Learning objectives
The training objective of the course is to provide common knowledge elements and a unique language for the team dedicated to emergency management to share problems.
In practice, we want to offer tools to ensure adequate preparation of students (future doctors) for effective management of the emergency, giving the opportunity to address the clinical problems of the emergency, through theoretical and practical training, and acquire the methodology that allows to deal with the emergency effectively. The method includes:
1. the need for a reference to the pathophysiology also in the face of the emergency
2. clear and rapid identification of priorities
3. the obligation to bring a conclusively analytical approach (differential diagnosis, diagnosis and therapy) into a conclusive and operational synthesis
Finally, we want to offer the possibility of approaching the operating room, from an anesthetic point of view, and in particular:
- approach the evaluation of patients to be subjected to general and loco-regional anesthesia
- know how to distinguish the pharmacological principles of the various anesthetic behaviors
- evaluate the monitoring of vital signs in the operating room for the different patients and the different types of "anesthesia"
- learn to recognize the different periods and post-operator journeys
In particular, students will learn the tools for:
- start to manage a cardiac arrest
- Analyze an BGA and frame the patient from the respiratory and metabolic point of view
- Diagnose an acute coronary syndrome, establish initial treatment and direct the patient to the most appropriate care setting
- Detect and categorize an arrhythmia, intervening on those dangerous for life
- Recognize and treat anaphylactic shock
- Hypothesize nature and organize treatment of acute diseases of the gastrointestinal tract
- Diagnose and start the management of acute and ketoacidosis, and manage complications
- Exclude or confirm the presence of life-threatening injuries in the traumatized patient
- Categorize respiratory urgencies and propose the most appropriate treatment
- Recognize signs of sepsis and septic shock, applying initial treatment and recognizing signs of worsening to transfer the patient to the most appropriate setting
- Answering the patient's questions on anesthesia, also briefly describing the goals, the sequence of events, the complications
- Know the risk factors for perioperative complications, proposing to the patient treatments aimed at minimizing the risk
The evaluation will be integrated with a judgment of learning BLSD and an oral exam that will relate to the clinical cases of PS, operating room and ICU, which will be a starting point for a discussion on "Course Topics." For any topics not covered in class, the student will be referred to the contents of the recommended texts. The student's ability to deal with simulated clinical cases will also be assessed.
Prerequisites
NA
Course unit content
The main issues related to emergency / emergency management in the hospital and on the territory will be addressed, assessing concrete clinical problems, through theoretical and practical training. The appropriate methodology will be provided to enable the urgency / emergency to be dealt with effectively. In addition, we will learn the main anesthetic techniques (general and regional anesthesia) and analgesia. They are showing peripheral blocks and related indications. Through practical exercises each student will understand the importance of pre-operative anesthetic assessment of individual patients, anesthetic drugs, the clinical monitoring of the operating period. Finally, the anesthesia will be explained for each surgery.
Full programme
• Cardio-circulatory arrest: etiology. pathophysiology, epidemiology and treatment
• BLS / ALS
• Principles of mechanical ventilation
• Triage and management of medical resources
• Lung diseases: ARDS, pulmonary embolism, pulmonary edema, bronchial asthma
• Blood gas analysis and metabolic urgencies.
• Acid-Base balance
• Cardiac arrhythmias: etiology. pathophysiology, epidemiology and treatment
• Acute myocardial infarction
• Hypertension
• Cerebrovascular accidents
• The inadequacy. acute renal
• Metabolism: decompensated diabetes and other diseases
• Monitoring of the critical patient
Shock: etiology, pathophysiology, epidemiology, definition, differential diagnosis and treatment
• Fluid therapy and vasoactive drugs
• The serious politrauma. Coma and brain death, organ donation. Poisoning and poisoning
• Physiopathology and therapeutic diagnostic path
• Acute abdomen: peritonitis and occlusion
Penetrating trauma of the abdomen: hemoperitoneum
The ruptured aneurysms and the limb ischemia
Chest traumas and emerging chest and mediastinal pathologies
• Pediatric emergency approach
• Principles of general and locoregional anesthesia
• Monitoring of vital functions
• Physiopathology of pain
• Pain therapy
Bibliography
• F. Della Corte. Manuale di Medicina d’urgenza
• Ferrari, Medicina d’emergenza urgenza, Elsevier
• ROSEN’S. Emergency Medicine
• Terapia Intensiva, principi fondamentali (P.Marino, MP Fink), Masson
• E.Romano, Anestesia- I principi e le tecniche, UTET
• JM Civetta, critical care: JB Lippincott, Philadelphia
Teaching methods
Frontal lessons and slides
Practical exercises and case
Assessment methods and criteria
The student’s knowledge, topics’ comprehension and her/his skill to apply them on the occupational contexts will be evaluated by questions on the topics related to the course content. Failed answer to one or more questions or proved insufficiency of the basic knowledge on the subject will preclude the successful completion of the exam. In case of completion of the exam, an evaluation that contributes to the final grade of the course will be defined and it will be based on the achievement of the objectives (excellent, good, fair, fully sufficient, barely sufficient).
Other information
NA
2030 agenda goals for sustainable development
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