Medical University of Bialystok. Sylabus.

SYLLABUS Vth Year

Name of a course/module	Anaesthesiology and Intensive Care
Faculty of	Medicine with Division of Dentistry and Division of Medical Education in English
Name of a field of study	Medicine
Level of education
Form of study
Language of instruction	English
Type of course	obligatory X facultative
Year of study/Semester	I £ II £ III £ IV £ V £ VI £	1 £ 2 £ 3 £ 4 £ 5 £ 6 £ 7£ 8 £ 9£ 10 £ 11 £ 12 £
Number of didactic hours of classes with division for forms of teaching	60 hours, 40 hours – classes, 20 hours - lectures
Assumptions and aims of the course	Student should obtain knowledge in the field of : preparing the patient to the anaesthesia and surgery, perioperative care of the patient, basics of intensive care, suspition and confirmation of brain death, principles and guidelines of cardiopulmonary resuscitation. Student should obtain practical skills in: peripheral vascular access, cardiopulmonary resuscitation with use of manual defibrillator and AED, giving first aid in most common situations, monitoring of the patient in perioperative period, assessment of unconscious patient according to commonly used scoring systems. Manual skills in following procedures: taking the temperature, pulse assessment, non-invasive blood pressure monitoring, monitoring vital signs with cardiomonitor and pulsoximeter, spirometric examination, passive oxygen therapy, orotracheal intubation, oropharyngeal tube insertion, bag with valve and mask ventilation, intravenous, intramuscular ad subcutaneous injections, obtaining arterial and venous blood for lab tests

Symbol of education outcomes in accordance with the standards	Description of directional effects of education	Methods of verification of achieved learning outcomes
	Knowledge (according to the detailed education outcomes)
F.W4	Knows the principles of perioperative safety, preparing patient for operation, principles of general anaesthesia, regional anaesthesia and monitored anaesthetic care	Classes – credit MCQ Final Exam
F.W5	Knows principles of postoperative care with postoperative pain management and postoperative bedside monitoring
F.W6	Knows indications for intensive therapy and principles of intensive therapy
F.W7	Knows guidelines for cardiopulmonary resuscitation in all age groups: newborn, children and adults
F.W15	Knows principles of suspicion of brain death and its confirmation
	Skills (according to the detailed education outcomes)
F.U 5	Obtain vascular access	Practical training in Medical Simulation Centre Performing particular procedures on manikins
F.U10	Basic life support with AED resuscitation
F.U11	Acts according to Advanced Life Support Algorithm
F.U12	Can monitor patient in postoperative course based on basic vital signs
F.U21	Can assess the unconscious patient condition according to international scoring systems
	Can perform medical procedures i.e.: Taking the temperature, pulse palpation and measurement, non-invasive blood pressure measurement Monitoring vital signs with cardiomonitor and pulsoximeter Spirometric measurements, oxygen therapy with passive oxygenation and supported and controlled mechanical ventilation Introducing oropharyngeal tube Intravenous, intramuscular and subcutaneous injections, obtaining peripheral venous blood and arterial blood for analyses
	Social competence (according to the general education outcomes)
K1	He /She recognizes his/her own diagnostic and therapeutic limitations, educational needs, planning of educational activity	Practical training in Medical Simulation Centre Continuous assessment by the teacher
K2	He /She is able to work in a team of professionals, in a multicultural and multinational environment
K3	He /She implements the principles of professional camaraderie and cooperation with representatives of other professionals in the range of health care
K4	He /She observes doctor-patient privilege; and patient rights

ECTS points		4
Student Workload
Form of Activity				Number of hours to complete the activity
Activities that require the participation of (academic) teacher
Realization of the course: lecture				20 hours
Realization on of the course: seminar				-
Realization of the course: classes				40
exam
electives
				total of hours 60
Self-study:
Preparation for classes
Preparation for credits / tests
Preparation for the exam / final test
				total of hours

Course contents
Topics						Form (lectures, classes etc.…)
Introduction to the topic, history of anaesthesia and intensive care, preoperative visit, interpretation of laboratory and physiological tests results, premedication, risk of anaesthesia, informed consent for anaesthesia and surgery, ethical and legal problems in anaesthesia						Lecture
General anaesthesia. Particular techniques of anaesthesia: volatile anaesthesia, intravenous and volatile anaesthetic agents, analgetic agents and muscle relaxants. New techniques of anaesthesia – TIVA, TCA. Obligatory requirements in intraoperative monitoring						Lecture
Regional anaesthesia – pharmacology of local anaesthetics. Peripheral regional anaesthesia of upper and lower extremities – indications, contraindications and possible complications. Regional intravenous anaesthesia						Lecture
Spinal and epidural anaesthesia – indications, contraindications, complications. Combined spinal-epidural anaesthesia. Thoracic epidural anaesthesia in postoperative pain management						Lecture
Techniques in anaesthesia in particular medical specialties: obstetric anaesthesia, day – case surgery, sedation for diagnostic procedures. Early and late complications of anaesthesia. Postoperative care						Lecture
Cardiopulmonary resuscitation in adults, children and newborn according to European Resuscitation Council Guidelines 2015. Post-resuscitation syndrome – diagnostic and therapeutic issues						Lecture
Principles of therapy in full-profile intensive care unit – indications for admission, contraindications, standards of monitoring and equipment. Patients chart in ICU						Lecture
Acute respiratory failure – principles of passive oxygenation and mechanical ventilation. Modes of mechanical ventilation. Monitoring of mechanical ventilation and its effectiveness. Acute Respiratory Distress Syndrome (ARDS): pathogenesis, diagnosis, therapy						Lecture
Central veins and arteries cannulation. Indications, contraindications and complications. Principles of nutritional therapy in ICU. Parenteral and enteral nutrition. Monitoring of effect of nutrition						Lecture
Sepsis, severe sepsis, septic shock and Multiple Organ Failure as the diagnostic and therapeutic problem in ICU. Hospital infections						Lecture
Brain death – sign and symptoms. Confirmation of brain death. Principles of care after organ donor. Selected issues in transplantology. Ethical issues in intensive care						Lecture
Acute and chronic pain – principles of therapy, techniques and drugs						Lecture
Fluid therapy – water and electrolyte balance. Blood and blood derivatives therapy. New methods of cardiac output monitoring.						Classes
Oxygen balance – oxygen delivery and oxygen uptake in physiology and pathology. Arterial blood gases – interpretation and correction. Oxygen therapy and oxygen toxicity. Side effects of mechanical ventilation						Classes
Shock, definition, classification, symptoms and principles of therapy. Pharmacological support in shock. Pulmonary artery catheter in shock monitoring and therapy, indications, contraindications and limitations.						Classes
Sepsis – symptoms, diagnosis and therapy. Severe sepsis and septic shock. Acute renal failure and renal replacement therapy in ICU. Multiple Organ Dysfunction Syndrome in ICU. Using scoring systems for ICU patient assessment.						Classes
Infections in ICU. Hospital Acquired Pneumonia. Ventilator Associated Pneumonia. Urinary tract infections. Blood born infections. Surgical Site Infections. Principles of microbiological diagnostics in ICU. Prevention of hospital infections. Analgesia and sedation in ICU						Classes
Clinical cases most commonly seen in ICU – bedside monitoring and therapy. Practical training in ICU procedures (mechanical ventilation, invasive procedures)						Classes
Practical training in operation room – different types of anaesthesia						Classes
Practical training in operation room in Cardiac Surgery Unit – postoperative monitoring after cardiac surgery						Classes
Specific aspects of paediatric anaesthesia and intensive care. Paediatric patient in in operation theatre						Classes
Basic Life Support, Advanced Life Support – practical training with manikins - endotracheal intubation, manual defibrillation						Classes
A list of recommended and optional books
Obligatory reading: PI Marino – The ICU book, 4^th ed. Wolters Kluwer, 2014 C Gwinnutt, M Gwinnutt. Clinical Anaesthesia, Lecture Notes 5^th ed, Wiley Blackwell 2016 2015 ERC Guideline for Cardiopulmonary Resuscitation. Available after free registration at: www.erc.org Additional reading: T. Lin, T Smith, C. Pinnock – Fundamentals of Anaesthesia, 4^th ed. Cambridge University Press, 2017
Conditions for receiving credit
The absolute necessary for receiving credit is credit for all classes during the course. Absence during classes, if justified with sick leave or other serious condition, may be accepted after personal training with particular teacher.
Date of issue:	05.03.2021		Course coordinator or the head of the department where the course is held		Juliusz Kosel, MD, PhD