FFICM Clinical Standards and Guidelines 2 — Questions and Answers
Question 1: According to the Surviving Sepsis Campaign guidelines, what is the recommended duration for the initial resuscitation bundle in septic shock?
- 1 hour (Correct answer)
- 3 hours
- 6 hours
- 12 hours
Correct answer: 1 hour
The 2018 Surviving Sepsis Campaign updated the bundle to a 1-hour bundle emphasizing immediate blood cultures, antibiotics, and fluid resuscitation.
Question 2: The NICE guideline CG83 on rehabilitation after critical illness recommends that a structured rehabilitation program begin at which point?
- Only after ICU discharge
- Within the first 24 hours of ICU admission
- As soon as the patient is medically stable in ICU (Correct answer)
- Only when transferred to a step-down unit
Correct answer: As soon as the patient is medically stable in ICU
NICE CG83 recommends rehabilitation planning begins as soon as the patient is medically stable, not deferred until discharge.
Question 3: Which core safety standard from NHS England mandates that all ICUs have a minimum staffing ratio of one nurse per how many patients for level 3 care?
- 1:1 (Correct answer)
- 1:2
- 1:3
- 1:4
Correct answer: 1:1
NHS England's Core Standards for Intensive Care Units specify a 1:1 nurse-to-patient ratio for level 3 (ICU) patients.
Question 4: The Faculty of Intensive Care Medicine's 'Care at the End of Life' guidelines emphasize which ethical principle as the primary driver for withdrawal of life-sustaining treatment decisions?
- Beneficence only
- Autonomy and best interests of the patient (Correct answer)
- Non-maleficence above all else
- Justice and resource allocation
Correct answer: Autonomy and best interests of the patient
FICM end-of-life guidance centres on patient autonomy and best-interests decision-making, incorporating family input when the patient lacks capacity.
Question 5: According to ICNARC standards, what is the benchmark target for ICU standardised mortality ratio (SMR) quality monitoring?
- SMR < 0.5
- SMR approaching 1.0 with confidence intervals crossing 1 (Correct answer)
- SMR > 1.5 triggers mandatory review
- SMR is not used as a quality benchmark
Correct answer: SMR approaching 1.0 with confidence intervals crossing 1
An SMR with confidence intervals crossing 1.0 indicates performance consistent with expected mortality; significant deviation triggers review.
Question 6: Which document sets out the minimum dataset that UK ICUs must submit to the Case Mix Programme (CMP)?
- FICM Quality Standards 2019
- ICNARC CMP Data Specification (Correct answer)
- NHS England Commissioning Standards
- BTS/ICS Weaning Guidelines
Correct answer: ICNARC CMP Data Specification
The ICNARC Case Mix Programme Data Specification defines the mandatory dataset submitted by participating ICUs for benchmarking.
Question 7: The NICE quality standard QS61 for infection prevention in ICU specifically recommends which intervention to reduce central line-associated bloodstream infections (CLABSI)?
- Routine antibiotic prophylaxis at insertion
- Chlorhexidine-impregnated dressings and daily review of line necessity (Correct answer)
- Replacing all central lines every 72 hours
- Using femoral access preferentially
Correct answer: Chlorhexidine-impregnated dressings and daily review of line necessity
QS61 recommends chlorhexidine dressings, aseptic insertion bundles, and daily review of whether the central line remains necessary.
FFICM Clinical Standards and Guidelines 2
According to the Surviving Sepsis Campaign guidelines, what is the recommended duration for the initial resuscitation bundle in septic shock?