ANESTHESIA by decree


									TRAUMATOLOGY : 40 hrs, 5 days

Subject Regulations:

All classes are obligatory. Classes take place at Departments in University
Hospitals as planned in the schedule.
Course consist of 5 days of classes and seminars.
The exam is at last class. The exam consist of test - 30 MCQ.
Excused absence is allowed for 1 class.
Classes start at 8.00.
Students must bring to the classes scrubs and boots for change.
Credit for the subject:
During each class the knowledge and preparation for the topic of the class will
be evaluated: student may receive 2 points: 1 for being prepared and 1 for
participation during class.
Each student will receive Student`s Individual Attendance Chart. On this chart
student must collect signatures of teachers for presence on the classes and points
for the classes. Presence will be also marked on the list made by the teacher.
Student who is late for the class will not receive 1 point for being prepared for
the class. Being late more than 15 minutes means not receiving 2 points.
Points are summarized with points from the exam – the MCQ test at last class.
Student can receive on the summary 8 points for classes and 30 points for test.
To pass the exam a 65% of total points is necessary but at least 5 points from
classes and 18 points from MCQ test.

Students may receive extra points to increase their final score and note by:
   - Preparing and presenting the clinical case, short presentation on subject
      connected with topic of class or lecture,
   - Very good knowledge on discussed topic.

grading scale :
35 - 38 points: 5.0 ( excellent),
32 – 34 points: 4.5 (very good ),
29 – 31 points: 4.0 (good),
26 – 28 points: 3.5 ( satisfactory),
23 -25 points: 3.0 (sufficient),
Less than 23 points: 2.0 ( failed)

·Injuries of bones and joints
·Injuries of Lower Extremity
- chest injury: minor, serious:
pneumothorax, hemothorax, myocardial contusion, pericardial tamponade, aortic
aneurysm, tracheobronchial injury, traumatic asphyxia – recognition, diagnostic,
immediate treatment
- abdomen injury: internal bleedings, spleen, liver rupture: recognition,
diagnostic, immediate treatment

2 . multiorgan injury
general :
- epidemiology
- definition of “golden hour”
- early diagnostic and stabilization of patients state
- rules of early management of trauma
- vital function monitoring and early treatment of life-threatening multi organ
- resuscitation in trauma patient
- in-hospital early stabilization and treatment of trauma patient

1 . evaluation of trauma patient state :
- “triage” – patient evaluation at the place of accident, in emergency room
- primary evaluation of vital function: airway, breathing, circulation,
consciousness: GCS: Glasgow Coma Scale, AVPU, Revised Trauma Score
- secondary advanced evaluation
- laboratory tests, advanced diagnostic in trauma patient
- monitoring in trauma patient

2 . TLS: Trauma Life Support – definition, rules, division: BTLS, PHTLS,
- transfusion strategy in traumatology: blood products, indications, rules of
- fluid therapy and drug management in traumatology: types of fluids,
indications, rules of administration, emergency drugs
- airway management in trauma patient: basic airway management, rescue
methods, cricoconicotomy, tracheotomy, fibersocopic airway management
- ventilation strategy in trauma patient: basic ventilation- self-inflation bag,
- shock in traumatology: definition, division, recognizing, treatment
- analgesia and sedation in trauma patients: analgesia and sedation in place of
accident, in emergency depatrment
- intensive therapy in multi organ injury

Neurotrauma – sylabus

Algorithms for prehospital and in-hospital management
Traumatic brain injury (TBI) - definition
Neurologic evaluation : Glasgow Coma Scale (GCS), response to pain,
examination of the pupils – asymmetry, fixed and dilated pupils
Moderate TBI
Severe TBI
Trauma Centers
Primary CNS injury
Secondary CNS injury
Cerebral herniation
Cerebral perfusion pressure (CPP)
Intracranial pressure (ICP)
Cytotoxic and vasogenic oedema
Invasive and non-invasive intensive care monitoring : ECG, continuous arterial
pressure measurement, pulse oximetry, end-tidal carbon dioxide, central venous
pressure, jungular venous oxygen saturation, urine output
Monitoring of the ICP : intraventricular, parenchymal, subarachnoid, subdural,
Intensive Care of Severe TBI
Hypotension treatment : fluid therapy, vasopressors
Airways management and ventilation
Oedema-reducing therapy : Mannitol, hyperventilation, sedation, antiseizure
Management of spinal cord injuries
Neurologic shock
Aims of student`s knowledge:

1. First aid and behavior in the place of accident, BLS , ALS
2. Pathophysiology and immediate treatment of traumatic shock – hemorrhagic
shock, spinal shock, hypovolemic shock in thermal burn
3. Recognition the most often trauma and their consequences
- head injury
-chest injury
- burst abdomen
- extremities injury
- vertebral column injury
- thermal burn
4. Knowledge in use of emergency medical aid ambulance equipment
5. Knowledge in use of emergency Department equipment
6. Medical first aid in politrauma, behavior in the place of accident, taking a
history, patient’s checking, interventions in life- threatening situations in in the
place of accident and in ambulance.
7. Treatment of politrauma during transport to hospital
8. Diagnostics and treatment in Emergency Department the trauma patient
9. Children politrauma

Students’ competencies required for receiving credits practical skills in:
- Basic Life Support and Advanced Life Support
- defibrillation
- supplying wounds and immobilizing limbs
- making intravenous injections on manikins
- tracheal intubation and other methods of artificial breathing
- using spinal immobilization equipment
- using automatic transport ventilators
- treatment of pneumothorax, heart tamponade in ambulance, equipment
- emergency pharmacotherapy and in traumatic shock

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