ANAESTHESIOLOGY AND HANDLING EMERGENCIES
Learning outcomes of the course unit
The educational objective of the course is to provide notions related to the different drugs used in Dentistry, such as local anesthesia, analgesics and drugs for any sedation (conscious, deep). Also: anxiety medications, anti-inflammatory drugs, painkillers and non-steroidal antipyretics (NSAIDs). Other pain medications. Drugs active on the cardiovascular system.
In particular, we want to offer the opportunity to approach in a practical way, from an anesthetic point of view, to:
- evaluation of patients to be subjected to loco-regional anesthesia, sedation, analgesia or general anesthesia
- know how to distinguish the pharmacological principles of the various anesthetic behaviors
- evaluate the monitoring of vital parameters for different patients and the different types of "anesthesia"
- learn how to recognize and manage emergency situations
Finally, we want to offer tools to ensure adequate preparation for the initial management of the emergency in the hospital, 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 exam will consist of an integrated assessment, inclusive of a BLSD learning judgment and a oral exam that will deal with clinical cases, which will be inspired for an in-depth analysis on the "Topics of the course". For topics not covered in class, the student will refer to the contents of the recommended texts. The student's ability to deal with simulated clinical cases will also be assessed.
Course contents summary
During the course the main anesthetic techniques will be addressed, such as loco-regional anesthesia, sedation and the main analgesia techniques. Through practical exercises each student will be able to understand the importance of the pre-procedure anesthesia evaluation of the different patients, of the anesthetic drugs and of the clinical monitoring of the patient. In addition, the main issues related to emergency management in the hospital (and outside) will be illustrated, evaluating real clinical problems, through theoretical and practical training. The appropriate methodology will be provided to enable the emergency to be dealt with effectively.
In particular, students will be presented:
• Principles of pharmacokinetics
• Principles of pharmacodynamics
• Pharmacology of the Autonomous Nervous System
• Drugs of anxiety and conscious sedation. Nitrous oxide. Anti-inflammatory drugs (NSAIDs). Other pain medications. Drugs active on the cardiovascular system. Active drugs on gastric function. Drugs acting on coagulation.
• Principles of Anesthesiology and Sedation in dentistry. Local-regional anesthesia. General anesthesia
- Cardio-pulmonary resuscitation in adults (with airway obstruction)
- Cardio-pulmonary resuscitation in children (with airway obstruction)
- The 118 system
- Cardiac arrhythmias
- Anaphylactic shock
- Syncope, lipothymia and vaso-vagal crisis
- Hypertensive crisis and acute pulmonary edema
- Acute myocardial infarction
- Asthmatic crisis + O2 therapy + invasive and non-invasive ventilation
- Neurological Emergencies: Stroke (ischemic / hemorrhagic) and convulsions
- General anesthesia and sedation.
- Local / locoregional anesthesia (toxicity of anesthesia drugs)
- Hemorrhage and anticoagulants
- Antibiotic prophylaxis
- operating room frequency
.Romano, Anestesia- I principi e le tecniche, UTET
• Manani G “Anestesia in Odontostomatologia”, IIIa Ed, Idelson-Gnocchi, 2011
• Katzung BG Farmacologia generale e clinica Piccin, Padova
• F. Della Corte. Manuale di Medicina d’urgenza
• Chiaranda M Urgenze ed emergenze: Istituzioni, IIIa Ed, Piccin, Padova, 2011
• ROSEN’S. Emergency Medicine
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).