Name of the subject FACULTY/INSTITUTE SYLLABUS COURSE TITLE: Intensive care Intensive care Department of Medical Rescue COURSE CODE DEGREE PROGRAMME FIELD OF STUDY DEGREE LEVEL STUDY MODE Medical rescue First degree programme Full time/ extramural COURSE FORMAT Main course - lectures + exercises + Practical exercises YEAR AND SEMESTER 2012/2013III semester VI Lectures - 30 exercises- 45 Practical activities - 50 vocational practice- 80 self-education- 10 NAME AND SURNAME OF THE COURSE COORDINATOR NAME OF THE TEACHER As assigned Course objectives A. Preparation of the student for interpreting and understanding the knowledge regarding: - The methods and principles of conducting anaesthesia; - Specificity of organisation and work of the intensive care ward; - Life-threatening conditions; - Principles of monitoring patients in the life-threatening conditions; - Principles of conduct in the conditions of immediate life-threatening B. Preparation of the student, in the scope of skills, for: - Cooperation with the personnel in the life-threatening situations in patients from intensive care wards. C. Shaping the attitude of the student towards: Extending knowledge in the scope of anaesthesiology and intensive care Preliminary requirements The student has a knowledge of anatomy, physiology, pathophysiology, pharmacology, internal diseases Learning outcomes Knowledge: Student: 1. Knows the course of the anaesthetic process and shows the principles and methods of care over an anaesthetic patient K_W74; 2. Characterises the methods of regional anaesthesia K_W75; 3. Recognises life-threatening conditions and defines monitoring of patients by equipment or non-equipment based methodsk_w76; 4. Numbers principles of eating habits of healthy persons at different ages and characterises the essence of intra intestinal and parenteral nutrition K_W57; 5. Knows the principles of dietary prophylaxis and treatment K_W58; 6. Defines hospital infections, with regard to sources and reservoir of microbes in the 1
hospital environment, portals of infections, prevention and fighting against hospital infections K_W65; 7. Knows the essence and aim of treating with blood and blood substitutes K_W119; Skills: Student: 1. Uses the knowledge of treating with blood and blood substitutes K_U10; 2. Gathers information by the technique of the interview, observation, direct and indirect measurements (scales), analysis of documentation (including the analysis of diagnostic research), physical examination in order to recognise the health condition of the patient K_U40; 3. Monitors the condition of the patient at every stage of the stay at a hospital or other health care centres, i.a. by means of the assessing basic life parameters: temperature, pulse, blood pressure, breath and consciousness, body weight and height K_U43; 4. Stores medicines according to currently binding regulations K_U44; 5. Administers the patients medicines by means of various ways, pursuant to the written referral of the physician and calculates medicine doses K_U45; 6. Uses various methods for feeding the patient K_U48; 7. Administers a catheter to the urinary bladder, monitors diuresis, takes the catheter, performs washing of the urinary bladder K_U50; 8. Puts the patient in bed in therapeutic positions and changes their positions K_U51; 9. Performs breathing gymnastics and folding drainage, inhalation and elimination of mucous from the respiratory tract K_U52; 10. Installs and removes a catheter from peripheral veins K_U56 11. Monitors, assesses and cares for the place of central, peripheral insertion and vessel port K_U57; 12. Performs pulsoximetry and capnometria K_U58 ; 13. Collects material for laboratory and bacteriological tests K_U59; 14. Checks off the performance of orders on the card of medical orders K_U61; 15. Implements standards of conduct preventing from hospital infections as well as the infections in other health care centres K_U75; 16. Uses safe disinfection agents and segregates medical wastes K_U76 K_U76; 17. Performs under supervision of a doctor, tracheal intubation in direct laryngology, with relaxants and performs supplementary ventilation K_U82; 18. Cares for the patient with a fistula, intubation and tracheotomic tube K_U89; 19. Performs and administers medicines by various ways, voluntary or upon the request of the doctor K_U95; 20. Collects material for diagnostic tests K_U96; 21. Diagnosis of the emergency case K_U100; 22. Runs the medical documentation K_U103. FINAL COURSE OUTPUT - SOCIAL COMPETENCES: Student: 1. Has knowledge of responsibility for their work and readiness to team work and being responsible for team actions K_K01; 2. Respects dignity and autonomy of persons to be cared K_K02;; 3. Permanently extends professional knowledge, shapes skills, aiming at professionalism K_K03; 4. Has moral responsibility for a person and performing professional tasks K_K05; 5. Obeys patient s rights K_K06; 6. Protects professional secret K_K08; 7. Shows empathy in relations with a patient, their family and co-workers. K_K20; 8. Respects dignity and autonomy of persons to be cared K_K02;. COURSE ORGANISATION LEARNING FORMAT AND NUMBER OF HOURS Lecture - 30 hours, Exercises - 45 hours, 2
Practical activities - 50 hours Vocational practice - 80 hours, Self-education - 10 hours Content No. Content - LECTURES/EXERCISES Number of hours W1 Supervision over the patient requiring intensive care 5 W2 The intensive care ward. The standards and procedures regarding intensive care ward. L3 Mechanical ventilation 4 L4 Non-equipment based methods of restoring the patency of respiratory ducts L5 Most common diseases treated at the intensive care ward 10 Ex 1 Cannulation of blood vessels. Monitoring of life functions 5 Ex2 Treatment of pain 5 Ex3 Nutrition in intensive care 10 Ex4 General principles of handling patients from the intensive care ward. 15 Ex5 Prophylaxis of infections at the intensive care ward. 5 Ex6 Medicines in rescue medicine, anaesthesiology and intensive care 10 6 5 Practical activities: No. Content: Number of hours 1 The intensive care ward 24 1.Equipment of the intensive care ward. Equipment and non-equipment monitoring of patients from the intensive care ward. Participation of medical rescuer in basic diagnostic and therapeutic procedures at the intensive care ward. Laboratory tests. Care for the unconscious patient. 2.Care for the patient with a diagnosed cardiac arrest. 3.Care for the patient with diagnosed respiratory failure. 4. New procedures of conduct and care for the injury of lungs and acute kidney failure. 5.Nursing the patient with the multi-organ injuries. 6. Nursing the patient with heavy sepsa. 2 Department of anaesthesiology 10 1. Role and functions of an anaesthesiologist. 2. Anaesthesiologic interview and patient s examination. 3
3. Methods of anaesthesia. General anaesthesia. Conduction anaesthesia (epidural, subarachnoid anaesthesia). 4. Indications and contradictions for anaesthesia. 5. Safety of anaesthesia, general and conduction anaesthesia complication. 6. Post-operating care at the ward of waking up. 3 Cardiovascular surgery department (post-operating department/operating room) 1. Characteristics of anaesthesia in cardiovascular surgery Monitoring in cardioanaesthesia. Extrasomatic circulation. 2. Methods of supporting the circulatory system (IABP, bio pump, artificial ventricles, ECMO) 3. Post-operative care for the patient after the cardiovascular operation 4 Cardiologic department (acute coronary syndromes) 8 1.Care for the patient with disorders of the heart rhythm. 2.Care for the patient with a clinical symptoms of acute coronary syndrome. 8 Vocational practice: No. Content: Number of hours Department of intensive care 40 1. Complete and individual nursing of an unconscious patient. 2.Complete and individual nursing of a patient in shock. 3. Complete and individual nursing of a patient after electrotherapy for disorders of heart rhythm. 4. Complete and individual nursing of a patient with disorders of heart rhythm requiring electro stimulation. 5. Complete and individual nursing of a patient with disorders of water and electrolyte balance. 6. Complete and individual nursing of a patient with disorders of acid and base balance. 7. Complete and individual nursing of a patient in diabetic coma. 8. Complete and individual nursing of a patient with hypertension crisis. 9. Complete and individual nursing of a patient with thyroid crisis. 10. Complete and individual nursing of a patient with acute poisoning. 11.Complete and individual nursing of a pregnant patient staying at the department of intensive care. 1. Complete and individual nursing of a child in a critical state. Department of Cardiology /Cardiovascular department (Postoperating/ Operating room) 1. Care for the patient after cardiovascular operation. 40 4
METHODS OF INSTRUCTION REQUIREMENTS AND ASSESSMENTS GRADING SYSTEM lecture with a multimedia presentation, exercises, group work, discussion, case studies, instructions Semester marks on the basis of partial marks, positive mark from the final examination - III year, VI semester Forms of obtaining credits: - The student is obliged to prepare theoretically themselves for each exercises - During the activities, the students knowledge is verified in a test. The test is in writing (passing the test constitutes 60% of the correct answers) Final test - Final examination (VI semester) Learning Metody oceny outcomes K_W74 K_W75 K_W119 K_W76 K_W65 K_W57 Odniesienie do treści kształcenia W1-W5 Ćw.1-6 W1-W5 Ćw. 1 6 zajęcia Ćw.1-6 Zajęcia W1-W5 Ćw. 1 6 zajęcia W1-W5 Ćw. 1 6 zajęcia Kolokwium Zaliczenie końcowe z oceną Kolokwium Zaliczenie końcowe z oceną Metody i narzędzia dydaktyczne praca w grupie ćwiczenia wykład dyskusja Exercises wykład K_W58 W1-W5 5
Ćw. 1 6 zajęcia K_U40 Ćw. 1-6 W2 K_U43 K_U44 K_U45 W2 Ćw.4-6 W2 Ćw.2 W1 Ćw.2-5 K_U48 W2,W5 K_U50 Ćw. 3 K_U51 Zajęcia K_U52 K_U56 K_U57 K_U58 K_U59 W1-5 K_U61 Ćw.1-6 K_U74 Zajęcia K_U76 K_U82 K_U90 K_U10 K_U90 K_U96 K_U97 K_U101 K_U104 K_K01 K_K02 K_K03 K_K05 K_K06 K_K08 K_K20 K_K21 Zajęcia Zajęcia ocena umiejętności praktycznych i wiedzy teoretycznej, przygotowany materiał dydaktyczny i jego prezentacja Ocena umiejętności praktycznych i wiedzy teoretycznej, Ocena umiejętności praktycznych i wiedzy teoretycznej, Ocena umiejętności praktycznych i wiedzy teoretycznej, 6
u TOTAL STUDENT WORKLOAD NEEDED TO ACHIEVE EXPECTED LEARNING OUTCOMES EXPRESSED IN TIME AND ECTS CREDIT POINTS Language of lectures INTERNSHIP Literatura Activity Student workload Lectures 30 Exercises 45 Practical activities 50 Vocational practice 80 Self-education 10 Total hours 215 Number of ECTS points 5 English, Praktyki w ramach Intensywnej terapii Odział Szpitalny 40 godzin Literatura podstawowa: 1. Andres J. (red): Wytyczne 2010 Resuscytacji Krążeniowo Oddechowej Europejska i Polska Rada Resuscytacji., Kraków. 2005. 2. Buchfelder M., Buchfelder A.: Podręcznik pierwszej pomocy. Wydawnictwo Lekarskie PZWL. Wydawnictwo Lekarskie PZWL, Warszawa 2008. 3. Gaszyński W.: Intensywna terapia i wybrane zagadnienia medycyny ratunkowej. Wydawnictwo Lekarskie PZWL, Warszawa 2008. 4. Jakubaszko J. (red.): ABC intensywnej terapii. Górnicki Wydawnictwo Medyczne, Wrocław 2004. 5. Jakubaszko J. (red.): Medycyna ratunkowa wieku dziecięcego. Wydawnictwo Urban & Partner, Wrocław 2003. 6. Kózka M.(red.): Stany zagrożenia życia. Wybrane standardy opieki i procedury postępowania pielęgniarskiego. Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków 2001. 7. Misiołek H., Knapik P. (red.): Pierwsza pomoc medyczna z elementami postępowania specjalistycznego. Wydawnictwo ŚAM, Katowice 2007. 8. Szreter T. (red.): Anestezjologia i intensywna terapia u dzieci. Wydawnictwo Urban & Partner. Wrocław 2007. 9. Wołowicka L., Dyk D. (red.): Anestezjologia i intensywna opieka. Wydawnictwo Lekarskie PZWL, Warszawa 2008. 10. Cenajek - Musiał D., Okulicz - Kozaryn I., Grześkowiak M.: Stany zagrożenia życia: postępowanie lecznicze i leki stosowane w ratownictwie medycznym, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu. - Wyd. 2, poszerz., Wydawnictwo Naukowe Uniwersytetu Medycznego im. Karola Marcinkowskiego, Poznań 2009. 11. Krajewska - Kułak E., Rolka H., Jankowiak B.: Standardy i procedury pielęgnowania chorych w stanach zagrożenia życia : podręcznik dla studiów medycznych, Wydawnictwo Lekarskie PZWL, Warszawa 2009. 12. Kubler A.: Leki w medycynie ratunkowej i intensywnej terapii, 7
Urban & Partner, Wrocław 2005. 13. A.R. Aitkenhead, D.J. Rowbotham, G. Smith, red. A. Kubler,Anestezjologia. Tom 1 2008, Urban & Partner 14. H. Künzig, P. Lemberger, red. A. Kübler Anestezjologia. Seria na dyżurze, 2008, Urban & Partner 15. Kruszyński Z. Anestezjologia położnicza, Położnicze stany naglące Wydawnictwo Lekarskie PZWL, Warszawa 2006 16. Kamiński Bogdan, Kübler Andrzej. Anestezjologia iintensywna terapia. PZWL 2002 17. Larsen R.red. wyd. pol. Kübler A. Anestezjologia. Urban & Partner 1996 6. Szreter T. Intensywna terapia dzieci. PZWL 2002 Podpis koordynatora przedmiotu Literatura uzupełniająca: 1. Hoffman M., Korewicki J., Purzycki Z.: Serce niewydolne. Wydawnictwo Med. Tour Press International, Warszawa 1994. 2. Kamiński B.: Anestezja i intensywna terapia medyczna. PZWL, Warszawa 1988. 3. Kamiński B., Dziak A.(red.): Doraźna pomoc lekarska. PZWL, Warszawa 1988. 4. Kamiński B., Dziak A.: Postępowanie w stanach zagrożenia życia. Wydawnictwo Lekarskie PZWL, Warszawa 1999. 5. Saint-Maurice C., Murat I., Ecoffey C.: Podręcznik anestezjologii pediatrycznej. Wydawnictwo Zakład Narodowy im. Ossolińskich, Wrocław-Warszawa-Kraków 1994. 6. Schuster H.P., Weileman: Kompendium intensywnej opieki medycznej łącznie z zatruciami. PZWL, Warszawa 1993. 7. Spring D., Chambers J.: Ostry dyżur. Praktyczny przewodnik postępowania w stanach nagłych. Podpis kierownika jednostki 8