FNB Trauma Anaesthesia and Critical Care: Admissions, Medical Colleges, Eligibility criteria, fees details

FNB Trauma Anaesthesia and Critical Care or Fellow of the National Board in Trauma Anaesthesia and Critical Care also known as FNB in Trauma Anaesthesia and Critical Care is a doctoral fellowship program for doctors in India that they do after completion of their postgraduate medical degree course. The duration of the FNB course is for 2 years.

FNB Trauma Anaesthesia and Critical Care aim to produce anaesthesiologists who after undergoing training will be able to deal effectively with the needs of a trauma patient in various setups. Trauma is a leading public health problem. Nearly 1.5 to 2 million people are injured and 1 million succumb to death every year due to trauma.

The course is a full-time course pursued at various accredited institutes/hospitals across the country, the top institutions include ESIC Medical College Hospital and Super Specialty Hospital, Hyderabad, and more.

Candidates can students get admission to 2 years FNB course after successfully qualifying for the FET (Fellowship Entrance Test) examination which NBEMS conducts. FET is conducted annually as per the prescribed schedule. The merit-based counselling for admissions to the FNB Programme after the conduct of FET is administered by NBEMS.

The fee for pursuing FNB Trauma Anaesthesia and Critical Care varies from accredited institute/hospital to hospital and is Rs.1,25,000 per year.

After completing their respective course, doctors can join the job market. Candidates can take reputed jobs at positions as research fellows, Senior residents, Consultants, etc. with an approximate average salary range of Rs. 10 lakhs to Rs. 51 lakhs per annum.

The Nomenclature of the FNB qualification awarded by the National Board of Examinations in Medical Sciences is “Fellow of National Board”. The FNB qualifications are recognized qualifications in terms of the Gazette notification dated 10th August 2016.

What is FNB in Trauma Anaesthesia and Critical Care?

FNB in Trauma Anaesthesia and Critical Care is a two-year doctoral fellowship program that candidates can pursue after completing a postgraduate degree.

The goal of the Trauma Anaesthesia and Critical Care Fellowship is to provide fellows with intensive training and broad exposure to the diagnosis and treatment of arthritis and related problems requiring joint replacement surgery. The fellow will learn to evaluate and treat routine and complicated cases of the Hip, Knees, shoulder, elbow, and ankle surgical and non-surgical methods of treatment.

The National Board of Examinations (NBE) has released a curriculum for FNB Trauma Anaesthesia and Critical Care.

The curriculum governs the education and training of FNB Trauma Anaesthesia and Critical Care.

Course Highlights

Here are some of the course highlights of FNB Trauma Anaesthesia and Critical Care

Name of Course	FNB Trauma Anaesthesia and Critical Care
Level	Fellowship
Duration of Course	Two years
Course Mode	Full Time
Minimum Academic Requirement	Candidates must have a postgraduate medical Degree in DNB/MD Anaesthesia obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.
Admission Process / Entrance Process / Entrance Modalities	The entrance Exam (FET) Merit-based counselling administered by NBEMS
Course Fees	Rs.1,25,000 per annum
Average Salary	Rs. 10 lakhs to Rs.51 lakhs per annum

Eligibility Criteria

The eligibility criteria for FNB in Trauma Anaesthesia and Critical Care are defined as the set of rules or minimum prerequisites that aspirants must meet to be eligible for admission, which includes:

Name of Fellowship course	Course Type	Prior Eligibility Requirement
Trauma Anaesthesia and Critical Care	FNB	DNB/MD Anaesthesia

Note:

· The feeder qualification for FNB Trauma Anaesthesia and Critical Care is defined by the NBE and is subject to changes by the NBE.

· The feeder qualification mentioned here is as of 2022.

· For any changes, please refer to the NBE website.

· There is no upper age limit for training in NBEMS Fellowship courses.

Admission Process

The admission process contains a few steps for the candidates for admission to FNB. Candidates can view the complete admission process for FNB Trauma Anaesthesia and Critical Care mentioned below:

Fees Structure

The fee structure for FNB Trauma Anaesthesia and Critical Care varies from accredited institute/hospital to hospital. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for FNB Trauma Anaesthesia and Critical Care is Rs.1,25,000.

Colleges offering FNB Trauma Anaesthesia and Critical Care

Various accredited institutes/hospitals across India offer courses for pursuing FNB Trauma Anaesthesia and Critical Care.

As per the National Board of Examinations website, the following accredited institutes/hospitals are offering (FNB Trauma Anaesthesia and Critical Care) courses for the academic year 2022-23.

Syllabus

FNB in Trauma Anaesthesia and Critical Care is a two years specialization course that provides training in the stream of Trauma Anaesthesia and Critical Care.

The course content for FNB Trauma Anaesthesia and Critical Care is given in the NBE Curriculum released by the National Board of Examinations, which can be assessed through the link mentioned below:

The fellow should be trained in all aspects of trauma care for all patients with various mechanisms of injury involving various systems. The training should include trauma in special populations like pediatric, geriatric, and obstetric patients.

The training path should include all content related to prehospital care, resuscitation, anesthesia for emergency trauma surgery, acute pain management, and care of critically ill trauma patients in the ICU.

The Fellow should know the local and systemic consequences of trauma involving various organs and regions:

The fellow should be trained in all aspects of trauma care for all patients with various mechanisms of injury involving various systems. The training should include trauma in special populations like pediatric, geriatric, and obstetric patients.

The training path should include all content related to prehospital care, resuscitation, anesthesia for emergency trauma surgery, acute pain management, and care of critically ill trauma patients in the ICU.

The Fellow should know the local and systemic consequences of trauma involving various organs and regions:

1. TRAUMA ACUTE CARE (Immediate Care in the Emergency

Department):

The training should include trauma care systems, trauma Epidemiology, Mechanisms of Injury, Prehospital Care, and all aspects of initial evaluation and resuscitation of an acutely injured patient.

a. Knowledge:

i. Trauma Care System, Epidemiology, Mechanisms of Injury, and

Prehospital Care

 A systematic approach to trauma care systems that includes national and state-wide trauma systems and categorization of institutions and emergency departments.

 Common causes of trauma.

 Mechanisms of blunt and penetrating injuries.

 Mechanisms of blast and high-velocity injuries.

 Pathophysiologic response to various types of injury.

 Management of mass casualty and Triaging.

 Pre-hospital care and on-site resuscitation

 Arrangement of Field teams (van calls or mass casualties): composition, directions, and communication with the trauma center.

 Modes of transport-both on ground and air- and understanding urgency of transport.

 Environmental hazards in trauma patient-Heat stroke, prolonged exposure to cold, water immersion, etc.

 Tetanus prophylaxis.

 Injury prevention/ epidemiology.

ii. Initial Evaluation and Management with Team Approach

 To learn the principles of Emergent Trauma Care and to develop an organized approach to the assessment, resuscitation, stabilization, and provision of definitive care for the trauma victim.

 Organization before trauma patient arrival – reception, directions, and planning

 Trauma team activation on patient arrival – the role of the team leader and each team member.

 Principles and practice of Advanced Trauma Life Support, Basic life support, Advanced cardiac life support, pediatric cardiac life support, Neonatal Life support, Advanced burn life support and

Advanced hazmat life support.

 Principles of pre-hospital trauma care including the role of BLS and

ALS ambulance services and air transport services.

 Organization of an emergency room.

 Recognize and treat immediate life and limb-threatening injuries in the trauma victim.

 Special considerations in the evaluation and management of the special population like pregnant, pediatric, and geriatric trauma victims.

 Airway assessment and management in trauma

 Guidelines and algorithms for emergency intubation.

 Airway equipment and techniques for emergency airway management in trauma.

 Oxygenation – principles, Indications, and devices

 Breathing and ventilation in chest trauma – principles & techniques of chest drain insertion

 Vascular cannulation – peripheral and central.

 Anatomy and physiology of circulation, the pathophysiology of hypovolaemia and blood loss, cardiac, renal, and brain function in shock state.

 Shock – identification, resuscitation and fluid therapy, damage control resuscitation

 Blood component therapy and trauma coagulopathy, massive transfusion protocols.

 Measurement of injury severity- various scales grading for different types of injuries.

 Evaluation of an unconscious patient and confounders.

 Effects of major burns and crush injuries on various body systems.

 Laboratory investigations during assessment and resuscitation – timing and interpretation.

 Radiological Imaging of trauma patients – “FAST” protocols, eFAST,

X-rays, CT, MRI, musculoskeletal USG, and Echocardiography.

 Identification of each injury and reassessment.

 Intra-hospital transfer – to CT scan, OR other intensive care areas

 Resuscitation in Special situations like polytrauma, burns drowning, high-velocity trauma, battlefield injuries, etc.

 Know special aspects of pediatric trauma/child abuse, and pregnant and geriatric trauma patients.

 To learn the principles of disaster management including Chemical,

Biological, Radiological, Nuclear and Use of explosive (CBRNE)

 To learn the principles of burn management.

iii. Medico-Legal Aspects Related to Trauma - suspected assaults, consent, brought dead patient, trauma documentation, need for an autopsy, etc.

b. Skills:

The core competencies will include the following in the context of treating a patient in the Emergency Room/ Emergency Department.

Through the above learning processes Trauma Anaesthesia and

Critical Care Fellow should be able to:

i. Demonstrate ability to rapidly and thoroughly assess victims of major and minor trauma.

ii. Demonstrate ability to establish priorities in the initial management of victims of life-threatening trauma.

iii. Should be able to rapidly triage patients in ER and identify patients requiring urgent attention.

iv. Should be able to perform primary survey rapidly and initiate emergency management as per protocols.

v. Should be able to identify potentially threatened/compromised airway and safely manage it.

vi. Anticipate and manage different airway management in various types of trauma patients-oxygenation, tracheal intubation, or surgical airway – cricothyroidotomy or percutaneous tracheostomy.

vii. Should be able to anticipate difficult airways and should be well versed with the use of video laryngoscope and supraglottic airway devices.

viii. Should identify overt or occult blood loss and assess the severity of hypovolemia. Demonstrate ability to manage fluid resuscitation of trauma victims-selecting fluid type and judging adequacy of volume replacement.

ix. Should be able to secure vascular access rapidly including difficult cases like obesity, burns, and shock state. Should demonstrate the ability to

perform the following procedures: intra-osseous needle insertion, insertion of large bore peripheral and central venous lines

x. Should be able to identify life-threatening conditions like pneumothorax. haemothorax, flail chest, and pericardial effusion and

appropriately manage it.

xi. Demonstrate ability to perform the following procedures: tube thoracostomy, splinting of extremity fractures, reduction, and

immobilization of joint dislocations, pericardiocentesis

xii. Identifies disability in case of head or suspected spinal cord injury and prevents secondary injury.

xiii. Demonstrate ability to calculate the Glasgow Coma Score and discuss its role in the evaluation and treatment of head-injured patients.

xiv. Demonstrate the ability to assess and initially manage facial trauma.

xv. Demonstrate the ability to evaluate and initially manage anterior neck injuries in ED.

xvi. Demonstrate the ability to assess and initially manage penetrating and blunt chest trauma in ED.

xvii. Demonstrate the ability to evaluate and manage blunt and

penetrating abdominal trauma in ED.

xviii. Demonstrate the ability to diagnose and initially treat pelvic fractures, keeping in mind their potential to cause massive bleeding.

xix. Demonstrate ability to use spine immobilization techniques in trauma victims.

xx. Demonstrate ability to diagnose and initially manage trauma victims with extremity fractures, dislocations, and subluxations in ED.

xxi. Demonstrate ability to manage soft tissue injuries including lacerations, avulsions, and high-pressure injection injuries.

xxii. Discuss the diagnosis and emergent management of compartment syndromes.

xxiii. Demonstrate the ability to manage the acute burns patient

xxiv. Demonstrate the ability to diagnose and treat smoke inhalation.

xxv. Be able to use point-of-care ultrasonography for the diagnosis of injury, for assisting interventional procedures, and to judge management response.

xxvi. Able to do miscellaneous procedures – urinary catheterization in male & female patients, Nasogastric tube insertion, chest tube insertion, Needle decompression of chest, traction splint application, etc.

xxvii. Appropriately manage ventilator strategies for various types of trauma patients.

xxviii. Should be able to monitor response to resuscitation.

xxix. Demonstrate ability to use and interpret imaging modalities in the evaluation of trauma patients. Demonstrate ability to interpret radiographs on trauma patients, including chest, cervical, thoracic and lumbar spine, pelvis, and extremity films.

xxx. Demonstrate appropriate use of analgesics and sedatives in trauma patients.

xxxi. Demonstrate appropriate use of antibiotics in trauma patients.

xxxii. Demonstrate ability to coordinate consultants involved in managing multiple trauma patients.

xxxiii. Discuss principles of disaster management and participate in disaster drills.

xxxiv. Discuss factors unique to the evaluation and initial management of pediatric geriatric, and pregnancy trauma in ED and demonstrate the ability to direct trauma resuscitation.

xxxv. Demonstrate skills in Advanced Trauma Life Support, Basic life support, advanced cardiac life support, pediatric cardiac life support, Neonatal Life support, advanced burn life support, and advanced hazmat life support.

xxxvi. Discuss the continuing care of the trauma victim, including operative, post-operative and rehabilitative phases of care.

2. TRAUMA ANAESTHESIA AND PAIN MEDICINE

a. Knowledge:

i. Understand the pre-operative issues relevant to the anesthetic care of trauma patients including coexisting morbidities, medications, allergic reactions, the physical examination, and the evaluation of

abnormal findings.

ii. Importance of reassessment with noting treatment received till then, complete physical examination, evaluating response to resuscitation.

iii. Know the indications for surgical intervention, pathophysiology, and anesthetic implications for common trauma surgical conditions.

iv. Understand the urgency of surgery in trauma and correlate with risks involved while timing the individual surgery.

v. For emergent surgeries-know concepts for resuscitative surgery, damage control surgery, and definitive surgeries.

vi. Understand the appropriate ordering of preoperative laboratory testing and interpretation in emergency settings.

vii. Understand fasting principles in trauma and its impact on gastric contents.

viii. Understand the basis of pharmacokinetic and pharmacodynamics differences for various trauma conditions for all ages and obstetric patients- differences in drug volume of distribution, MAC, protein

binding, metabolism, and excretion. Of all sedatives and anesthetic agents.

ix. Know the doses of intravenous anesthetic medications including induction agents, opioids, neuromuscular blockers, reversal agents, and emergency medications including side – effects and contraindications in hypovolemic trauma patients of all ages

[including burns and obstetric patients].

x. Understand difficult airways and know the criteria for surgical airway-tracheostomy for head and neck trauma patients.

xi. Understand principles of increased intracranial pressure, cerebral blood flow & cerebral metabolism, and measures to manage them

intraoperatively.

xii. Knowledge about the effects of massive blood loss, transfusion protocols, trauma coagulopathies, and principles of blood component

therapy.

xiii. Knowledge about criteria for extubation in different kinds of trauma and indications for delayed extubation and ventilatory support.

xiv. Understand the indications and contraindications for regional anesthesia and peripheral nerve blocks in trauma patients with side effects and complications for anesthesia or analgesia.

xv. Understand the post-operative anesthetic complications for trauma patients-nausea/vomiting and emergency delirium and their management.

xvi. Knowledge about indications and reasons for damage control surgery and multiple staged surgeries.

xvii. Understand the implications of laparoscopy surgery pneumoperitoneum and the physiological changes due to carbon dioxide/air insufflations.

xviii. Understand the hemodynamic changes in thoracoscopic procedures and the physiology of one lung ventilation lung trauma

patient. Know Lung isolation techniques in thoracic surgery and the devices available in the appropriate age group.

xix. Understand the implications of providing monitored anesthesia care/ sedation for CT scans, MRI, cardiac procedures, and additional procedures outside of the traditional OR environment.

xx. Basic principles and practice of Battlefield Anaesthesia and

Analgesia – drugs, techniques, and limitations.

xxi. Understand methods for recognition, assessment, and measure pain indifferent trauma age groups.

xxii. Know various methods for the treatment of acute postoperative pain in trauma patients.

xxiii. Understand the various opioid analgesics and their indications in the trauma patient.

xxiv. Know different regional analgesia techniques for acute and acute postoperative pain relief.

xxv. Understand the pathophysiology and treatment of common chronic or acute chronic painful conditions-reflex sympathetic dystrophy.

b. Skills:

The trainee will develop advanced skills relevant to the care of the trauma patient, particularly trauma resuscitation, anesthesia, and pain management.

The Skills will include:

i. OT preparedness for anticipated emergency surgery.

ii. Performs appropriate preoperative evaluation of all trauma patients, identifies newer developments in status, and evaluates response to resuscitation.

iii. Obtain information about medical and surgical history from the patient or informant when possible.

iv. Obtain informed consent from a trauma patient and next of kin.

v. Administer appropriate premedication.

vi. Able to do basic non-invasive monitoring and invasive hemodynamic monitoring using appropriate devices.

vii. Develop skills to manage anesthesia for all types of trauma patients and techniques involved in it for its management.

viii. Appropriately administer anesthesia to all age groups and all types of trauma patients posted for various types of surgical operations.

ix. Perform inhalation inductions in a trauma patient if required.

x. Develop the ability to choose appropriately between endotracheal intubation, supraglottic devices, or facemask ventilation for any trauma surgical procedures.

xi. Perform face mask ventilation, SGD [supraglottic device] placement, and tracheal intubation on trauma patients.

xii. Airway management skills include awake fibreoptic aided intubation, airway blocks, and performing one lung anesthesia when indicated.

xiii. Should be able to demonstrate simple surgical procedures (e.g. needle cricothyroidotomy, percutaneous cricothyroidotomy) and use of a trans-tracheal jet ventilator

xiv. Appropriately manage upper airway obstruction, laryngospasm, and bronchospasm in trauma patients.

xv. Resuscitation skills: Basic principles of damage control resuscitation

xvi. Secure venous access, both peripheral and central through various routes in indicated patients.

xvii. Able to secure arterial lines in major trauma cases.

xviii. Able to appropriately select intravenous fluids and judge the adequacy of fluid therapy.

xix. Calculate the maximum permitted blood loss in the trauma patient.

xx. Demonstrate the ability to estimate blood loss in trauma patients and

replace it with appropriate blood components. Manage massive blood transfusions as per protocols

xxi. Monitor patient temperature and perform warming methods to prevent and treat hypothermia.

xxii. Able to appropriately manage intraoperative increased ICP

xxiii. Able to conduct Minimal access surgery (laparoscopy and thoracoscopy) in trauma patients.

xxiv. Able to discuss different aspects and risks involved in surgery and plan time and extent for surgery in unstable or high-risk trauma patients.

xxv. Able to manage intraoperative cardiac or respiratory complications.

xxvi. Perioperative management of hip fracture patients as per International guidelines

xxvii. Management of brain-dead patients in OR for Organ Donation

xxviii. Interpretation of diagnostic imaging (including FAST, transthoracic echocardiography, CXR, lung US, etc)

xxix. Provide general and regional anesthesia for a range of elective and emergency trauma cases, including neurotrauma, thoracic trauma, abdominal trauma, orthopedic trauma, facial trauma and burns

xxx. Should be safely able to perform Regional Anaesthesia procedures - Upper and lower limb blocks (Landmark / USG guided/ PNS), perineural catheter insertion, and pain management.

xxxi. Demonstrate the ability to develop and carry out a plan to manage and treat postoperative pain.

xxxii. Learn and perform epidural catheterization and regional nerve blocks for acute pain relief.

xxxiii. Learn the use of portable epidural pumps and Patients Controlled

Analgesia pumps.

xxxiv. Demonstrate the ability to treat refractory postoperative pain.

xxxv. Be able to evaluate and treat common complications of analgesic therapy in children (e.g., nausea, vomiting, pruritus, and respiratory depression).

xxxvi. Be able to evaluate and manage trauma patients with epidural analgesia and breakthrough pain.

xxxvii. Learn the diagnosis and treatment of chronic pain (the result of traumaneuropathic pain in amputations). · · ·

xxxviii. Code Blue Team Resuscitation. Knowledge of LA, its toxicity, and management of LAST.

3. TRAUMA CRITICAL CARE (Care of the critically ill Trauma

Patient in the Trauma Intensive Care Unit):

The Trauma critical care training must enable the trainee to acquire an advanced body of knowledge and level of skill in the management of critically ill trauma patients to assume a leadership role in teaching and research in trauma critical care.

This advanced body of knowledge and level of skill must include the mastery of

1. The use of advanced technology and instrumentation to monitor and treat the physiologic status of adults or children of both sexes, including those in the neonatal, pediatric, child-bearing, or advanced years.

2. Management of Postoperative patient

3. Organizational and administrative aspects of a critical care unit; and

4. Ethical, economic, and legal issues as they pertain to critical care.

Didactic Curriculum

The program must provide the opportunity for residents to acquire advanced knowledge of the following aspects of critical care, particularly as they relate to the management of patients with hemodynamic instability, multiple system organ failures, and complex coexisting medical problems:

1. Cardiorespiratory resuscitation

2. Physiology, pathophysiology, diagnosis, and therapy of disorders of the cardiovascular, respiratory, gastrointestinal, genitourinary, neurological, endocrine, musculoskeletal, and immune systems, as well as of infectious diseases

3. Detailed knowledge about various aspects of respiratory failure and its management by adequate ventilator management with the help of mechanical ventilation.

4. Metabolic, nutritional, and endocrine effects of critical illness

5. Hematological and coagulation disorders

6. Analgesia: IV and regional analgesia techniques for pain relief in trauma victims.

7. Renal disorders and their management in trauma patients.

8. Critical obstetric and gynecologic disorders in injured females

9. Trauma, thermal, electrical, and radiation injuries

10. Inhalation and immersion injuries

11. Monitoring and medical instrumentation

12. Critical pediatric surgical conditions

13. Pharmacokinetics and dynamics of drug metabolism and excretion in critical illness

14. Ethical and legal aspects of surgical critical care

15. Principles and techniques of administration and management of ICU

16. Biostatistics and experimental design

a. Knowledge

The candidate must understand the pathophysiology, construct a differential diagnosis and apply the appropriate prophylactic and therapeutic interventions in the following disorders.

i. Respiratory

Management of airways (including respiratory arrest, upper airway obstruction, smoke or burns airways damage), pulmonary edema, adult respiratory distress syndrome, hypercapnic respiratory failure, severe asthma, chest trauma, disorders, and thoracic surgery. Understand the indications and principles of mechanical ventilation and modes of ventilation and weaning in trauma patients.

ii. Cardiovascular

Hemodynamic instability and shock, cardiac arrest, acute myocardial infarction, unstable angina, heart failure, common arrhythmias, conduction disturbance, specific cardiac disorders (cardiomyopathies, valvular heart disease, atrial or ventricular septal defects, myocarditis), cardiac tamponade, pulmonary embolism, aortic dissection, hypertensive crisis, peripheral vascular diseases. Cardiopulmonary resuscitation (CPR), Advanced Trauma Life Support (ATLS), and Advance Life Support (ALS)

iii. Neurology

Coma, traumatic brain injury, intracranial hypertension, cerebrovascular accidents, cerebral vasospasm, post-anoxic brain

damage, acute confusional states, spinal cord injury, neurosurgery, and brain death. Understand the principles and determinants of intracranial pressure (ICP). Various techniques to measure ICP. Understand measures to prevent secondary brain injury. Understand sequelae of spinal cord trauma-spinal shock, autonomic hyperreflexia, etc – and their management

iv. Renal Oliguria. Acute renal failure, renal replacement therapy

v. Metabolic & Nutritional

Fluid electrolyte and acid-base disorders, endocrine disorders (including diabetes), nutritional requirements, and monitoring of nutrition.

vi. Haematological

Disseminated intravascular coagulation and other coagulation disorders, hemolytic syndromes, acute anemia, blood component therapy, blood conservation techniques, and immune disorders.

vii. Infections

Severe infection due to aerobic and anaerobic bacteria, viruses, fungal, nosocomial infection, infection in the immune-compromised, tropical disease, antimicrobial therapy, immunotherapy.

viii. Gastro-intestinal Inflammatory bowel diseases, pancreatitis, acute and chronic liver failure, prevention and treatment of acute G.I. Bleeding, peritonitis, mesenteric infarction, perforated viscus, bowel obstruction, abdominal trauma.

ix. Environmental Hazards

Burns, hypo-and hyperthermia, near-drowning electrocution, radiations, chemical injuries, and animal bites.

x. Toxicology, poisoning Acute intoxications, drug overdose, serious adverse reactions, anaphylaxis.

xi. General

 Pharmacology, pharmacokinetics, and drug interactions.

Analgesia, sedation and muscle relaxants, inflammation and anti-inflammatory agents, multiple trauma, transport of the critically

ill, multisystem disorders (including Multi-Organ Dysfunction

syndrome MODS and the Systemic Inflammatory Response

Syndrome SIRS) Management of the organ donor.

 Support of the potential organ donor.

 Knowledge about Positioning of trauma cases and immobilization.

 Know techniques for the prevention of DVT, pulmonary embolism, fat embolism, and bed sores.

 Rehabilitation and supportive care in trauma.

 Psychiatric issues following traumatic injuries including PTSD.

 Role of physiotherapist and occupational therapist for trauma patients

b. Skills

i. General

Pharmacology, pharmacokinetics, and drug interactions. Analgesia, sedation and muscle relaxants in critically ill patients, inflammation and anti-inflammatory agents, multiple trauma, transport of the critically ill, multisystem disorders (including Multi-Organ Dysfunction syndrome MODS and the Systemic Inflammatory Response Syndrome SIRS) Management of the organ donor.

ii. Respiratory

Management of the airway, endotracheal intubation (oral and nasal) and emergency cricothyrotomy suctioning of the airway, setting and turning of the respirator with different modes of ventilation, titration of oxygen therapy, techniques of weaning from mechanical ventilation, placement of an intercostal tube and percutaneous

tracheostomy, implementation of respiratory pharmacological support, fiberoptic bronchoscopy, interpretation of arterial and mixed venous blood gases, assessment of gas exchange and respiratory mechanics. Knowledge of High-frequency oscillatory ventilation, ECMO, etc.

iii. Cardiovascular

Placement of a central venous catheter (by different routes), arterial catheter (by different routes) measurement and interpretation of the hemodynamic variables (including the derived variables),

implementation of cardiovascular support antiarrhythmic therapy, and thrombolysis. Invasive and noninvasive monitoring techniques include TEE, Cardiac Ultrasound, and transvenous pacing.

iv. Neurologic

Basic interpretation of brain CT/MRI scan, Able to use various techniques of intracranial pressure monitoring. Application of Transcranial Doppler in traumatic brain injury. Diagnosis and management of brain-dead patient

v. Nutrition

Metabolic and Nutritional Implementation of intravenous fluid therapy. Should be able to calculate and provide enteral and parenteral nutrition.

vi. Haematologic

Correction of hemostatic and coagulation disorders, interpretation of a coagulation profile, blood conservation techniques, and implementation of thrombolysis.

vii. Renal:

Bladder catheterization, renal replacement techniques.

viii. Gastro-intestinal and Hepatic:

Placement of gastric tube, utilization of gastrointestinal intubation and endoscopic techniques in the management of the critically ill patient; application of enteral feedings; management of stomas, fistulas, and percutaneous catheter devices.

ix. Infectious disease:

Diagnosis of infections and application of isolation techniques, pharmacokinetics, drug interactions, and management of antibiotic therapy during organ failure; nosocomial infections; indications for applications of hyperbaric oxygen therapy.

x. Monitoring/bioengineering: use and calibration of transducers, amplifiers, and recorders.

xi. Analgesia:

Intravenous and regional anesthetic techniques for adequate pain relief

xii. Miscellaneous:

use of special beds for specific injuries; employment of pneumatic anti-shock garments, traction, and fixation devices

4. NON-TECHNICAL SKILLS

1. Informed written Consent/Consent in unknown patient

2. Principles of Crisis management, conflict resolution, and debriefing

3. Breaking bad news

4. Counselling relatives for Organ donation in brain dead patient

5. Ethical and family issues in trauma

6. Medicolegal aspects in trauma

7. Disaster Management strategies and prevention measures by Government and other authorities

Career Options

After completing FNB Trauma Anaesthesia and Critical Care, candidates will get employment opportunities in Government and the Private sector.

In the Government sector, candidates have various options to choose from which include Junior research fellow, Teaching at academic medical centers, and Consultants.

While in the Private sector the options Fellow (Trauma Anaesthesia and Critical Care), Junior research fellow (Trauma Anaesthesia and Critical Care), Senior Research fellow (Trauma Anaesthesia and Critical Care), and Consultants (Trauma Anaesthesia and Critical Care).

Frequently Asked Questions (FAQs) –FNB Trauma Anaesthesia and Critical Care Course /FNB in Trauma Anaesthesia and Critical Care Course

• Question: What is the complete form of FNB?

Answer: The full form of FNB is Fellow of National board.

Answer: FNB in Trauma Anaesthesia and Critical Care or Fellow of National Board in Trauma Anaesthesia and Critical Care is a doctoral fellowship program for doctors in India that they do after completion of their postgraduate medical degree course.

• Question: What is the duration of FNB in Trauma Anaesthesia and Critical Care?

Answer: FNB in Trauma Anaesthesia and Critical Care is a doctoral fellowship program of two years.

Answer: The candidate should have DNB/MD Anaesthesia degree obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE. The prerequisite requirements mentioned here are as of 2022. For any further changes, please refer to the NBE website.

Answer: FNB Trauma Anaesthesia and Critical Care offer candidates various employment opportunities and career prospects.

Answer: The FNB Trauma Anaesthesia and Critical Care candidate’s average salary is between Rs.10 lakhs to Rs. 51 lakhs per annum depending on the experience.

Answer: Yes, the candidate can teach in a medical college/hospital after completing the fellowship.