Universitat Internacional de Catalunya
Critical Medicine: Protocols in Immediate Action
Teaching staff
Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:
Professor responsable de l'assignatura:
Professors associats: Dra. Olga Rubio (orubio@althaia.cat) / bl073152@uic.es
Introduction
Intensive or Critical Medicine is a medical specialty in Spain for over 30 years being devoted to the treatment of patients with life-threatening illnesses acutely, but reversible. This will serve patients in specific areas of the hospital where it accumulates a number of technical and human resources far superior to any other.
The treatments used in support, and often temporarily replace the function of vital organs including mechanical ventilators, pacemakers, dialyzers, parenteral nutrition, central catheters, ....
This specialty focuses intensely on pathophysiological approach, while medical actions are reinforced by the immediate effect of most treatments, both to deepen the strategy decided, to refocus the whole process when evolution is unfavorable.
This peculiarity also explains the high presence of clinical research in this area. As an example, in medical research while Spain is between the 9th and 10th in the world (according to other indicators, economic, industrial, ...) in critical care we are in 5th place worldwide.
Currently it requires the involvement of intensivists not only in the ICU, but also in supporting patients suddenly unstable in other areas such as emergency departments, hospital wards, day hospitals, and even pre-hospital care.
Pre-course requirements
The student must have advanced knowledge of various generic pathological situations that occur in the body.
Objectives
Acquire a fundamental knowledge of the critical care and have the ability to immediately assess and treat serious or life situations most common serious. Understand and recognize the effects, mechanisms and manifestations of the disease on the structure and function of the human body.
· Acquire basic life support skills, including diagnosis, treatment of shock and basic skills related procedure.
· Master the skills in advanced life support.
· Acquiring the ability to differentiate and treat common serious problems.
· Learn the severity criteria of the different diseases in ICU, ER and hospital wards.
· Learn the severe multiple trauma patient management, including initial resuscitation and subsequent management.
· Acquire mastery of basic skills of procedures such as airway management and venous access.
· Learn to prioritize care to patients with more severe problems.
Competences/Learning outcomes of the degree programme
- 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
- 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
- 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
- 16 - Recognize and deal with situations that put life in immediate danger and those that require immediate attention.
- 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
- 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
Learning outcomes of the subject
· Argue the importance of history and examination data to assigned cases.
· Develop a differential diagnosis in a case assigned. Prioritize accurate diagnostic tests based on the severity and the expected performance.
· Argue indications for surgery in selected cases.
· Perform initial ICU treatment plan according to pathology the patient.
· Correctly apply basic resuscitation techniques (fluids, oxygen, vasoactive drugs).
Syllabus
Lectures (CM)
Class 1: Respiratory failure, critical nephrology and neurocritical care.
Shock: Critical cardiology and shock.
Practice:
After attending the lectures, there will be 8 days of clinical practice in Intensive Care Units from 8 to 15 hours. Mentored by a specialist in critical care the students attend and participate in ICU specific techniques and information to patients and their families. Also they learn practically simulator life support techniques.
In all classes and practices represent a total of 46 hours (6h in class + 40 h of practice). The remaining hours until 2 ECTS (= 60 h) is the personal work.
In addition students are invited to make, in his spare time, duties in the intensive care unit and depending on demand and subject to be able to program in the hospital emergency service.
Teaching and learning activities
In person
The master class is the stage in which a teacher transmits knowledge in a classroom to the whole group of students. They will be based on the description of the basic information of each subject, to follow with three clinical cases with similar presentation that lead to the differential diagnosis and specific treatment.
During their hospital internship, the student will rotate with an assigned physician to whom they will comment on the assigned cases and the attitude to follow in each case. You will also need to learn the basic techniques in the ICU (central venous access, intubation, temporary pacemaker, continuous hemodialysis, etc.).
Evaluation systems and criteria
In person
The final grade will result from the summation of the grade in the theoretical exam which will account for 70% of the grade and the grade obtained during the rotating (30%: based on Attitudes (40%), skills (20%) and report (40%). %)). Prior knowledge, attitude and approach to the patient will be assessed, so a negative report from the practical part will prevent passing the course.
The theoretical exam will be a test type with multiple options but only one correct one, with a negative error score. Questions will be asked about content addressed in classes and practices.
Bibliography and resources
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Irwin & Rippe's Manual of Intensive Care Medicine Sixth Edition, by Richard S. Irwin MD, Craig Lilly MD, James M. Rippe MD. Editorial: Lippincott Williams and Wilkins
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The Washington Manual of Critical Care (Lippincott Manual) Second, Revised Edition, by Marin Kollef MD, Warren Isakow MD. Editorial: Lippincott Williams and Wilkins