OBSTETRICS AND GYNAECOLOGY IN LIFE-THREATENING SITUATIONS
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- Versione italiana
- Academic year
- 2017/2018
- Teacher
- SAVINO OCCHIONORELLI
- Credits
- 7
- Didactic period
- Secondo Semestre
Training objectives
- GENERAL SURGERY
The course aims to provide the student with the necessary elements to understand:
- the various aspects of general surgery.
- the importance of the clinical history and examination of the patients, of surgical physiopathology in order to formulate a differential diagnosis of clinical conditions
ANESTHESIA AND INTENSIVE CARE
The course allows you to provide knowledge and ability to apply the knowledge learned to manage the pregnant woman expertise in the perioperative period in respect of
-anesthesia elective and emergency
-management adverse events in anesthesia
-Systems and monitoring of patients under anesthesia principals
-Principles and principals for postoperative analgesia
OBSTETRICAL GINECOLOGICAL SCIENCES
The BLSD course teaches the knowledge related to cardiopulmonary resuscitation according to the guidelines of the Italian Resuscitation Council ( IRC ) and to acquire the manual skills, intervention schemes and the use of the AED. Acquire self-control in critical situations. Cognitive objectives: knowledge of purpose and limitations , incidence of cardiac arrest ; concept of anoxic brain damage, the chain of survival, early defibrillation techniques and sequences of basic cardiopulmonary resuscitation and early AED. Objectives gestural: practical training on computerized mannequins cognitive objectives: technical and BLS and defibrillation sequences with semi-automatic equipment.
Relational objectives: to acquire motivation execution of BLSD. Relate with other helpers.
The course also provides students with the knowledge for the perioperative care in the most frequent health problems that require a surgical approach . The course allows you to: identify different surgical care environments, the structural peculiarities, organizational and welfare. Recognize the main clinical signs and symptoms, diagnostic flows and risks / complications of patients undergoing surgery d identify the specific care . Such method of valuation and post-operative pain management. Indicate the organizational and rehabilitative role of the midwife and strategies to ensure continuity of care. Ability to apply the acquired knowledge to the care planning pre- and post -operative patient underwent surgery and identification of the principal risks and possible problems and obstetrical interventions postoperatively
RADIOPROTECTION
Knowledge and understanding: Knowledge of physics in ionizing radiation both electromagnetic and corpuscolate; radiation interaction with matter, in particular with living matter. Order of size, units of measure and detectors.
Applying knowledge and understanding: Knowledge of fundamental principles of radiation protection, and the effects of ionizing radiation on the living. Skills in protection of workers, patients and population from harmful effects of ionizing radiations. Knowledge of national and european regulation concerning radiation protection.
Making judgements: critical knowledge of professional operating conditions in presence of ionizing radiation, related to protection of workers, patients and population. Ability to detect and evaluate operational risk in presence of ionizing radiation.
Communication skills: Knowledge of safety signs. ability of relating with the competent authorities and the emergency staff consciously and with appropriate terminology. Prerequisites
- Good knowledge of human anatomy, physiology and general pathology
Elementary bases of ionized radiation physics, particularly related to energy utilized for human imaging and oncological radiotherapy. Course programme
- GENERAL SURGERY
.
Intestinal occlusion. Acute abdominal. Peritonitis and septic shock. Acute appendices. Open abdomen. Compartmental syndrome. Triage, Vital Parameters ,. ABCDE rating and monitoring. The Trauma. The Shock (Venous Accesses). Chest trauma (pneumothorax, embolism, coastal fractures, obesity, cardiac tamponade). Abdominal trauma
Basin fractures. Cranial trauma and bone marrow. Muscle-skeletal trauma. Compartmental syndrome. Pediatric trauma. Trauma in the pregnant woman. Venous system pathophysiology (venous thrombosis and pulmonary embolism).
ANAESTHESIA and ICU
Principles of general anesthesia and general anesthesia for TC
Airway management in pregnant and oro- tracheal intubation. Principles of subarachnoid anesthesia, epidural , and combined local-regional anesthesia for TC. Analgesia during labor
Principles of resuscitation and intensive care in pregnant. Pregnancy-induced hypertension
Preeclampsia, eclampsia
S. HELLP. Bleeding in pregnancy. Cardiac arrest and BLSO
OBSTETRIC GYNAECOLOGICAL SCIENCES
BLS Acquire and outline the knowledge of the cardiac arrest treatment with automated external defibrillator according to the guidelines Italian Resuscitatio Council; presentation of the DAE, technical, explanation of the algorithm, the roles of rescuers, safety. Training in open groups airway -ventilation mouth mask – chest compressions -Position side security, Heimlich –Sequence with two rescuers (ball - mask) interval sequences BLSD - 2 responders with AEDs readily available sequence with initial non-shockable rhythm.
Surgical Department (operational unit, pre-admissions surgery, after surgery, operating rooms, day surgery); the preoperative assessment and health conditions and treatments in place, physical condition, emotional state. the essential nutritional support therapies to be used in pre and post-operative The patient's physical preparation (trichotomy, bowel preparation, skin preparation) Preparation of the patient on the day of intervention (pre-anesthesia, documentation, preparation holder of the room, assistance to family members, the accompaniment patient safety in the operating theater. the post-operative monitoring (PA, PF, SaO2 and FR, diuresis, and wound) and post-operative problems with particular reference to the significant data to be collected. the management of the surgical site (surgical incision and drainage). Scale of assessment and the main actions to be taken in case of pain - the main method of controlling postoperative pain, bleeding and water disturbances (risk factors, monitoring through the water and PVC budget). The management of drainage the main postoperative complications (immediate and delayed).The preparation of the patient discharge: information necessary for patient compliance to diet, wound management and the problems that may arise.
RADIOPROTECTION
Radioactivity and Ionizing radiation. Atomic nucleus, Nuclear decay.
Interactions of ionizing radiation with matter. Measuring radioactivity. Order of size and units of measure.
Radiobiology basics. Potential damages in livings. Deterministic and stochastic damages of ionizing radiations. Fundamental principles of radiation protection.
National and european regulation concerning ionizing radiation protection. Didactic methods
- Frontal lessons – skills laboratory-simulation
Learning assessment procedures
- GENERAL SURGERY
Oral Exam: Teacher's 2 questions are asked to investigate sequentially and hierarchically:
-the basic knowledge of the topic proposed for discussion and the clinical linkage skills between the various topics that are related
-Diagnostic capacity and clinical reasoning, planning skills, performance assistance and teamwork, the ability to verify and diagnose risk factors and the complications of the intervention.
- the technical and organizational skills in autonomy and in the team in the implementation of the emergency care intervention, demonstrating the ability to evaluate the patient's effectiveness
The test is considered outdated if the student responds correctly to the questions asked by the Teacher.
The test is considered insufficient if the student fails to respond to the knowledge, epidemiological and scientific evidence, because they are considered to be barred for the continuation of the test.
Language-specific property indicators are the ability to create functional theoretical and functional correlations to midwifery skills. The vote was 30/30. In order to give praise the teacher proposes further study to the student. Duration of test: 30/40 minutes.
ANAESTHESIA
The test is oral duration of 30 minutes. They are formulated by the teacher 2/3 questions that go to investigate sequential and hierarchical manner :
1.The topic proposed knowledge and theoretical integrations and knowledge of drug use . 2. The clinical skills link between the various topics that are related to the ability to care intervention and implementation of competence in obstetric team .
The test is passed if the student responds correctly to the questions posed by the teacher.
The test is considered insufficient if the student does not answer the first question concerning the knowledge considered barrier to the continuation of the trial. Evaluation indicators are the property of language, the ability to create theoretical correlations and theoretical functional practices to midwives skills and as a team.
OBSTETRIC GYNAECOLOGICAL SCIENCES
BLS test dummy on the skills test is deemed passed if the student is able to reproduce the sequence in performing CPR techniques and is able to respond positively to the 2 questions regarding a medical condition. The test lasts about 20 minutes.
The written questionaire of 30 multiple choice questions go to investigate the knowledge and ability to apply the knowledge on surgical patient. Students who do not total at least 24 right questions will have to take an oral examination on the questions considered inaccurate to be agreed with the teacher
The rating is expressed in 30/30
RADIOPROTECTION
The exam will be held by means of a multiple choice test, with an allocated time of 45 minutes. The questions will be thirty-two, with four answers proposed, of wich only one is exact. The questions pertain to the topics carried out during the lectures. The evaluation criteria are: plus 1 point (+1) for each single correct answer; minus half point (-0,5) for each single wrong answer; no point (0) for each single missing answer.
A final score of "31" points or more implies the evaluation "cum laude". These evaluation criteria are reported in the test sheet along with the compilation instructions.
THE FINAL GRADE IS A WEIGHTED AVERAGE OF THE MARKS OBTAINED IN EACH TESTS. Reference texts
- GENERAL SURGERY
P. Giulietti, N. Marrano, Manuale di chirurgia generale per scienze Infermieristiche”, Monduzzi Ed. 2005
W. Craus, Argomenti di chirurgia generale per le professioni sanitarie, V. Pironti Ed. 2003
RADIOPROTECTION
Biagini C., Radiobiologia e Radioprotezione, Piccin, Padova, 1999
Marano P., Diagnostica per immagini, Casa Editrice Ambrosiana, Milano 1999
Cittadini G., Diagnostica per immagini e radioterapia, ECIG, Genova, 2002
ANAESTHESIA
Celleno Danilo, Frigo M. Grazia, Anestesia, analgesia e terapia intensiva in ostetricia, Ed. CISU 2008
OBSTETRIC GYNAECOLOGICAL SCIENCES
Guana M. et al., La disciplina ostetrica. McGraw-Hill 2011
S.C. Smeltzer, B. Bare, J. Hinkle, K. Cheever Brunner & Suddarth- Infermieristica medico-chirurgica Vol 1-2, CEA 2010
P.Wicker. J.O’Neill Assistenza infermieristica perioperatoria McGraw-Hill, 2007
Linee guida European Resuscitation Council per la Rianimazione 2015
