Teaching code

4S000102

Credits

8

Coordinatore

Stefano De Togni

Language

Italian

Moodle Seminars

The teaching is organized as follows:

Learning outcomes

The course aims to investigate the pathophysiological, clinical and caring aspects of different types of emergency situations either in hospital, home and community setting. This course will focus on risk assessment and identification of patient’s complexity and intervention priorities. GENERAL SURGERY (CHIRURGIA D’URGENZA): The aim of the course is to provide the student with the knowledge of the major emergency pathologies that may include surgical disises starting from epidemiology to deepen clinical presentation in abdominal and thoracic pathologies. EMERGENCY MEDICINE The course is aimed to increase the knowledge on pathophysiological and clinical aspects of the more relevant emergency problems in the nursing clinical practice. SURGICAL ADVANCED NURSING The aim of the course is to investigate physiopathologic, clinical and emergency aspect of emergency situations selectet according to their epidemiological relevance and exemplarity in different contexts (territory,domicile, hospitail). The course it also focuses on achieving risks factors for caring pazients with chest and cardiac surgery problems. ANAESTHESIOLOGY The course aims to provide the students with the adequate knowledge related to medical emergencies. Particular attention is paid to the clinical-diagnostic pathway of specific pathologies, so as to provide the students with the information which are required to differentiate them and partecipate to an appropriate and rapid diagnostic procedure. Single treatments are individualized within their specific context (territory, home, ambulante, E.R., floor, I.C.U, etc). Furthermore, all treatments are proposed on the basis of available Evidence Based Medicine. INTENSIOVE CARE NURSING: Learing outcome: To recognize critical situations in patients in the intensive care unit, to describe the specific monitoring interventions related to patients' clinical evolution, to describe the specific support strategies for patient and family in ICU EMERGENCY NURSING: The aim of the cousre is to undertsnad physiopathological aspects, clinical and nursing aspects in emergency situation, selected based on their epidemiological and exemplarity importance in different situations (territory, hospital, home).

Program

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MM: CHIRURGIA D'URGENZA
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Vascular Urgencies: From Acute Mesenteric Ischemia to Chronic Vascular Insufficiency Blunt abdominal trauma and polytrauma: definition, classification of diagnostic iter and therapeutic timing Digestive hemorrhage: Clinical presentation and treatment. Pain in the right iliac fossa: epidemiology, clinical presentation and differential diagnosis. Acute and chronic pancreatitis: diagnostic flow chart and role of surgeon. Acute diverticulitis: from physiopathology to clinic with emphasis on diagnostic criteria, classifications and treatment strategies. Acute disease of the esophagus: from perforations to the effect of caustic swallowing. Intestinal occlusion: clinical, diagnosis and therapy.
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MM: MEDICINA D'URGENZA
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APPROACH TO ACUTE CHEST PAIN IN THE EMERGENCY ROOM. Rapid recognition of life-threatening conditions (Acute Coronary Syndromes, Pulmonary Embolism, Hypertensive Pneumothorax, Mediastinitis, Aortic Dissection, Pericardial Tamponade). Differential diagnosis (principles). ACUTE CORONARY SYNDROMES (ACS) ST-Elevation Myocardial Infarction (STEMI), Non ST-Elevation Myocardial Infarction (NSTEMI), Unstable Angina (UA). Definitions, pathophysiology, symptoms. Role of the nurse in the management of patients with ACS. Principles of treatment of ACS. Recognition and management of the main complications, like cardiogenic shock and arrhythmias (particularly Ventricular Fibrillation and III-degree Atrioventricular Block. The main drugs used for cardiovascular urgencies and emergencies (mechanism of action, indications/contraindications, adverse reactions). AORTIC DISSECTION Definition, pathophysiology, symptoms. Principles of diagnosis and treatment. CARDIOGENIC ACUTE PULMONARY EDEMA Definitions, pathophysiology, symptoms. Principles of diagnosis and treatment. Role of the nurse in the management of patients with cardiogenic acute pulmonary edema. NON-CARDIOGENIC ACUTE PULMONARY EDEMA (Acute Respiratory Distress Syndrome, ARDS) Definition, pathophysiology, symptoms. Principles of diagnosis and treatment. Role of the nurse in the management of patients with non-cardiogenic acute pulmonary edema. VENOUS THROMBOEMBOLISM (VTE) Deep Venous Thrombosis (DVT) and Pulmonary Embolism. Definition, pathophysiology, symptoms. Risk factors. Strategies for VTE prevention. Diagnostic algorithms. Role of the Well’s score (or other similar scores) and of D-dimer. Principles of VTE treatment. MAIN ACUTE ORGAN FAILURES. ACUTE LIVER FAILURE Definition, pathophysiology, symptoms. Porto-Systemic Encephalopathy. Main acute complications in the cirrhotic patient. Principles of diagnosis and treatment. MAIN METABOLIC URGENCIES. MAIN ACUTE COMPLICATIONS IN THE PATIENT WITH DIABETES MELLITUS. DIFFERENT TYPES OF DIABETIC COMA. Classification. Definition, pathophysiology, symptoms. Principles of diagnosis and treatment. Role of the nurse in the management of patients with diabetic coma. MAIN INTOXICATIONS/POISONING Approach in the emergency room. Clinical recognition based on physical examination (vital signs, ocular signs, body temperature, halitosis, cutaneous discoloration). Acetaminophen intoxication and other intoxications by commonly used drugs. Acute alcoholic intoxication. Opioid intoxication. Cocaine intoxication. CO intoxication.
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MM: INFERMIERISTICA CHIRURGICA SPECIALISTICA
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Post-operative nursing assistance in complex situations Nursing care in the postoperative course of esophagectomy, relating to: - resumption of nutrition (from NE to OS) and education to avoid early and late complications - long-term needs and symptom management Nursing assistance in the postoperative course of lobectomy / pneumectomy, relating to: - chest drainage management - postoperative respiratory rehabilitation - chest pain and movement and early mobilization - post-discharge needs: activity tolerance and deconditioning, dyspnea Nursing assistance in the postoperative course of coronary artery bypass surgery with still heart, through the use of cardiopulmonary bypass, and beating heart surgery, referred to in OFFPUMP., Relating to: - hospitalization in intensive care and discharge criteria in the OU and "specific" monitoring - early mobilization, mode of motion by sternal incision - Cognitive disorders of the cardiac surgery patient: relevance and risk factors, critical period, association D. hypoactive and negative outcomes, prevention interventions - Rehabilitation and self-care actions: respiratory gymnastics, cardiomotor and food activities and lifestyles Transfusion and infusion of blood components: - Pre-transfusion investigations - Homologous blood transfusion - Stages of the transfusion process - Request for the blood component and sampling for compatibility tests - Bedside identification with double pre-start transfusion check
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MM: RIANIMAZIONE
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* oxygen delivery and its main disturbances * acid-base balance and its main disturbances * respiratory failure * shock * trauma
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MM: INFERMIERISTICA IN SITUAZIONI DI CRITICITA'
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1. critical and critical care patient: the care peculiarities. 2. Supervision and monitoring of the patient with neurological and cardiorespiratory instability: a. Monitoring and management of respiratory function: - Invasive ventilation: purposes and management of endotracheal intubation and artificial ventilation; monitoring and prevention strategies of early and late complications related to endotracheal intubation and respiratory device; - Non-invasive ventilation: indications, contraindications, monitoring and adaptation strategies and prevention of complications in the NIV; - Tracheotomy: indications, main types of access, tracheal stoma care, patient care tracheostomy feeding and phonation. b. assessment indicators and monitoring of neurologic function. c. Monitoring and management of cardiovascular function: indications and management of invasive blood pressure monitoring and PVC. d. Intra aortic baloon pump: indications, controindications and patient monitoring 3. Monitoring, expected effects, side effect, interactions and responses to intravenous complex drug treatments. 4. Impact of stay in the ICU: - Peculiarities in critical care patient’s hygiene and infection prevention; - Stress and adaptation of the patient and the family. 5. Nutritional approach to critical patients.
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MM: INFERMIERISTICA CLINICA NEI SERVIZI DI EMERGENZA
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The emergency and health emergency system Triage in the emergency room Cardiovascular arrest and advanced resuscitation in the extra-hospital emergency Non-technical skills Approach to polytrauma in the extra-hospital emergency The hypothermic patient

Bibliography

Examination Methods

Ingrated exam with others of the same teaching modules. Written test consisting of 60 quizzes (10 per module) multiple choice.