ICM logbook summary |
Please use a CROSS (X) for each question and complete this form in BLOCK CAPITALS and BLACK ink.
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Trainee’s surname |
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Trainee’s forename(s) |
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GMC Number |
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GMC NUMBER MUST BE COMPLETED |
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Hospital placement: |
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Duration of placement: |
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Total beds: |
Level 2: Level 3: Mixed 2/3: |
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Level of training: |
Core Step 1 Step 2 Step 3 |
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Speciality: |
General Cardiac Neuro Paeds |
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Total unit admissions during placement: |
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Event |
Local supervision |
Distant supervision |
Teaching |
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Ward review |
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Admission |
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Lead ward round |
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Cardiac arrest |
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Trauma team |
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Intra-hospital transfer |
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Inter-hosptial transfer |
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Discussion with relatives |
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End of life care/donation |
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Procedure |
Local supervision |
Distant supervision |
Teaching |
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Airway & Lungs |
Emergency intubation |
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Percutaneous tracheostomy |
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Bronchoscopy |
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Chest drain - seldinger |
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Chest drain – blunt dissection |
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Lung ultrasound |
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Cardiovascular |
Arterial cannulation |
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Central venous access – IJ |
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Central venous access – SC |
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Central venous access – Femoral |
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Pulmonary artery catheter |
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Non-invasive CO monitoring |
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Echocardiogram |
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Abdomen |
Ascitic drain/tap |
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Sengstaken tube placement |
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Abdominal ultrasound/FAST |
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CNS |
Lumbar puncture |
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Brainstem death testing |
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Experience of the all the above procedures is desirable but NOT essential