTACK

HEAD INJURY/TRAUMA

CONFUSION/ENCEPHALITIS

CASE STUDY – COLLAPSE AND REDUCED GCS

GASTROINTESTINAL

CASE STUDY – ABDOMINAL PAIN

PHARMACOLOGY

NUCLEAR MEDICINE

SEDATION

DRUG HISTORY

LEARNING EVENTS

DELAYED REPORTING

REFERENCES

FURTHER READING

CHAPTER 16: Principles of Point of Care Ultrasound

INTRODUCTION

HOW IS ULTRASOUND GENERATED?

HEART ULTRASOUND

RED FLAG PATHOLOGY

DISTRIBUTIVE (OR VASOPLEGIC) SHOCK AND HYPOVOLEMIC SHOCK

LUNG ULTRASOUND

RED FLAG PATHOLOGY

VASCULAR ULTRASOUND

DEEP VEIN THROMBOSIS (DVT) ASSESSMENT

RED FLAG PATHOLOGY

ABDOMINAL ULTRASOUND

RED FLAG PATHOLOGY

DISCUSSION

REFERENCES

CHAPTER 17: Laboratory Tests

INTRODUCTION

BLOOD COLLECTION

U&ES

LIVER FUNCTION TESTS

ARTERIAL BLOOD GASES (ABGS)

OTHER KEY BIOCHEMISTRY INVESTIGATIONS

CARDIOVASCULAR

GASTROENTEROLOGY

HAEMATOLOGY

RESPIRATORY

RENAL

ENDOCRINOLOGY

FIELDS OF PRACTICE – PAEDIATRICS

FIELDS OF PRACTICE – MENTAL HEALTH

FIELDS OF PRACTICE – LEARNING DISABILITIES

LEARNING EVENTS

PHARMACOLOGICAL PRINCIPLES

REFERENCES

FURTHER READING

CHAPTER 18: Pharmacology and Prescribing for the Acute, Emergency, and Critical Care Populations

INTRODUCTION

GENERAL PRESCRIBING FRAMEWORKS AND GOVERNANCE CONSIDERATIONS

LEGAL AND ETHICAL CONSIDERATIONS IN PRESCRIBING

CLINICAL ASSESSMENT FOR PRESCRIBING

GUIDED ASSESSMENT

IMPLICATIONS OF RESULTS

PHARMACOLOGY–PHYSIOLOGY INTERFACE

PHARMACOLOGICAL FACTORS

KINETIC CHANGES IN ACUTE AND CRITICAL ILLNESS

PRESCRIBING FOR PATIENTS UNDERGOING CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT)

PRESCRIBING IN OBESITY

PRESCRIBING IN PREGNANCY

PRESCRIBING IN LIVER IMPAIRMENT

AUTHORISATION OF BLOOD AND BLOOD PRODUCTS

CONSENT AND TRANSFUSION

RISK FACTORS

SPECIALIST REQUIREMENTS

REFERENCES

FURTHER READING

CHAPTER 19: Advanced and Extended Procedures for AECC Populations

INTRODUCTION

GOVERNANCE, NATIONAL SAFETY STANDARDS FOR INVASIVE PROCEDURES (NATSSIPS) AND LOCAL SAFETY STANDARDS FOR INVASIVE PROCEDURES (LOCSSIPS)

CONSIDERATIONS FOR ALL PROCEDURES

ANALGESIA AND ANAESTHESIA

COMPLICATIONS OF LOCAL ANAESTHESIA

LUMBAR PUNCTURE (DIAGNOSTIC)

LARGE VOLUME PARACENTESIS (LVP)

THE SELDINGER TECHNIQUE

ARTERIAL CATHETERISATION

CENTRAL VENOUS CATHETERS

THORACENTESIS

REFERENCES

FURTHER READING

UNIT 5: RESUS & 1ST STAGE MX OF THE CRITICALLY UNWELL

CHAPTER 20: Advanced Life Support

INTRODUCTION

CRITICAL CARE EMERGENCIES AND HUMAN FACTORS

DEBRIEFING

REFERENCES

FURTHER READING

CHAPTER 21: Shock

INTRODUCTION

CLASSIFICATION AND AETIOLOGY

PATHOPHYSIOLOGY OF SHOCK

PATHOPHYSIOLOGY OF SEPSIS

STAGES OF SHOCK

ASSESSMENT AND MANAGEMENT OF SHOCK

CLINICAL INVESTIGATIONS

FIELD OF PRACTICE: PAEDIATRICS

PHARMACOLOGICAL PRINCIPLES

PATHOLOGICAL CONSIDERATIONS

REFERENCES

FURTHER READING

CHAPTER 22: Intra/Inter Hospital Transfers

INTRODUCTION

GENERAL TRANSFER PRINCIPLES

ADVANCED PRACTITIONERS LEADING TRANSFERS

COMMUNICATION AND DOCUMENTATION

PREPARATION

OXYGEN CALCULATIONS – SPONTANEOUSLY BREATHING PATIENT

OXYGEN CALCULATIONS – VENTILATED PATIENT

HANDOVER/AUDIT

RED FLAGS

CLINICAL INVESTIGATIONS AND PROCEDURES

PSYCHOLOGICAL, SOCIAL, AND CULTURAL CONSIDERATIONS

MEDICATION MANAGEMENT

REFERENCES

CHAPTER 23: Organ Donation and Optimisation

INTRODUCTION

METHODS OF ORGAN DONATION

EARLY NOTIFICATION TO THE SPECIALIST NURSE ORGAN DONATION SERVICE

ROLE OF THE SPECIALIST NURSE FOR ORGAN DONATION

DONOR PHYSIOLOGY

DIAGNOSIS OF DEATH

THE TESTS

OPTIMISATION AND THE DONOR OPTIMISATION CARE BUNDLE

PATIENT OPTIMISATION

TISSUE DONATION

REFERENCES

FURTHER READING

Prefixes and Suffixes

Normal Values

Index

End User License Agreement

List of Tables

Chapter 2

TABLE 2.1 The differences between types of supervision roles.

Chapter 3

TABLE 3.1 The four‐box approach to clinical ethics.

TABLE 3.2 Guidance on professional standards and ethics for doctors.

TABLE 3.3 Disclosure process for low‐harm incidents (Professional Duty of C...

TABLE 3.4 Building a culture of candour.

Chapter 4

TABLE 4.1 SPIKES communication framework.

TABLE 4.2 Barriers to effective communication.

Chapter 5

TABLE 5.1 Key factors and components of clinical reasoning and complex decis...

TABLE 5.2 Decision‐making in complex scenarios and in EOLC decisions.

Chapter 6

TABLE 6.1 Enhanced Calgary‐Cambridge consultation model.

TABLE 6.2 Components of an adult health history and associated mnemonics.

TABLE 6.3 Specific challenges in taking a history of neurodiverse populatio...

TABLE 6.4 Alternative agendas and suggested communication tools.

TABLE 6.5 The diverse range of terms used to refer to clinical reasoning wi...

TABLE 6.6 The characteristics of dual process theory.

TABLE 6.7 Five steps to improve teaching and learning critical thinking skil...

TABLE 6.8 The clinical reasoning process within a consultation.

TABLE 6.9 Statistical terms pertaining to evidence‐based diagnosis.

Chapter 7

TABLE 7.1 mMRC dyspnoea scale.

TABLE 7.2 ECOG performance status.

TABLE 7.3 The common precipitating factors of asthma.

TABLE 7.4 Differential diagnosis of asthma.

TABLE 7.5 Management of acute asthma.

TABLE 7.6 Discharge criteria for a patient with asthma.

TABLE 7.7 Signs and symptoms of respiratory failure.

TABLE 7.8 Examples of ABG showing respiratory failure.

TABLE 7.9 Signs and symptoms of CAP.

TABLE 7.10 CURB 65 criteria to assess risk of mortality in hospital.

TABLE 7.11 Complications of CAP.

TABLE 7.12 NICE criteria for safe discharge from hospital.

TABLE 7.13 Clinical characteristics of PE.

TABLE 7.14 Risk factors for PE.

TABLE 7.15 The PERC rule.

TABLE 7.16 Wells score.

TABLE 7.17 PE severity risk.

TABLE 7.18 Choice of coagulation.

TABLE 7.19 Risk factors for lung cancer.

TABLE 7.20 Investigations and rationale.

TABLE 7.21 Classification of lung cancer.

Chapter 8

TABLE 8.1 Causes of red flag: chest pain.

TABLE 8.2 Causes of red flag: shortness of breath.

TABLE 8.3 Risk factors in CVD.

TABLE 8.4 Special cardiac considerations in diverse groups.

TABLE 8.5 Inspection findings.

TABLE 8.6 Palpation findings.

TABLE 8.7 Auscultation findings.

TABLE 8.8 ECG features, waves and segments.

TABLE 8.9 Routine blood tests to be requested in conjunction with cardiac‐s...

TABLE 8.10 BNP and NT‐proBNP as a diagnostic tool for heart failure.

TABLE 8.11 Commonly used cardiac drugs in AECC.

TABLE 8.12 Acute coronary syndromes.

TABLE 8.13 Heart failure.

TABLE 8.14 Supraventricular tachycardia.

TABLE 8.15 Infective endocarditis.

Chapter 9

TABLE 9.1 The NIHSS tool.

Chapter 10

TABLE 10.1 The aetiology of AKI.

TABLE 10.2 AKI diagnostic criteria.

TABLE 10.3 AKI staging criteria.

TABLE 10.4 A demonstration of multisystem signs and symptoms of CKD.

TABLE 10.5 UTI sites, signs, and symptoms.

TABLE 10.6 Specialist tests and investigations.

TABLE 10.7 Key prescribing considerations in renal presentations.

Chapter 11

TABLE 11.1 Causes of acute pancreatitis.

TABLE 11.2 Clinical features of pancreatitis.

TABLE 11.3 Investigations in acute pancreatitis.

TABLE 11.4 Identifies the main causes of ALF.

TABLE 11.5 Laboratory testing in acute liver failure.

TABLE 11.6 Treatment for the less common presenting causes of ALF.

TABLE 11.7 Causes of upper gastro‐intestinal bleeding and occurrence freque...

Chapter 12

TABLE 12.1 Examples of molecular markers used in cancer diagnosis and progn...

TABLE 12.2 Classification by tissue type and malignant tumours.

Chapter 13

TABLE 13.1 Classification of rheumatologic emergencies.

TABLE 13.2 Classification of immunological conditions.

TABLE 13.3 Common autoimmune diseases.

Chapter 15

TABLE 15.1 Radiation doses for commonly ordered investigations in acute car...

TABLE 15.2 Pros and cons of key imaging modalities.

TABLE 15.3 Imaging investigations for cardiac presentations.

TABLE 15.4 Imaging investigations for musculoskeletal presentations.

TABLE 15.5 Gynaecological pathologies.

TABLE 15.6 Imaging investigations for urological presentations.

TABLE 15.7 Structured approach to x‐ray interpretation.

TABLE 15.8 Findings and investigations in common respiratory pathologies.

TABLE 15.9 Imaging investigations for neurological pathologies.

TABLE 15.10 CT findings in neurological pathologies.

TABLE 15.11 National Institute of Health and Care Excellence (NICE) Guidanc...

TABLE 15.12 Imaging investigations in abdominal presentations.

TABLE 15.13 Imaging considerations in special populations.

Chapter 16

TABLE 16.1 Focussed heart clinical questions.

TABLE 16.2 Focussed lung clinical questions.

TABLE 16.3 Focussed DVT clinical Questions.

TABLE 16.4 Focussed abdomen clinical questions.

TABLE 16.5 Five pillars of point‐of‐care ultrasound.

Chapter 17

TABLE 17.1 Common blood collection tubes.

TABLE 17.2 Full blood count: red cells.

TABLE 17.3 Full blood count: white cells.

TABLE 17.4 Full blood count: platelets.

TABLE 17.5 Haematinics.

TABLE 17.6 U&Es

TABLE 17.7 LFTs.

TABLE 17.8 ABGs.

TABLE 17.9 Other biochemistry investigations.

TABLE 17.10 Clotting tests.

TABLE 17.11 Clinical pictures.

TABLE 17.12 Cardiovascular symptom plan.

TABLE 17.13 Gastroenterology symptom plan.

TABLE 17.14 Haematological symptom plan.

TABLE 17.15 Respiratory symptom plan.

TABLE 17.16 Renal symptom plan.

TABLE 17.17 Endocrinology symptom plan.

Chapter 18

TABLE 18.1 The effect of acidosis on cardiac muscle.

TABLE 18.2 The effect of acidosis on vasculature smooth muscle and endothel...

TABLE 18.3 Worked example of use of the Henderson‐Hasselbalch equation in c...

TABLE 18.4 Adjusting doses for extremes of weight.

TABLE 18.5 Minimum requirements for written authorisation of blood.

Chapter 19

TABLE 19.1 Characteristics of the amide local anaesthetic agents.

TABLE 19.2 Complications of local anaesthesia.

TABLE 19.3 Signs and symptoms of LA toxicity.

TABLE 19.4 Target vessel position and anatomical landmark.

Chapter 20

TABLE 20.1 Airway emergencies that may be encountered within AECCE.

TABLE 20.2 Breathing emergencies that may be encountered within AECCE.

TABLE 20.3 Circulatory emergencies that may be encountered within AECCE....

TABLE 20.4 Neurological emergencies that may be encountered within AECCE....

TABLE 20.5 Emergencies concerning exposure, endocrine, electrolytes

TABLE 20.6 The SBAR tool.

Chapter 21

TABLE 21.1 Distributive shock.

TABLE 21.2 Cardiogenic shock.

TABLE 21.3 Hypovolaemic shock.

TABLE 21.4 Obstructive shock.

TABLE 21.5 Haemodynamic variables in shock.

TABLE 21.6 Stages of shock.

TABLE 21.7 Possible findings on CVS examination in shock.

TABLE 21.8 Normal heart rates in children.

TABLE 21.9 First hour management of shock in children.

TABLE 21.10 Effects of vasoactive medication in children.

Chapter 22

TABLE 22.1 MINT mnemonics (Malpass et al. 2012).

TABLE 22.2 The A–E assessment for transfer (Malpass et al. 2012).

TABLE 22.3 PERSONAL mnemonic for transfer (Malpass et al. 2012).

Chapter 23

TABLE 23.1 Pathophysiological response and the clinical consequences to neu...

TABLE 23.2 Hallmark signs of Cushing's reflex.

TABLE 23.3 Confirmation of death – neurological and circulatory.

TABLE 23.4 Brain stem tests and cranial nerves.

List of Illustrations

Chapter 2

FIGURE 2.1 Layers of professional development and transition in advanced pra...

FIGURE 2.2 The professional development journey.

Chapter 4

FIGURE 4.1 Model of patient‐centred communication.

FIGURE 4.2 GMC considerations for communicating with children.

Chapter 6

FIGURE 6.1 Consultation models and their differing emphasis on four common d...

FIGURE 6.2 A pictorial representation of the open to closed cone described i...

FIGURE 6.3 The elements involved in clinical reasoning, underpinned by a kno...

FIGURE 6.4 Traditional findings versus evidence‐based method of diagnosis. A...

FIGURE 6.5 A two‐by‐two square.

Chapter 7

FIGURE 7.1 Hospital admissions in the 10 years (1999–2019) for respiratory c...

FIGURE 7.2 Signs and symptoms of respiratory illness.

FIGURE 7.3 Algorithm for asthma diagnosis.

FIGURE 7.4 Pharmacological management of asthma.

FIGURE 7.5 Virchow's Triad.

FIGURE 7.6 Signs and symptoms of both specific and non‐specific to lung canc...

Chapter 8

FIGURE 8.1 The heart, major structures and blood flow.

FIGURE 8.2 Structures of arteries, veins, and capillaries.

FIGURE 8.3 The circulatory system.

FIGURE 8.4 Conduction system of the heart.

FIGURE 8.5 Heart sound auscultation points.

FIGURE 8.6 Chest leads.

FIGURE 8.7 Limb leads.

FIGURE 8.8 ECG waveform.

FIGURE 8.9 A normal 12‐lead ECG.

FIGURE 8.10 Sinus tachycardia.

FIGURE 8.11 Ventricular arrhythmias.

FIGURE 8.12 Atrioventricular rhythms.

FIGURE 8.13 Troponin Complex.

FIGURE 8.14a CXR pulmonary oedema.

FIGURE 8.14b CXR cardiomegaly.

FIGURE 8.14c CXR pacemaker/ICD and sternotomy wires in PA and lateral views....

FIGURE 8.15 (a and b) Curved multiplanar reconstruction of CTCA correlates w...

FIGURE 8.16 Cardiac MRI short‐axis view depicting (a) normal heart and (b) p...

FIGURE 8.17 ECG with inferior and lateral ST elevation‐ACS. There is ST elev...

FIGURE 8.18 ECG with broad‐complex tachycardia, LBBB pattern.

FIGURE 8.19 CXR of pulmonary oedema.

FIGURE 8.20 ECG with supraventricular tachycardia. Arrow heads point to P wa...

FIGURE 8.21 Transoesophageal echocardiogram of aortic valve vegetation and p...

Chapter 9

FIGURE 9.1 Equation for cerebral perfusion pressure where MAP is mean arteri...

FIGURE 9.2 Clinical features of thyrotoxicosis and the additional features o...

FIGURE 9.3 CT scan showing left‐sided EDH.

FIGURE 9.4 CT scan image demonstrating right sided SDH.

FIGURE 9.5 CT scan image demonstrating an IPH with ventricular extension....

FIGURE 9.6 CT scan image demonstrating IVH.

FIGURE 9.7 Non‐contrast CT head demonstrating SAH.

FIGURE 9.8 This image shows hyperdense SAH in the basal cisterns (white arro...

FIGURE 9.9 This image shows a prior left‐sided ischaemic stroke due to an MC...

FIGURE 9.10 This image shows a pre‐operative CT scan of a patient showing a ...

FIGURE 9.11 This image shows a young man with shotgun injury. Bone window (a...

FIGURE 9.12 Coronal MRI structures.

FIGURE 9.13 Sagittal MRI brain slices.

FIGURE 9.14 Axial MRI brian slices.

FIGURE 9.15 (a) Iron deposits in the Globus Pallidus (black arrows). (b) Com...

FIGURE 9.16 Illustrates the normal swallow tail sign of the substantia nigra...

FIGURE 9.17 Representative examples of normal (arrowheads) and abnormal (arr...

Chapter 10

FIGURE 10.1 CKD classifications.

FIGURE 10.2 The multisystem effects of renal failure.

FIGURE 10.3 Glomerular nephritis.

FIGURE 10.4 Neprotic versus nephritic syndromes.

FIGURE 10.5 Renal potassium regulation.

FIGURE 10.6 Renal acid‐base handling.

FIGURE 10.7 Anion gap equations.

FIGURE 10.8 HAGMA/NAGMA.

FIGURE 10.9 Pharmacokinetics in renal impairment.

FIGURE 10.10 Hyper and hypokalaemia.

Chapter 11

FIGURE 11.1 Common presenting symptoms and their association with GI and HPB...

FIGURE 11.2 Abdominal quadrants and the potential or differential diagnosis....

FIGURE 11.3 Process for performing an abdominal examination.

Chapter 12

FIGURE 12.1 Examination of a lump.

FIGURE 12.2 Types of leukaemia (American Cancer Society 2023).

FIGURE 12.3 Side effects of chemotherapy and radiotherapy (acute/pink, and l...

FIGURE 12.4 Sickle cell disease: acute and chronic clinical complications.

Chapter 13

FIGURE 13.1 (a), (b) Representative organ‐specific and systemic autoimmune d...

FIGURE 13.2 ANCA‐associated Vasculitis disease subsets and immune features....

Chapter 14

FIGURE 14.1 The common‐sense model of self‐regulation of health and illness ...

FIGURE 14.2 Conceptual framework for post‐intensive care syndrome.

Chapter 16

FIGURE 16.1 Sonographic reasoning method.

FIGURE 16.2 Ultrasound transducer and the generation of sound waves.

FIGURE 16.3 Ultrasound and its interaction with tissue.

FIGURE 16.4 Production of a 2D image using B Mode technology.

FIGURE 16.5 Basic ultrasound views of the heart.

FIGURE 16.6 (a) Parasternal view demonstrating pericardial effusion collapsi...

FIGURE 16.7 Sonographic reasoning method – cardiac presentation exemplar....

FIGURE 16.8 Parasternal short axis view demonstrating dilated RV, paradoxica...

FIGURE 16.9 Apical four chamber view demonstrating dilated RV and McConnell'...

FIGURE 16.10 (a) Patient in the semi‐recumbent position. (b) Patient in the ...

FIGURE 16.11 (a) BLUE points.(b) BLUE protocol decision tree.

FIGURE 16.12 Flowchart on diagnosis of pneumothorax.

FIGURE 16.13 (a) Anterior lung zone with small area of subpleural consolidat...

FIGURE 16.14 Anterior lung zone demonstrating B‐lines (B) in a patient with ...

FIGURE 16.15 Posterolateral lung zone demonstrating a large simple pleural e...

FIGURE 16.16 Sonographic reasoning method – respiratory presentation exempla...

FIGURE 16.17 High frequency, linear probe.

FIGURE 16.18 (a) Transverse view, needle out of plane. (b) Longitudinal view...

FIGURE 16.19 Two‐point compression points. SFV, saphenofemoral vein, PV, pop...

FIGURE 16.20 (a) Mickey Mouse sign. CFA, common femoral artery. LSV, long sa...

FIGURE 16.21 Non‐compressible common femoral vein (CFV) secondary to early t...

FIGURE 16.22 Partial filling defect (blue) identified on colour flow doppler...

FIGURE 16.23 Sonographic reasoning method – vascular presentation exemplar....

FIGURE 16.24 Transverse view of right kidney displaying moderate hydronephro...

FIGURE 16.25 (a) Intra‐abdominal free fluid (asterisk) adjacent to the cauda...

FIGURE 16.26 Abdominal aortic aneurysm. Abnormal dimensions >3 cm maximal di...

FIGURE 16.27 Abdominal aortic dissection. Intimal flap indicated by arrows....

FIGURE 16.28 Sonographic reasoning method – trauma presentation exemplar....

Chapter 18

FIGURE 18.1 RPS competency framework for all prescribers.

FIGURE 18.2 Prescribing competencies within legal and ethical considerations...

FIGURE 18.3 The effect of pH on drug ionisation.

FIGURE 18.4 The three‐compartment model for pharmacokinetics.

FIGURE 18.5 Increase in tissue in the intravascular space due to capillary l...

FIGURE 18.6 Barrier breakdown during sepsis.

FIGURE 18.7 Differing clearance mechanisms of CVVHD and CVVHDF.

FIGURE 18.8 Conceptualised CVVHDF circuit.

FIGURE 18.9 Ratio of adipose tissue to lean body weight in normal BMI and Hi...

FIGURE 18.10 Phase 1 and 2 reactions.

Chapter 19

FIGURE 19.1 Example of nasogastric tube insertion LocSSIPP.

FIGURE 19.2 Identification of site for LP using anatomical landmarking. Line...

FIGURE 19.3 Anatomical locations of drain insertion.

FIGURE 19.4 Z‐injection technique.

FIGURE 19.5 Typical sterile tray for Seldinger procedure – specifically CVC ...

FIGURE 19.6 Needle length within the right IJV.

FIGURE 19.7 Ultrasound anatomy of internal jugular vein (IJV) in transverse ...

Chapter 20

FIGURE 20.1 Causes of deterioration.

FIGURE 20.2 ABCDE approach to assessment.

FIGURE 20.3 ABCDE approach to management.

FIGURE 20.4 Adult in‐hospital resuscitation algorithm.

FIGURE 20.5 Adult advanced life support for COVID‐19 patients – acute hospit...

FIGURE 20.6 Intubation checklist.

FIGURE 20.7 Tracheal intubation of critically ill adults.

FIGURE 20.8 Can't Intubate, Can't Oxygenate (CICO) in critically ill adults....

FIGURE 20.9 Adult bradycardia algorithm.

FIGURE 20.10 Adult tachycardia algorithm.

FIGURE 20.11 Consensus‐based algorithm for the management of severe traumati...

FIGURE 20.12 Graphic representation of the Consensus REVised Imaging and Cli...

FIGURE 20.13 Post‐resuscitation care algorithm.

Chapter 21

FIGURE 21.1 Cellular respiration.

CHART 21.1 Diagnosis of shock in children.

Chapter 22

FIGURE 22.1 Oxygen calculations for the spontaneously breathing patient.

FIGURE 22.2 (a) Minute volume calculation. (b) Oxygen calculation for the ve...

Chapter 23

FIGURE 23.1 The sympathetic storm and the pro‐inflammatory cascade.

Guide

Cover Page

Title Page

Copyright Page

Table of Contents

About the Editors

Notes on Contributors

Preface

Acknowledgements

How to Use Your Text Book – Pedagogical Features Contained Within Your Textbook

Begin Reading

Prefixes and Suffixes

Normal Values

Index

WILEY END USER LICENSE AGREEMENT

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The Advanced Practitioner in Acute, Emergency and Critical Care

Edited by

Sadie Diamond‐Fox

MCP ACCP (FICM ACCP Member), BSc (Hons) RN, PGCAHP, NMP (V300), FHEA.Advanced Critical Care Practitioner (ACCP) & ACCP Programme Co‐Lead, Newcastle upon Tyne Hospitals; Advancing Practice Specialty Advisor for Critical Care, NHS England, North East and Yorkshire. Assistant Professor in Advanced Critical Care Practice and Subject Lead for Advanced Practice Programmes, Northumbria University, Newcastle upon Tyne, UK

Barry Hill

MSc Adv Prac, PGCAP, BSc (Hons) CCRN, DipHE/O.A. Dip, SFHEA, TEFL, NMC RN RNT/TCH V300.Associate Professor of Nursing and Critical Care; Employability Lead for Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK

Sonya Stone

MSc ACP FICM ACCP Member FHEA.Associate Professor of Advanced Clinical Practice; Director of Postgraduate Taught Education (School of Health Sciences); Faculty Director of Higher Degree Apprenticeships (Medicine & Health Sciences); ACP, Cardiac Intensive Care Unit, Nottingham University Hospitals NHS Trust; Faculty of Intensive Care Medicine (FICM) Clinical Lead for e‐ICM

Caroline McCrea

MSc Cardiorespiratory nursing, PG Dip ACCP (FICM), BN (Hons), NMC RN and V300.Advanced Critical Care Practitioner (ACCP) at Portsmouth University Hospital Trust

Natalie Gardner

MSc Critical Care, FICM ACCP Member, BSc (Hons) Physiotherapy, PG Cert Clinical Education, FHEA, MAcadMEd, HCPC Physiotherapist and V300.Trust Clinical Lead for Advanced Clinical Practice and Non‐Medical Prescribing; Advanced Critical Care Practitioner; Co‐Chair FICM ASC Physiotherapist; Kings College Hospital NHS Foundation Trust

Angela Roberts

MSc Advanced Critical Care Practitioner (FICM ACCP Member), NMP V300, BSc (Hons) Adult Nursing.Advanced Nurse Practitioner at Southern Health, Petersfield Hospital

Series Editor: Ian Peate

This edition first published 2024© 2024 John Wiley & Sons Ltd

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The right of Sadie Diamond‐Fox, Barry Hill, Sonya Stone, Caroline McCrea, Natalie Gardner, and Angela Roberts to be identified as the authors of the editorial material in this work has been asserted in accordance with law.

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Library of Congress Cataloging‐in‐Publication Data

Names: Diamond‐Fox, Sadie, editor.Title: The Advanced Practitioner in Acute, Emergency and Critical Care / [edited by] Sadie Diamond‐Fox, Barry Hill, Sonya Stone, Caroline McCrea, Natalie Gardner, Angela Roberts.Description: First edition. | Hoboken, NJ : Wiley‐Blackwell, [2024] | Includes index.Identifiers: LCCN 2023016544 (print) | LCCN 2023016545 (ebook) | ISBN 9781119908289 (paperback) | ISBN 9781119908302 (adobe pdf) | ISBN 9781119908296 (epub)Subjects: MESH: Critical Care–methods | Emergency Treatment–methods | Acute Disease–therapy | Health Personnel | United KingdomClassification: LCC RC86.7 (print) | LCC RC86.7 (ebook) | NLM WX 218 | DDC 616.02/8–dc23/eng/20230727LC record available at https://lccn.loc.gov/2023016544LC ebook record available at https://lccn.loc.gov/2023016545

Cover Design: WileyCover Image: © Mutlu Kurtbas/Getty Images

About the Editors

Sadie Diamond‐Fox, Barry Hill, Sonya Stone, Natalie Gardner, Caroline McCrea, Angela Roberts and Ian Peate (Series Editor)

Angela Roberts

Advanced Critical Care Practitioner (FICM ACCP Member), NMP (V300), BSc Adult Nursing

Angela qualified as an adult nurse in 2007 (MMU) and has since worked at Pilgrim Hospital, Boston, Basingstoke, and North Hampshire Hospital Intensive Care Units after qualifying.

Since 2007, she has progressed as an Advanced Critical Care Practitioner (ACCP) in 2017 and is a non‐medical prescriber. Due to family commitments, she left the ICU to become an Advanced Nurse Practitioner at Southern Health, Petersfield Hospital.

Angela has always been passionate about education and supporting others through postgraduate healthcare.

Barry Hill

Associate Professor of Nursing andCritical Care; Director of Employability for Nursing, Midwifery, and Health

PhD, MSc, PGCAP, BSc (Hons), DipHE, OA Dip, RN, NMC RNT/TCH, SFHEA. Associate Professor, and Director of Employability, Northumbria University, Consultant Editor for International Journal of Advancing Practice (IJAP); Clinical Editor for the British Journal of Nursing (BJN).

Barry is an experienced leader, academic, educator, researcher, and clinical nurse. His current role is Associate Professor and Director of Employability for Nursing, Midwifery, and Health. He has a demonstrated history of working within academia in Higher Education (HE). Barry is a senior fellow (SFHEA) and an HEA mentor, a certified Intensive Care Nurse, with an MSc in Advanced Practice (Clinical); NMC Registered Nurse (RN), NMC Registered Teacher (TCH), and NMC registered independent and supplementary prescriber (V300). He is skilled in clinical research and clinical education, and is passionate about higher education, especially nursing science, advanced clinical practice (ACP), critical care, non‐medical prescribing (NMP), and pharmacology. Barry’s clinical career was at Imperial College NHS Trust, London. Barry is a strongly education‐focused professional who has published 9 books, 60 book chapters, and 100 peer‐reviewed journal articles. He is the Consultant Editor for the International Journal of Advancing Practice (IJAP) and the Clinical Editor for the ‘At A Glance’ and ‘Advanced Clinical Practice’ series within the British Journal of Nursing (BJN).

Caroline McCrea

MSc Cardiorespiratory nursing, PG Dip ACCP (FICM ACCP Member), BN (Hons), NMC RN and V300

Caroline qualified as a nurse in 2008 and began her career in Cardiac Nursing. The first eight years of her career were spent in specialist Cardiothoracic Nursing roles. In 2014, she completed her MSc in Cardiorespiratory Nursing and went on to become a Cardiothoracic Nurse Practitioner and non‐medical prescriber. Following on from this specialist role, she progressed further to become an Advanced Critical Care Practitioner (ACCP) and was awarded Faculty of Intensive Care Medicine (FICM) Membership. Caroline has always had a great passion for education, and continues to compliment her clinical work with teaching across a variety of disciplines. Her key interests are ECHO, Simulation, advanced level practice, and medical education.

Natalie Gardner

MSc Critical Care, FICM ACCP Member, BSc (Hons) Physiotherapy, PG Cert Clinical Education, FHEA, MAcadMEd, HCPC Physiotherapist and V300

Natalie is the Trust Lead for Advanced Clinical Practice and Non‐Medical Prescribing at King’s College Hospital in London, and works clinically as an Advanced Critical Care Practitioner. Natalie started her ACCP training at King’s in 2017, and has sat on the Faculty of Intensive Care Medicine ACCP Sub‐Committee since 2020, of which she is now the ACCP Co‐Chair. Prior to this, Natalie has worked as a physiotherapist specialising in respiratory and critical care, since 2007. Natalie also serves as an Army Reserve Officer in the Royal Army Medical Corps, with significant prior service in the Royal Logistic Corps, since 2008. Natalie has served overseas in Afghanistan, Africa, and on a UN Peace Keeping Mission, and upon Commissioning at the Royal Military Academy Sandhurst in 2017, Natalie was presented the prestigious MacRobert Sword of Honour by Major General Ranald Munro.

Sadie Diamond‐Fox

MCP ACCP (FICM ACCP Member), BSc (Hons) RNA, PGCAHP, Fellow (HEA) NMC RN & V300

Sadie has developed a portfolio career in advanced practice since beginning her training as an Advanced Critical Care Practitioner (ACCP) in 2012. She continues to work clinically as an ACCP at Newcastle upon Tyne Hospitals and more recently has taken a position as trainee ACCP education co‐lead. Sadie is Subject Lead for Advanced Practice programmes, Assistant Professor in Advanced Critical Care Practice (FHEA) and PhD candidate (‘ImpACCPt’ study) at Northumbria University. She is also Advancing Practice Training Programme Director (AP TPD) for Critical Care for Health Education England’s Advancing Practice Faculty in the North East and Yorkshire. Her external positions also include Honorary Assistant Professor in Advanced Clinical Practice (ACP) at Nottingham University, External Examiner for Advanced Clinical Practice Programmes at University of Southampton; Intensive Care Society (ICS) Education Committee member; Advanced Practitioners in Critical Care (APCC) Professional Advisory Group (PAG) member to the ICS; Co‐Founder and Co‐Lead Advanced Critical and Clinical Practice Academic Network (ACCPAN); Editor for Wiley publishing Advanced Practice series, and most recently Editorial Board member for the International Journal of Advancing Practice (IJAP).

Sonya Stone

BSc, MSc, RN, ACCP, FICM ACCP Member, FHEA

Sonya is an Associate Professor of Advanced Clinical Practice at the University of Nottingham, and Advanced Clinical Practitioner in Cardiac Intensive Care at Nottingham University Hospitals. Sonya trained as a nurse in Nottingham and spent much of her nursing career in Intensive Care. She trained as an advanced critical care practitioner in Portsmouth in 2016 and took her first academic post at the University of Southampton as a clinical teaching fellow in 2018.

Sonya is an experienced leader, clinician, and academic, with an interest in critical illness and maternal critical care. She leads postgraduate taught education and CPD in the school of health sciences and is faculty academic director for higher degree apprenticeships. Sonya is an educationalist, with a passion for advancing practice and multi‐professional learning.

Ian Peate

OBE FRCN EN(G) RGN DipN(Lond) RNT Bed (Hons) MA(Lond) LLM

Editor in Chief British Journal of Nursing

Consultant Editor Journal of Paramedic Practice

Consultant Editor International Journal for Advancing Practice

Visiting Professor Northumbria University

Visiting Professor St George’s University of London and Kingston University London

Professorial fellow University of Roehampton

Visiting Senior Clinical Fellow University of Hertfordshire

Ian began his nursing career at Central Middlesex Hospital, becoming an enrolled nurse practising in an intensive care unit. He later undertook 3 years’ student nurse training at Central Middlesex and Northwick Park Hospitals, becoming a staff nurse and then a charge nurse. He has worked in nurse education since 1989. His key areas of interest are nursing practice and theory. Ian has published widely. Ian was awarded an OBE in the Queen’s 90th Birthday Honours List for his services to nursing and nurse education and was granted a fellowship from the Royal College of Nursing in 2017.

Notes on Contributors

Name

Bio

Alexandra Gatehouse

MSC, PG Dip ACCP (FICM ACCP member) BSc (Hons) Physiotherapy, CSP member and V300, Advanced Critical Care Practitioner

Alex Gatehouse qualified as a physiotherapist in 2000, and, following Junior Rotations in the Newcastle Trust, she specialised in Respiratory Physiotherapy in Adult Critical Care, also working within New Zealand. In 2012, she trained as an Advanced Critical Care Practitioner, completing a Masters in Clinical Practice in Critical Care and a non‐medical prescribing qualification. Alex continues to rotate within all of the Critical Care Units in Newcastle Upon Tyne, also enjoying teaching on Advanced Life Support courses, Regional transfer courses, and within the units. Her interests are transfer, advanced airway management, ECHO, and education.

Andrew Lee

MSc, BSc (Hons), DipHE

Andrew is an Advanced Clinical Practitioner specialising in respiratory care. His medical journey was initiated in 2002 at Stoke Mandeville Hospital, Buckinghamshire, on a spinal and orthopaedic ward as a Health Care Assistant. He earned his nursing qualification from De Montfort University in 2007, progressing to work on a Vascular Surgery ward. His passion for respiratory care was ignited at Glenfield Hospital, where he served in a respiratory and cardiology admissions unit, subsequently advancing to the position of Critical Care Outreach Nurse. In 2018, Andrew completed his advanced practice master’s degree at the University of Nottingham, and since then, he has been diligently serving as a respiratory ACP in Nottingham. With a special interest in pulmonary vascular disease, Andrew manages a pulmonary embolism follow‐up clinic. Demonstrating his leadership skills, he is currently chairing the Respiratory ACP Network, working collaboratively with a remarkable team of respiratory ACPs.

Angela Roberts

Advanced Critical Care Practitioner (FICM ACCP Member), NMP (V300), BSc Adult Nursing

Angela qualified as an adult nurse in 2007 (MMU) and has since worked at Pilgrim Hospital, Boston, Basingstoke, and North Hampshire Hospital Intensive Care Units after qualifying. Since 2007, she has progressed as an Advanced Critical Care Practitioner (ACCP) in 2017 and is a non‐medical prescriber. Due to family commitments, she left the ICU to become an Advanced Nurse Practitioner at Southern Health, Petersfield Hospital. Angela has always been passionate about education and supporting others through postgraduate healthcare.

Barry Hill

Associate Professor, Critical Care; Director of Employability for Nursing, Midwifery, and Health Programmes

PhD, MSc, PGCAP, BSc (Hons), DipHE, OA Dip, RN, NMC RNT/TCH, SFHEA. Associate Professor, and Director of Employability, Northumbria University, Consultant Editor for

International Journal of Advancing Practice (IJAP)

; Clinical Editor for the

British Journal of Nursing (BJN)

. Barry is an experienced leader, academic, educator, researcher, and clinical nurse. His current role is Associate Professor and Director of Employability for Nursing, Midwifery, and Health. He has a demonstrated history of working within academia in Higher Education (HE). Barry is a senior fellow (SFHEA) and an HEA mentor, a certified Intensive Care Nurse, with an MSc in Advanced Practice (Clinical); NMC Registered Nurse (RN), NMC Registered Teacher (TCH), and NMC registered independent and supplementary prescriber (V300). He is skilled in clinical research and clinical education, and is passionate about higher education, especially nursing science, advanced clinical practice (ACP), critical care, non‐medical prescribing (NMP), and pharmacology. Barry’s clinical career was at Imperial College NHS Trust, London. Barry is a strongly education‐focused professional who has published 9 books, 60 book chapters, and 100 peer‐reviewed journal articles. He is the Consultant Editor for the

International Journal of Advancing Practice (IJAP)

and the Clinical Editor for the ‘At A Glance’ and ‘Advanced Clinical Practice’ series within the

British Journal of Nursing (BJN)

.

Caroline McCrea

MSc Cardiorespiratory Nursing, PG Dip ACCP (FICM ACCP Member), BN (Hons), NMC RN and V300

Caroline qualified as a nurse in 2008 and began her career in Cardiac Nursing. The first eight years of her career were spent in specialist Cardiothoracic Nursing roles. In 2014, she completed her MSc in Cardiorespiratory Nursing and went on to become a Cardiothoracic Nurse Practitioner and non‐medical prescriber. Following on from this specialist role, she progressed further to become an Advanced Critical Care Practitioner (ACCP) and was awarded Faculty of Intensive Care Medicine (FICM) Membership. Caroline has always had a great passion for education, and continues to compliment her clinical work with teaching across a variety of disciplines. Her key interests are ECHO, Simulation, advanced level practice, and medical education.

Clare Allabyrne

Clare Allabyrne is currently the Associate Professor and Professional Lead for the MSc Advanced Clinical Practice Mental Health (ACPMH) at London Southbank University and a Fellow of the Higher Education Academy

A dual qualified nurse (Adult and Mental Health) by profession, her areas of expertise include advanced clinical practice in mental health, child and adolescent mental health, forensic psychiatry, liaison psychiatry, substance use, physical health care in mental health, service user involvement/people participation, multi‐agency/partnership working, leadership, service creation, and innovation. Clare worked for 35 years in the NHS across physical and mental health care services in clinical, therapeutic, senior operational, clinical academic, and corporate/strategic leadership roles.

David Thom

MSc DipIMC(RCSEd) BSc(Hons) MCPara SRParaNMP(V300)

,

Anaesthesia Associate and Advanced Practitioner – Critical Care

David qualified as a Paramedic in 2013 working in the West Midlands and the Southeast while completing his BSc in Pre‐Hospital and Emergency Care. He has worked in a range of domains, including frontline services, the Isle of Man TT, major public events, and sport. He subsequently trained as a FICM Advanced Critical Care Practitioner, completing his MSc and Non‐Medical Prescribing. Subsequently, he worked on the Dorset and Somerset Air Ambulance and passed the DipIMC(RCSEd) by examination. More recently, he is undergoing training as an Anaesthesia Associate on the PGDip pathway. Interests include Pharmacology, Education, and Critical Care.

Francesca Riccio

Paediatric Consultant Anaesthetist, FRCA, Bachelor of Medicine

Francesca is a paediatric anaesthetist working in University Hospital Southampton. She has always had a keen interest in teaching, in particular, simulation. Throughout her training she has watched the development of advanced practitioners, particularly in the acute setting and believes they are hugely valuable to an ever expanding and demanding healthcare system.

Emma Toplis

Advanced Clinical Practitioner

Emma is a Registered Nurse who began her career in older people’s care. In 2015, she embarked on her journey as a trainee Advanced Clinical Practitioner (tACP). This transition allowed her to explore various clinical specialities, build a comprehensive knowledge base and enhance her skills in advanced practice. Among the several specialities, Emma fosters a deep passion for respiratory medicine. She has since developed a sub‐specialist interest in interstitial lung disease. Additionally, she has become an instrumental figure in the quest for quality improvement within respiratory care, cementing her role as a core member of the In‐hospital Quality Improvement for Respiratory (InQuIRe) quality improvement faculty. Emma also successfully completed a quality improvement project on improving tobacco dependency management with the Respiratory team at the University Hospitals of Derby and Burton. This project was presented at the BTS 2022 summer conference and awarded the first prize. Through the respiratory Advanced Clinical Practitioner network, Emma finds an excellent opportunity to champion and share best practices in her speciality.

Emma Underdown

MSc Advanced Clinical Practice, PGDip Advanced Clinical Practice, BSc (Hons) Intensive Care Practice, DipHE Adult Nursing, NMC RN and V300 Independent Non‐Medical Prescriber

Emma qualified in 2011 as a nurse and began her career initially as a surgical specialty nurse before moving into Critical Care. She worked for four years as an Intensive Care nurse, gaining her post‐graduate degree in Intensive Care Practice. She later spent three years working as a Senior Sister in Critical Care Outreach. She commenced her Advanced Clinical Practice training in 2019 within Emergency Medicine, where she continues to work. Emma is a keen clinician and clinical educator who delivers education and training across various disciplines and specialties. Her areas of interest include Advanced Life Support, Medical Education, service development, and PoCUS.

Hannah Conway

MSc, DipHE, AFHEA, A/Professor Advanced Clinical Practice, Advanced Critical Care Practitioner (AHP)

Hannah specialises in critical care echocardiography and ultrasound and sits on the committee for Focused Ultrasound in Intensive Care (FUSIC), taking a lead role in FUSIC Heart (FICE). Hannah is an approved supervisor and examiner for multiple accreditations and has over a decade of experience in ultrasound education. Hannah is a keen clinical researcher and is currently conducting a study into the use of telemedicine to aid echocardiography mentoring in intensive care. Another area of research interest is the characterisation of right ventricular (RV) injury. Hannah is co‐chair of PRORVnet, an international, RV‐centric research network.

National roles:

Intensive Care Society (ICS) Council Member, FUSIC and Education Committee Member Chair ICS Advanced Practitioners in Critical Care (APCC) Professional Advisory Group Co‐Chair Advanced Clinical Practitioners Academic Network (ACPAN) Co‐Chair of Protecting the Right Ventricle Network (PRORVnet) Honorary Secretary National Association of Advanced Critical Care Practitioners (NaACCP)

Jill Bentley

MSc Adv Prac, FICM ACCP Member, MSc Pain Management, BSc, DipHE, PGCAP, FHEA, RN (Adult) IP (v300), Lecturer / ACCP

Jill qualified as a nurse in 2001 and started her career in theatres, working in Anaesthesia, Recovery, and Outreach. She then moved into a clinical specialist role, working at a large tertiary centre in acute and chronic pain management. After gaining her masters in this specialty, she took the next step to complete her ACP training in critical care, gaining a second MSc in 2012, followed by gaining the award of FICM membership as the ACCP evolved. Jill has a keen interest in education, having worked in a lecturer practitioner role for several years. Her areas of special interest are medication safety, prescribing in advanced practice, pain management, and critical care.

Jill Featherstone

National Professional Development Specialist and Medical Education Lead

Jill is a National Lead Professional Development Specialist for NHS Blood and Transplant, responsible for medical education and working alongside national clinical leads in organ donation. Her earlier critical care career was in cardiac, general, and neurology centres in Bristol, Swindon, and South Tees, including some paediatric work and as a specialist nurse in organ donation for four years. She is passionate about supporting good family experiences, teamwork, simulation, and innovation using a wide variety of forums to have as much impact and reach as possible, including leading the much‐respected multidisciplinary National Deceased Donation Course for ICM trainees and conference sessions.

Joe Wood

BSc (Hons) Physiotherapy, MSc Advanced Practice, PgCert Clinical Education

Joe began his career as a Physiotherapist in Kent, with a focus on Respiratory intervention and tracheostomy management. Developing his interest in acute care, he then completed an MSc in Advanced Practice in Critical Care to become an Advanced Critical Care Practitioner. A PgCert in clinical education followed – investigating the role of simulation in healthcare education. He continues to work towards higher accreditation in medical ultrasound and acts as mentor and supervisor for point‐of‐care ultrasound accreditation for AHP and Medical colleagues across acute medicine, emergency, and critical care.

John Wilkinson

MBBS PGCertMedEd, Anaesthetics Registrar

John is an anaesthetics registrar at the Northern School of Anaesthesia and Intensive Care Medicine. Following studying medicine at Newcastle University and completing Foundation Training in Newcastle Trust Hospitals, he has trained in anaesthetic and critical care departments across the North of England, including as a Clinical and Education Fellow in Critical Care. He has a particular interest in Multidisciplinary Team simulation training, including creating resources for sessions involving medical, nursing, and midwifery students from Newcastle and Northumbria Universities.

Joseph Tooley

MPharm, PG Dip (Hospital Pharmacy), IP (Clinically enhanced), Lead Critical Care Pharmacist

Joseph qualified as a pharmacist in 2012 and has been a specialist pharmacist for critical care and theatres for the last seven years, working in both general ICUs and previously in neurosciences. He has contributed to the national programme for postgraduate pharmacy training with HEE and regional training on acute kidney injury with CPPE. He is currently the lead pharmacist for critical care, theatres, and surgery at Portsmouth Hospitals University NHS Trust. His interests are pharmacokinetics in critical illness, dosing drugs with renal replacement therapy, neuroscience, and critical care nutrition.

Kathryn Thomas

Advanced Clinical Practitioner and Clinical Educator

As a Registered Nurse (RN) specialising in critical care, Kathryn brings a decade’s worth of experience, having trained and subsequently qualified as an Advanced Clinical Practitioner (ACP). Throughout this journey, She has had the opportunity to rotate across several specialties, with a particular emphasis on specialist medicine, and has enhanced her skills within advanced respiratory care. Her professional engagements extend across the four pillars of advanced clinical practice. Her previous roles include being a divisional lead ACP for medicine and cancer care. She also imparts her knowledge as a clinical educator for the school of medicine at Nottingham University. Actively engaged in furthering her research, she continuously seeks to enhance her advanced practice role and contribute more significantly to her discipline and level of practice.

Kirstin Geer

BSc (Hons) MSc (Advanced Clinical Practice) PGDip (Advanced Critical Care Practice) FICM ACCP Member

Kirstin qualified as a nurse in 2005 and has worked in Emergency Admissions and Critical Care Outreach. Became a qualified ACCP in 2016. Special interests include Critical Care Transfer and Simulation.

Kirsty Laing

MSc Advanced Practice, PgDip in Respiratory Medicine, BA(Hons) Nursing Studies, HND Biomedical Science, NMC RN and V300 Independent Prescriber

Kirsty qualified as a registered nurse with the Nursing and Midwifery Council (NMC) in 2004, working in medical admissions, coronary care, and critical care outreach. She later embarked on her MSc in Advanced Practice. Kirsty completed her MSc in 2013, gaining a wealth of experience as an Advanced Clinical Practitioner (ACP) in various fields, including acute medicine, frailty, gastroenterology, cardiology, community rehabilitation, and respiratory medicine. Kirsty currently specialises in pleural disease and has successfully established an ACP pleural service. As an enthusiastic member of the Pleural Society and the Respiratory ACP Network, she values and thrives in collaborative, multi‐professional environments. Kirsty works diligently to improve the quality of services delivered to patients, using education and supervision as primary tools for development and enhancement.

Mark Cannan

MCP ACCP, BSc (Hons), Dip HE

Mark gained a diploma as an ODP in 2013 (University of Central Lancashire), having witnessed the work of an ODP first‐hand in the theatres of Camp Bastion. He completed an Honours Degree in Acute and Critical Care (University of Cumbria). Having excluded career progression in managerial or educational roles, the ACCP role seemed to best fit his aspirations. Mark qualified as an ACCP (Northumbria University) in 2019 and has since completed his Master’s Degree. He has specialist interests in advanced airway management, regional anaesthesia and transfer of the critically ill patient. He is also on the national working group working towards legislation change to allow ODPs who have progressed into advanced practice the ability to undertake non‐medical prescribing.

Natalie Gardner

MSc Critical Care, FICM ACCP Member, BSc (Hons) Physiotherapy, PG Cert Clinical Education, FHEA, MAcadMEd, HCPC Physiotherapist and V300

Natalie is the Trust Lead for Advanced Clinical Practice and Non‐Medical Prescribing at King’s College Hospital in London, and works clinically as an Advanced Critical Care Practitioner. Natalie started her ACCP training at King’s in 2017, and has sat on the Faculty of Intensive Care Medicine ACCP Sub‐Committee since 2020, of which she is now the ACCP Co‐Chair. Prior to this, Natalie has worked as a physiotherapist specialising in respiratory and critical care, since 2007. Natalie also serves as an Army Reserve Officer in the Royal Army Medical Corps, with significant prior service in the Royal Logistic Corps, since 2008. Natalie has served overseas in Afghanistan, Africa, and on a UN Peace Keeping Mission, and upon Commissioning at the Royal Military Academy Sandhurst in 2017, Natalie was presented the prestigious MacRobert Sword of Honour by Major General Ranald Munro.

Nick Fox

BSc(Hons), MSc, RN & V300