Accident, Emergency, Critical care
A New branch of clinical medicine involving the management of critically ill Patients presenting with life threatening problems like Acute Myocardial Infarction, acute stroke, Poly Trauma, Head Injury, Poisoning, Snake & Scorpion bites etc..
TRAUMA CARE TRAUMATIC DISORDERS
– Principles of care
– Prehospital trauma care
– Triage
– Resucitation and stabilisation
. Hemorrhagic shock
. Neurogenic shock
– Role of emergency physician
– Team response
– Reassessment and monitoring
– Diagonosis
– Treatment
– Consultation
– Diposition
– Injury prevention and control
. Case of injury
– Homocide
– Suicide
– Family violence
– Motor vehicle crashes
– Falls
– Drowning/near drowning
– Poisoning
– Burns and fire related injuries
– Occupational injuries
. Radiological evaluation
– Plain radiography
– Contrast radiography
– CT scan
– Angiography
– MRI
– Ultrasound
. Mechanism of injury
– Blunt
– Penetrating
. Gunshot wounds
. Stab wounds
– Kinematics
. Diagnosis and management by anatomic areas
– Head trauma
. Scalp lacerations/avulsions
. Skull fractures
. Brain concussions, contusions
. Intracranical hematomas
. Brain stem injuries
. Penetrating head trauma
. Cerebra spinal flid leaks
. Spinal cord and peripheral nervous system trauma
. Complete spinal cord injuries
. Incomplete cord injuries
. Cauda equina injuries
. Nerve route injuries
. Brachial and lumbo sacral injuries
. Peripheral nerve injuries
. Injuries of the spine
. Fractures
– Cervical
– Thoracic
– Lumbar
– Sacral/coccygeal
. Dislocations/subluxations
-Unilateral facet
– Bilateral facet
. Ligamentous injuries
. Facial fractures
– Frontal sinus
– Mandibular
– Maxillary
– Nasal
– Orbital
– Nasal
– Dental fractures and avulsions
– Zygomatic
Objectives
At the end of the clinical postings in Emergency Medicine, the medical student should
1. Be able to evaluate each patient as a person in society and not merely as a collection of organ systems.
2. Have developed an interest in and care for all types of patients. Recognise differences between normal and abnormal presentation of the diseases.
3. Be able to discern the hopes and fears of patients which inevitably underlie the symptom complexes and know how to handle these emotions, both in the patient and in others.
4. Possess sound knowledge of common diseases, their clinical manifestations and natural history.
5. Elicit a good clinical history and physical findings, elucidate the clinical problems based on these and discuss the differential diagnosis.
6. Requisition relevant laboratory tests and perform common side lab procedures.
7. Be familiar with common imaging techniques, their advantages, diadvantages and indications; be aware of radiation hazzards and measures to protect thereform.
8. Outline the principles of management of various diseases, including the medical and surgical procedures available.
9. Describe the mode of action of commonly used drugs, their doses, side effects, toxicity, indications, contraindications and drug interactions.
10. Have an open attitude to the newer developments in medicine to keep abreast of new knowledge.
11. Diagnosis and provide competent initial care to medical emergencies. Refer medical problems to secondary and tertiary care at appropriate times. Recognise the problems arising in patients of AIDS.
12. Have an understanding of the art of medicine involving communication with patients, demonstration of empathy, reassurance, patient education and an understanding of the patient’s socioeconomic circumstances in relation to management.
13. Learn to be adaptable to new ideas and new situations where resources may be limited.
14. Possess knowledge of an perform certain procedure.
15. Understand the ethical and legal implications of one’s medical decisions
Course Contents
SYLLABUS
Prehospital Care
. Emergency Medical Services
. Prehospital Equipment and Adjuncts
. Air medical Transport
. Neonatal and pediatric Transport
. Mass Gatherings
Disater Preparedness
. Diaster Medical Services.
. Bioterrorism Response:Implications for the Emergency Clinician
. Diaster Mangement for Chemical Agents of Mass Destruction
. Blast and Crush Injuries
. Radiation Injuries.
Resuciative Problems
. Sudden Carduic Death
. Basic Cardiopulmonary Resuscitation in Adults
. Neonatal Resuscitation and Emergencies
. Pediatric Cardiopulmonary Resuscitation
. Resuciation Issues in Pergnancy
. Ethical Issues in Pregnancy
. Noninvasive Airway Mangement
. Tracheal Intubation and Mechanical Ventilation
. Surgical Airway Mangement
. Vascular Access
. Invasive Monitoring, Pacing Techniques, and Automatic and Implantable Defibrillators
. Cerbral Resuscitation
. Newer Resuscitation
. Acid-Base Disorders
. Blood Gases: Pathophysiology and Interpretation
. Fluid and Electrolyte Problems
. Disturbances of Cardic Rhythm and Conduction
. Pharmacology of Antidysrhythmic and Vasoactive medications
Skills
PROCEDURES / SkILLS
. Airway techniques
– Cricothyrotomy
– Heimleichs maneovre
– Intubation
. Esophageal obturator airway
. Nasotracheal
. Oratracheal
. Rapid sequence
. Fiber optic
– Mechhanical ventilation
– Percutaneous transtracheal ventilation
– Airway adjuncts
. Anaesthesia
– Local
– Regional
– Intravenous anaesthesia
– Regional nerve blocks
– Genral anaesthesia
Teaching & Learning methods
FIRST YEAR
Emergency Room 2 months
Multi disciplinary ICU 2 months
General Medicine 2 months
Paediatrics 2 months
Orthopaedics 2 months
Obstertrics 1 month
Obstertrics and Gynaecology 1 month
Nephrology 1 month
SECOND YEAR
Emergency Room 2 months
Multi disciplinary ICU 2 months
Cardiology ICU 1 Month
Nephrology 1 month
Anesthesiology 1 month
PUlmonary / Neurology 1 month
Radiology / Neuro Surgery 1 month
Genral Surgery 1 month
THIRD YEAR
Emergency Room 3 months
Pediatrics 2 months
Cardiology ICU 2 months
Genral medicine 2 months
orthopedics 2 months