Upon completion of this course, the student should be able to:

Describe the major concepts related to the epidemiology (risk factors), pathogenesis, and clinical presentation of major acute diseases in critical situations.

Describe the basic elements of pharmacology related to the major acute diseases in critical situations.

Use the above knowledge for a reasoned analysis of the nursing approach to the patient in the critical care area.

Describe the proper treatment of the polytraumatized patient, according to international guidelines.

Describe the techniques of immobilization, atraumatic mobilization and transport.

Describe the main acute abdominal viscera pathologies (etiology, pathophysiology, diagnosis and treatment).

Describe the management and treatment of ACC (Cardiac Arrest) and Post ACC according to international guidelines.

Describe the principles of interpretation of emergency blood chemistry tests, blood gas analysis, ECG.

Describe invasive and non-invasive monitoring techniques.

Describe the management of invasive and non-invasive ventilation.

Describe the cardiovascular triad and management of the hypoperfused patient.

Describe airway management using basic and advanced techniques.

Describe the management and treatment of major organ failure.

Describe the main organizational models of the rescue chain and the 118 territorial emergency service.

Describe intra- and extra-hospital triage.

In accordance with the Dublin Descriptors the student at the end of the course will be able to :

Cope with intra ex extra hospital emergency situations, planning interventions as per national protocols based on the best scientific evidence;
Use assessment techniques to collect data accurately and precisely in critical life situations;
Correctly use basic supplies needed to cope with emergency situations;
Adapt communication to the patient and family members and to the context considering the situation and location of the emergency;
Use the knowledge acquired for a reasoned analysis of the nursing approach to the patient in the critical area;
Collaborate with the multi-professional team to address critical situations;
Evaluate the progress of care in collaboration with the interdisciplinary team;
Update their knowledge independently through the search for scientific evidence; Interpret and apply research findings to nursing practice; Link research processes to theoretical development of the discipline of nursing in the emergency area.
Demonstrate ability to self-evaluate one's own competencies and outline one's own developmental and learning needs.

Lectures

Anesthesiology and resuscitation: 15 hours

Nursing emergency and intensive: 30 hours

Cardiology: 15 hours

Emergency Medicine: 15 hours.

Frontal lessons

Exercises on simulated clinical cases, also in small groups

Exercises of care planning on cases, in small groups

Practical exercises in simulated situations

Multidisciplinary seminars on specific topics

written barrier exam:

multiple choice question test consisting of 25 questions:

10 of nursing, 5 of cardiology, 5 of emergency medicine, 5 of anesthesia and resuscitation

each question has 4 answers of which only 1 correct

time available 50 minutes

You access the oral with the achievement in each module of 60% of correct answers

The final grade is determined only by the oral exam

The critical patient: definition and pathway.
The concepts of emergency, urgency and critical area.
Intrahospital emergency: the RRS.
The territorial emergency system: purpose, organization, type of services and their characteristics.
In-hospital and out-of-hospital triage.
Evaluation of the patient at risk and of the patient in cardio-circulatory arrest with methods provided by international guidelines.
Basic and advanced cardiorespiratory resuscitation.
Airway management with basic and advanced techniques, with particular reference to endotracheal intubation.
Vascular approaches in emergency situations, management of venous, arterial and intraosseous accesses and of the main pharmacological therapies.
Therapeutic hypothermia in post-cardiac arrest: indications, methods and nursing care.
The hypoperfused patient and the cardiovascular triad: pump, volume and rate issues.
Notes on hemodynamic monitoring: PAC, PVC, VIGILEO, PICCO, SWAN GANZ AND IABP.
The polytraumatized patient: evaluation, care and treatment in and out of the hospital (head trauma, skeletal trauma, abdominal trauma, wounds, fractures, amputations and burns).
Elements of first aid in cases of minor trauma.
The means of atraumatic immobilization and mobilization of the trauma patient.
Identification and management of the following conditions: shock, sepsis, intoxication, coma, diagnosis of brain death and post-resuscitation syndrome.
Interpretation of the main laboratory tests in urgency and haemogasanalytic pictures.
Sedation, general anesthesia, loco-regional anesthesia: monitoring, techniques and drugs.
Acute pain management in emergency and post-operative care.
Artificial nutrition in the critical patient: parenteral and enteral.
Respiratory failure: physiology, airway management, oxygen use, invasive and non-invasive mechanical ventilation and CPAP.
ARDS, COPD.
Nursing care in non-invasive and invasive ventilation.
Spontaneous pneumothorax.
Syncope.
Chest pain.
Hypertensive crisis.
Respiratory physiopathology
Obstructive diseases: asthma, chronic bronchitis, emphysema
Respiratory tract infections: viral, bacterial, tuberculosis
Pulmonary edema
Pulmonary embolism
Aneurysm of the aorta and dissection of the aorta.
The acute coronary syndrome: diagnosis and interventional treatment.
Arrhythmias (tachycardias and bradycardias).
Non-pharmacological treatment of the main arrhythmias with device implantation.
Acute heart failure.
Acute renal failure: pathophysiology and replacement techniques.
Anaphylaxis and transfusion reactions.
The hypoglycemic crisis.
Acute hepatic failure.
Acute pancreatitis.
Acute cholangitis.
The hemorrhagic gastric ulcer.
Thyrotoxicosis and adrenal cortical insufficiency.
DIC and hemolytic anemia.
Acute cerebral ischemia and cerebral hemorrhage.
Ethical issues regarding the critical care area.
Information, communication, relationship with the critical patient and his/her family members.