Learning outcomes of the course unit
The training objective of the course is to provide common knowledge elements and a unique language for the team dedicated to the management of emergencies to acquire a sharing of the problems. In practice, we want to offer tools to ensure adequate preparation of students for effective management of the emergency in the hospital (operating room, ward, ICU and emergency room), giving the opportunity to address the clinical problems of the emergency, through theoretical training and practice.
In particular, students will learn the tools for:
- Evaluate a case of cardiac arrest
- Frame the patient from a respiratory and metabolic point of view
- Diagnose an acute coronary syndrome
- Detect an arrhythmia, intervening on those dangerous for life
- 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
- 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 to reduce 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.
Course contents summary
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.
Cardio-circulatory arrest: etiology. pathophysiology, epidemiology and treatment
• BLS / ALS
• Principles of mechanical ventilation
• Triage and management of medical resources
• Lung diseases:
• Blood gas analysis and metabolic urgencies.
• Acid-Base balance
• Cardiac arrhythmias: etiology. pathophysiology, epidemiology and treatment
• Acute myocardial infarction
• Cerebrovascular accidents
• Acute renal failure
• Monitoring of the critical patient
Shock: etiology, pathophysiology, epidemiology, definition, differential diagnosis and treatment
• Fluid therapy and vasoactive drugs
• Physiopathology and therapeutic diagnostic path
• 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
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).