Emergencies
A.Y. 2023/2024
Learning objectives
The course integrates tree main disciplines: anesthesiology, general surgery and internal medicine. Aim of the course is to provide knowledge on the main pathologies that may rapidly and severely affect the integrity (or even the survival) of the patient. For each pathology the underlying mechanisms are clarified to students, in order to allow a targeted management.
Expected learning outcomes
At the end of the course students are expected to know how to deal with (anesthesiology): - the comatose patient - cardiac arrest and cardiopulmonary resuscitation (CPR) - traumatic brain injury - acid-base disturbances and blood gas analysis - shock - acute respiratory failure - sepsis - intensive care after major surgery ( internal medicine): a critic patient - shortness of breath - hypertensive urgencies and emergencies - chest pain - endocrinologic emergency - cardiac emergency (general surgery): - the organization of general and trauma emergencies in Italy - intra-hospital management of trauma patient - head, face, neck and chest trauma - trauma of the abdomen, pelvis and extremities - the peritonitis - bowel obstruction - gastro-intestinal bleeding and intestinal infarction
Lesson period: First semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.
Course syllabus and organization
Single session
Responsible
Prerequisites for admission
To take the Emergencies exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Furthermore, they must have already passed the following exams: Pharmacology 1 and 2, System Diseases 1, 2 and 3, Neurobiology Human Behaviour and Clinical Neuroscience, Clinical and Surgical Pathology.
A reasonable understanding of pathophysiological mechanisms involved in acute respiratory and hemodynamic failures is necessary.
Furthermore, they must have already passed the following exams: Pharmacology 1 and 2, System Diseases 1, 2 and 3, Neurobiology Human Behaviour and Clinical Neuroscience, Clinical and Surgical Pathology.
A reasonable understanding of pathophysiological mechanisms involved in acute respiratory and hemodynamic failures is necessary.
Assessment methods and Criteria
The exam will be based on a written, multiple choice, test.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to the exam through SIFA is mandatory.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to the exam through SIFA is mandatory.
Internal medicine
Course syllabus
The course is based on a strong integration of different disciplines (Internal medicine, general surgery and Anesthesiology, thus the program of the single disciplines must be considered embedded in the program of the whole course.
BLOCK 1 (INTERNAL MEDICINE)
BLOCK 1 (INTERNAL MEDICINE)
Teaching methods
Synchronous: lectures
Asynchronous: clinical cases discussion, journal club, videos in clinical medicine
Asynchronous: clinical cases discussion, journal club, videos in clinical medicine
Teaching Resources
· Teasdale G, Maas A, Lecky F, Manley G, Stocchetti N, Murray G. Lancet Neurol: The Glasgow Coma Scale at 40 years: standing the test of time. 2014 Aug;13(8):844-54.
Examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. Intensive Care Med. 2014 Apr;40(4):484-95.
· Chang MP, Idris AH: The past, present, and future of ventilation during cardiopulmonary resuscitation. Curr Opin Crit Care. 2017 Jun;23(3):188-192.
· Nichol G, Leroux B, Wang H, Callaway CW, Sopko G, Weisfeldt M, Stiell I, Morrison LJ, Aufderheide TP, Cheskes S, Christenson J, Kudenchuk P, Vaillancourt C, Rea TD, Idris AH, Colella R, Isaacs M, Straight R, Stephens S, Richardson J, Condle J, Schmicker RH, Egan D, May S, Ornato JP; ROC Investigators: Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015 Dec 3;373(23):2203-14.
· Abella BS: High-quality cardiopulmonary resuscitation: current and future directions. Curr Opin Crit Care. 2016 Jun;22(3):218-24.
· Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P; Resuscitation Outcomes Consortium Investigators: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016 May 5;374(18):1711-22.
· Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O'Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R; PARAMEDIC2 Collaborators: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018 Aug 23;379(8):711-721.
· Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, Callaway C, Clark RS, Geocadin RG, Jauch EC, Kern KB, Laurent I, Longstreth WT, Merchant RM, Morley P, Morrison LJ, Nadkarni V, Peberdy MA, Rivers EP, Rodriguez-Nunez A, Sellke FW, Spaulding C, Sunde K, Hoek TV: Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008 Dec;79(3):350-79.
· Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99.
· Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, Sunde K, Deakin CD; Adult advanced life support section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015 Oct;95:100-47.
· Maas AIR, Menon DK, et al: Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16: 987- 1048.
· Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Peter Smielewski P, Zoerle T, Menon DK: Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol 2017; 16: 452-64.
· Fencl V, Leith DE: Stewart's quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol. 1993 Jan;91(1):1-16.
· Langer T, Ferrari M, Zazzeron L, Gattinoni L, Caironi P: Effects of intravenous solutions on acid-base equilibrium: from crystalloids to colloids and blood components. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):350-60.
· ACLS Provider Manual Supplementary Material. American Heart Association. 2016; 1-76
· Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377.
· B. Taylor Thompson, Rachel C. Chambers, and Kathleen D. Liu. Acute Respiratory Distress Syndrome. N Engl J Med 2017;377:562-72. DOI: 10.1056/NEJMra1608077
· O'Driscoll BR, Howard LS, Earis J, et al. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 2017;4: e000170. doi:10.1136/bmjresp-2016-000170
· Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
· Hotchkiss RS1, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003 Jan 9;348(2):138-50.
· Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology: Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65.
· Miller TE, Myles PS: Perioperative Fluid Therapy for Major Surgery. Anesthesiology. 2019 May;130(5):825-832.
· Nieman LK: Clinical manifestations of adrenal insufficiency in adults. UpToDate 2018.
· Nieman LK: Treatment of adrenal insufficiency in adults. UpToDate 2019.
· Hollander JE, Chase M: Evaluation of the adult with chest pain in the emergency department. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. UpToDate 2018.
· Prutkin JM: Overview of the acute management of tachyarrhythmias. UpToDate 2019.
· Shane E: Clinical manifestations of hypercalcemia. UpToDate 2019.
· Shane E, Berenson JR: Treatment of hypercalcemia. UpToDate 2019.
· Varon J, Elliott WJ: Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. UpToDate 2019.
· Elliott WJ, Varon J: Evaluation and treatment of hypertensive emergencies in adults. UpToDate 2018.
· Gaieski DF, Mikkelsen ME: Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock. UpToDate 2019.
· Cook DA, Sherbino J, Durning SJ: Management Reasoning: Beyond the Diagnosis. JAMA. 2018 Jun 12;319(22):2267-2268.
· Adrogué HJ, Madias NE: Hypernatremia. N Engl J Med. 2000 May 18;342(20):1493-9.
· Adrogué HJ, Madias NE: Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.
· Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, Lobban T, Dayer M, Vickery J, Benger J; REVERT trial collaborators: Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015 Oct 31;386(10005):1747-53.
· Ahmed A, Graber MA: Evaluation of the adult with dyspnea in the emergency department. UpToDate 2019.
· Simpkin AL, Schwartzstein RM: Tolerating Uncertainty - The Next Medical Revolution? N Engl J Med. 2016 Nov 3;375(18):1713-1715.
· Sterns RH: Etiology, clinical manifestations, and diagnosis of volume depletion in adults. UpToDate 2017
More papers will be provided during classes
Chiara O, Ed: Trauma Centers and Acute Care Surgery, Springer 2021 (eBook https://doi.org/10.1007/978-3-030-73155-7).
Examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. Intensive Care Med. 2014 Apr;40(4):484-95.
· Chang MP, Idris AH: The past, present, and future of ventilation during cardiopulmonary resuscitation. Curr Opin Crit Care. 2017 Jun;23(3):188-192.
· Nichol G, Leroux B, Wang H, Callaway CW, Sopko G, Weisfeldt M, Stiell I, Morrison LJ, Aufderheide TP, Cheskes S, Christenson J, Kudenchuk P, Vaillancourt C, Rea TD, Idris AH, Colella R, Isaacs M, Straight R, Stephens S, Richardson J, Condle J, Schmicker RH, Egan D, May S, Ornato JP; ROC Investigators: Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015 Dec 3;373(23):2203-14.
· Abella BS: High-quality cardiopulmonary resuscitation: current and future directions. Curr Opin Crit Care. 2016 Jun;22(3):218-24.
· Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P; Resuscitation Outcomes Consortium Investigators: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016 May 5;374(18):1711-22.
· Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O'Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R; PARAMEDIC2 Collaborators: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018 Aug 23;379(8):711-721.
· Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, Callaway C, Clark RS, Geocadin RG, Jauch EC, Kern KB, Laurent I, Longstreth WT, Merchant RM, Morley P, Morrison LJ, Nadkarni V, Peberdy MA, Rivers EP, Rodriguez-Nunez A, Sellke FW, Spaulding C, Sunde K, Hoek TV: Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008 Dec;79(3):350-79.
· Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99.
· Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, Sunde K, Deakin CD; Adult advanced life support section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015 Oct;95:100-47.
· Maas AIR, Menon DK, et al: Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16: 987- 1048.
· Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Peter Smielewski P, Zoerle T, Menon DK: Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol 2017; 16: 452-64.
· Fencl V, Leith DE: Stewart's quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol. 1993 Jan;91(1):1-16.
· Langer T, Ferrari M, Zazzeron L, Gattinoni L, Caironi P: Effects of intravenous solutions on acid-base equilibrium: from crystalloids to colloids and blood components. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):350-60.
· ACLS Provider Manual Supplementary Material. American Heart Association. 2016; 1-76
· Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377.
· B. Taylor Thompson, Rachel C. Chambers, and Kathleen D. Liu. Acute Respiratory Distress Syndrome. N Engl J Med 2017;377:562-72. DOI: 10.1056/NEJMra1608077
· O'Driscoll BR, Howard LS, Earis J, et al. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 2017;4: e000170. doi:10.1136/bmjresp-2016-000170
· Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
· Hotchkiss RS1, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003 Jan 9;348(2):138-50.
· Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology: Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65.
· Miller TE, Myles PS: Perioperative Fluid Therapy for Major Surgery. Anesthesiology. 2019 May;130(5):825-832.
· Nieman LK: Clinical manifestations of adrenal insufficiency in adults. UpToDate 2018.
· Nieman LK: Treatment of adrenal insufficiency in adults. UpToDate 2019.
· Hollander JE, Chase M: Evaluation of the adult with chest pain in the emergency department. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. UpToDate 2018.
· Prutkin JM: Overview of the acute management of tachyarrhythmias. UpToDate 2019.
· Shane E: Clinical manifestations of hypercalcemia. UpToDate 2019.
· Shane E, Berenson JR: Treatment of hypercalcemia. UpToDate 2019.
· Varon J, Elliott WJ: Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. UpToDate 2019.
· Elliott WJ, Varon J: Evaluation and treatment of hypertensive emergencies in adults. UpToDate 2018.
· Gaieski DF, Mikkelsen ME: Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock. UpToDate 2019.
· Cook DA, Sherbino J, Durning SJ: Management Reasoning: Beyond the Diagnosis. JAMA. 2018 Jun 12;319(22):2267-2268.
· Adrogué HJ, Madias NE: Hypernatremia. N Engl J Med. 2000 May 18;342(20):1493-9.
· Adrogué HJ, Madias NE: Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.
· Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, Lobban T, Dayer M, Vickery J, Benger J; REVERT trial collaborators: Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015 Oct 31;386(10005):1747-53.
· Ahmed A, Graber MA: Evaluation of the adult with dyspnea in the emergency department. UpToDate 2019.
· Simpkin AL, Schwartzstein RM: Tolerating Uncertainty - The Next Medical Revolution? N Engl J Med. 2016 Nov 3;375(18):1713-1715.
· Sterns RH: Etiology, clinical manifestations, and diagnosis of volume depletion in adults. UpToDate 2017
More papers will be provided during classes
Chiara O, Ed: Trauma Centers and Acute Care Surgery, Springer 2021 (eBook https://doi.org/10.1007/978-3-030-73155-7).
General surgery
Course syllabus
The course is based on a strong integration of different disciplines (Internal medicine, general surgery and Anesthesiology, thus the program of the single disciplines must be considered embedded in the program of the whole course.
BLOCK 2 (GENERAL SURGERY)
TOPIC 1. The organization of general and trauma emergencies in Italy
TOPIC 2. Intra-hospital management of trauma patient
TOPIC 3. Head, face, neck and chest trauma
TOPIC 4. Trauma of the abdomen, pelvis and extremities
TOPIC 5. The peritonitis: physiopathology and general assessment
TOPIC 6. Common clinical conditions with acute peritonitis (the itis four)
TOPIC 7. Bowel obstruction
TOPIC 8. Gastro-intestinal bleeding and intestinal infarction
BLOCK 2 (GENERAL SURGERY)
TOPIC 1. The organization of general and trauma emergencies in Italy
TOPIC 2. Intra-hospital management of trauma patient
TOPIC 3. Head, face, neck and chest trauma
TOPIC 4. Trauma of the abdomen, pelvis and extremities
TOPIC 5. The peritonitis: physiopathology and general assessment
TOPIC 6. Common clinical conditions with acute peritonitis (the itis four)
TOPIC 7. Bowel obstruction
TOPIC 8. Gastro-intestinal bleeding and intestinal infarction
Teaching methods
Synchronous: lectures
Asynchronous: clinical cases discussion, journal club, videos in clinical medicine
Asynchronous: clinical cases discussion, journal club, videos in clinical medicine
Teaching Resources
· Teasdale G, Maas A, Lecky F, Manley G, Stocchetti N, Murray G. Lancet Neurol: The Glasgow Coma Scale at 40 years: standing the test of time. 2014 Aug;13(8):844-54.
Examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. Intensive Care Med. 2014 Apr;40(4):484-95.
· Chang MP, Idris AH: The past, present, and future of ventilation during cardiopulmonary resuscitation. Curr Opin Crit Care. 2017 Jun;23(3):188-192.
· Nichol G, Leroux B, Wang H, Callaway CW, Sopko G, Weisfeldt M, Stiell I, Morrison LJ, Aufderheide TP, Cheskes S, Christenson J, Kudenchuk P, Vaillancourt C, Rea TD, Idris AH, Colella R, Isaacs M, Straight R, Stephens S, Richardson J, Condle J, Schmicker RH, Egan D, May S, Ornato JP; ROC Investigators: Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015 Dec 3;373(23):2203-14.
· Abella BS: High-quality cardiopulmonary resuscitation: current and future directions. Curr Opin Crit Care. 2016 Jun;22(3):218-24.
· Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P; Resuscitation Outcomes Consortium Investigators: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016 May 5;374(18):1711-22.
· Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O'Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R; PARAMEDIC2 Collaborators: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018 Aug 23;379(8):711-721.
· Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, Callaway C, Clark RS, Geocadin RG, Jauch EC, Kern KB, Laurent I, Longstreth WT, Merchant RM, Morley P, Morrison LJ, Nadkarni V, Peberdy MA, Rivers EP, Rodriguez-Nunez A, Sellke FW, Spaulding C, Sunde K, Hoek TV: Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008 Dec;79(3):350-79.
· Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99.
· Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, Sunde K, Deakin CD; Adult advanced life support section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015 Oct;95:100-47.
· Maas AIR, Menon DK, et al: Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16: 987- 1048.
· Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Peter Smielewski P, Zoerle T, Menon DK: Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol 2017; 16: 452-64.
· Fencl V, Leith DE: Stewart's quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol. 1993 Jan;91(1):1-16.
· Langer T, Ferrari M, Zazzeron L, Gattinoni L, Caironi P: Effects of intravenous solutions on acid-base equilibrium: from crystalloids to colloids and blood components. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):350-60.
· ACLS Provider Manual Supplementary Material. American Heart Association. 2016; 1-76
· Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377.
· B. Taylor Thompson, Rachel C. Chambers, and Kathleen D. Liu. Acute Respiratory Distress Syndrome. N Engl J Med 2017;377:562-72. DOI: 10.1056/NEJMra1608077
· O'Driscoll BR, Howard LS, Earis J, et al. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 2017;4: e000170. doi:10.1136/bmjresp-2016-000170
· Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
· Hotchkiss RS1, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003 Jan 9;348(2):138-50.
· Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology: Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65.
· Miller TE, Myles PS: Perioperative Fluid Therapy for Major Surgery. Anesthesiology. 2019 May;130(5):825-832.
· Nieman LK: Clinical manifestations of adrenal insufficiency in adults. UpToDate 2018.
· Nieman LK: Treatment of adrenal insufficiency in adults. UpToDate 2019.
· Hollander JE, Chase M: Evaluation of the adult with chest pain in the emergency department. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. UpToDate 2018.
· Prutkin JM: Overview of the acute management of tachyarrhythmias. UpToDate 2019.
· Shane E: Clinical manifestations of hypercalcemia. UpToDate 2019.
· Shane E, Berenson JR: Treatment of hypercalcemia. UpToDate 2019.
· Varon J, Elliott WJ: Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. UpToDate 2019.
· Elliott WJ, Varon J: Evaluation and treatment of hypertensive emergencies in adults. UpToDate 2018.
· Gaieski DF, Mikkelsen ME: Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock. UpToDate 2019.
· Cook DA, Sherbino J, Durning SJ: Management Reasoning: Beyond the Diagnosis. JAMA. 2018 Jun 12;319(22):2267-2268.
· Adrogué HJ, Madias NE: Hypernatremia. N Engl J Med. 2000 May 18;342(20):1493-9.
· Adrogué HJ, Madias NE: Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.
· Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, Lobban T, Dayer M, Vickery J, Benger J; REVERT trial collaborators: Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015 Oct 31;386(10005):1747-53.
· Ahmed A, Graber MA: Evaluation of the adult with dyspnea in the emergency department. UpToDate 2019.
· Simpkin AL, Schwartzstein RM: Tolerating Uncertainty - The Next Medical Revolution? N Engl J Med. 2016 Nov 3;375(18):1713-1715.
· Sterns RH: Etiology, clinical manifestations, and diagnosis of volume depletion in adults. UpToDate 2017
More papers will be provided during classes
Chiara O, Ed: Trauma Centers and Acute Care Surgery, Springer 2021 (eBook https://doi.org/10.1007/978-3-030-73155-7).
Examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. Intensive Care Med. 2014 Apr;40(4):484-95.
· Chang MP, Idris AH: The past, present, and future of ventilation during cardiopulmonary resuscitation. Curr Opin Crit Care. 2017 Jun;23(3):188-192.
· Nichol G, Leroux B, Wang H, Callaway CW, Sopko G, Weisfeldt M, Stiell I, Morrison LJ, Aufderheide TP, Cheskes S, Christenson J, Kudenchuk P, Vaillancourt C, Rea TD, Idris AH, Colella R, Isaacs M, Straight R, Stephens S, Richardson J, Condle J, Schmicker RH, Egan D, May S, Ornato JP; ROC Investigators: Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015 Dec 3;373(23):2203-14.
· Abella BS: High-quality cardiopulmonary resuscitation: current and future directions. Curr Opin Crit Care. 2016 Jun;22(3):218-24.
· Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P; Resuscitation Outcomes Consortium Investigators: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016 May 5;374(18):1711-22.
· Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O'Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R; PARAMEDIC2 Collaborators: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018 Aug 23;379(8):711-721.
· Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, Callaway C, Clark RS, Geocadin RG, Jauch EC, Kern KB, Laurent I, Longstreth WT, Merchant RM, Morley P, Morrison LJ, Nadkarni V, Peberdy MA, Rivers EP, Rodriguez-Nunez A, Sellke FW, Spaulding C, Sunde K, Hoek TV: Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008 Dec;79(3):350-79.
· Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99.
· Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, Sunde K, Deakin CD; Adult advanced life support section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015 Oct;95:100-47.
· Maas AIR, Menon DK, et al: Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16: 987- 1048.
· Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Peter Smielewski P, Zoerle T, Menon DK: Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol 2017; 16: 452-64.
· Fencl V, Leith DE: Stewart's quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol. 1993 Jan;91(1):1-16.
· Langer T, Ferrari M, Zazzeron L, Gattinoni L, Caironi P: Effects of intravenous solutions on acid-base equilibrium: from crystalloids to colloids and blood components. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):350-60.
· ACLS Provider Manual Supplementary Material. American Heart Association. 2016; 1-76
· Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377.
· B. Taylor Thompson, Rachel C. Chambers, and Kathleen D. Liu. Acute Respiratory Distress Syndrome. N Engl J Med 2017;377:562-72. DOI: 10.1056/NEJMra1608077
· O'Driscoll BR, Howard LS, Earis J, et al. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 2017;4: e000170. doi:10.1136/bmjresp-2016-000170
· Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
· Hotchkiss RS1, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003 Jan 9;348(2):138-50.
· Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology: Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65.
· Miller TE, Myles PS: Perioperative Fluid Therapy for Major Surgery. Anesthesiology. 2019 May;130(5):825-832.
· Nieman LK: Clinical manifestations of adrenal insufficiency in adults. UpToDate 2018.
· Nieman LK: Treatment of adrenal insufficiency in adults. UpToDate 2019.
· Hollander JE, Chase M: Evaluation of the adult with chest pain in the emergency department. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. UpToDate 2018.
· Prutkin JM: Overview of the acute management of tachyarrhythmias. UpToDate 2019.
· Shane E: Clinical manifestations of hypercalcemia. UpToDate 2019.
· Shane E, Berenson JR: Treatment of hypercalcemia. UpToDate 2019.
· Varon J, Elliott WJ: Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. UpToDate 2019.
· Elliott WJ, Varon J: Evaluation and treatment of hypertensive emergencies in adults. UpToDate 2018.
· Gaieski DF, Mikkelsen ME: Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock. UpToDate 2019.
· Cook DA, Sherbino J, Durning SJ: Management Reasoning: Beyond the Diagnosis. JAMA. 2018 Jun 12;319(22):2267-2268.
· Adrogué HJ, Madias NE: Hypernatremia. N Engl J Med. 2000 May 18;342(20):1493-9.
· Adrogué HJ, Madias NE: Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.
· Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, Lobban T, Dayer M, Vickery J, Benger J; REVERT trial collaborators: Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015 Oct 31;386(10005):1747-53.
· Ahmed A, Graber MA: Evaluation of the adult with dyspnea in the emergency department. UpToDate 2019.
· Simpkin AL, Schwartzstein RM: Tolerating Uncertainty - The Next Medical Revolution? N Engl J Med. 2016 Nov 3;375(18):1713-1715.
· Sterns RH: Etiology, clinical manifestations, and diagnosis of volume depletion in adults. UpToDate 2017
More papers will be provided during classes
Chiara O, Ed: Trauma Centers and Acute Care Surgery, Springer 2021 (eBook https://doi.org/10.1007/978-3-030-73155-7).
Anesthesiology
Course syllabus
The course is based on a strong integration of different disciplines (Internal medicine, general surgery and Anesthesiology, thus the program of the single disciplines must be considered embedded in the program of the whole course.
BLOCK 3 (ANESTHESIOLOGY)
TOPIC 1 In-hospital emergencies
TOPIC 2 Monitoring of vital signs
TOPIC 3 ARDS
TOPIC 4 ACC
TOPIC 5 Shock
TOPIC 6 Sepsis
TOPIC 7 Multiple organ failure
TOPIC 8 Coma
TOPIC 9 Truamatic Brain injury
TOPIC 10 Hemorrhagic stroke
TOPIC 11 Organization of the ICU
TOPIC 12 ICU after major surgery
TOPIC 13 Oncological emergencies
TOPIC 14 Brain death and organ donation
BLOCK 3 (ANESTHESIOLOGY)
TOPIC 1 In-hospital emergencies
TOPIC 2 Monitoring of vital signs
TOPIC 3 ARDS
TOPIC 4 ACC
TOPIC 5 Shock
TOPIC 6 Sepsis
TOPIC 7 Multiple organ failure
TOPIC 8 Coma
TOPIC 9 Truamatic Brain injury
TOPIC 10 Hemorrhagic stroke
TOPIC 11 Organization of the ICU
TOPIC 12 ICU after major surgery
TOPIC 13 Oncological emergencies
TOPIC 14 Brain death and organ donation
Teaching methods
Synchronous: lectures
Asynchronous: clinical cases discussion, journal club, videos in clinical medicine
Asynchronous: clinical cases discussion, journal club, videos in clinical medicine
Teaching Resources
· Teasdale G, Maas A, Lecky F, Manley G, Stocchetti N, Murray G. Lancet Neurol: The Glasgow Coma Scale at 40 years: standing the test of time. 2014 Aug;13(8):844-54.
Examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. Intensive Care Med. 2014 Apr;40(4):484-95.
· Chang MP, Idris AH: The past, present, and future of ventilation during cardiopulmonary resuscitation. Curr Opin Crit Care. 2017 Jun;23(3):188-192.
· Nichol G, Leroux B, Wang H, Callaway CW, Sopko G, Weisfeldt M, Stiell I, Morrison LJ, Aufderheide TP, Cheskes S, Christenson J, Kudenchuk P, Vaillancourt C, Rea TD, Idris AH, Colella R, Isaacs M, Straight R, Stephens S, Richardson J, Condle J, Schmicker RH, Egan D, May S, Ornato JP; ROC Investigators: Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015 Dec 3;373(23):2203-14.
· Abella BS: High-quality cardiopulmonary resuscitation: current and future directions. Curr Opin Crit Care. 2016 Jun;22(3):218-24.
· Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P; Resuscitation Outcomes Consortium Investigators: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016 May 5;374(18):1711-22.
· Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O'Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R; PARAMEDIC2 Collaborators: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018 Aug 23;379(8):711-721.
· Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, Callaway C, Clark RS, Geocadin RG, Jauch EC, Kern KB, Laurent I, Longstreth WT, Merchant RM, Morley P, Morrison LJ, Nadkarni V, Peberdy MA, Rivers EP, Rodriguez-Nunez A, Sellke FW, Spaulding C, Sunde K, Hoek TV: Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008 Dec;79(3):350-79.
· Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99.
· Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, Sunde K, Deakin CD; Adult advanced life support section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015 Oct;95:100-47.
· Maas AIR, Menon DK, et al: Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16: 987- 1048.
· Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Peter Smielewski P, Zoerle T, Menon DK: Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol 2017; 16: 452-64.
· Fencl V, Leith DE: Stewart's quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol. 1993 Jan;91(1):1-16.
· Langer T, Ferrari M, Zazzeron L, Gattinoni L, Caironi P: Effects of intravenous solutions on acid-base equilibrium: from crystalloids to colloids and blood components. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):350-60.
· ACLS Provider Manual Supplementary Material. American Heart Association. 2016; 1-76
· Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377.
· B. Taylor Thompson, Rachel C. Chambers, and Kathleen D. Liu. Acute Respiratory Distress Syndrome. N Engl J Med 2017;377:562-72. DOI: 10.1056/NEJMra1608077
· O'Driscoll BR, Howard LS, Earis J, et al. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 2017;4: e000170. doi:10.1136/bmjresp-2016-000170
· Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
· Hotchkiss RS1, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003 Jan 9;348(2):138-50.
· Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology: Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65.
· Miller TE, Myles PS: Perioperative Fluid Therapy for Major Surgery. Anesthesiology. 2019 May;130(5):825-832.
· Nieman LK: Clinical manifestations of adrenal insufficiency in adults. UpToDate 2018.
· Nieman LK: Treatment of adrenal insufficiency in adults. UpToDate 2019.
· Hollander JE, Chase M: Evaluation of the adult with chest pain in the emergency department. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. UpToDate 2018.
· Prutkin JM: Overview of the acute management of tachyarrhythmias. UpToDate 2019.
· Shane E: Clinical manifestations of hypercalcemia. UpToDate 2019.
· Shane E, Berenson JR: Treatment of hypercalcemia. UpToDate 2019.
· Varon J, Elliott WJ: Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. UpToDate 2019.
· Elliott WJ, Varon J: Evaluation and treatment of hypertensive emergencies in adults. UpToDate 2018.
· Gaieski DF, Mikkelsen ME: Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock. UpToDate 2019.
· Cook DA, Sherbino J, Durning SJ: Management Reasoning: Beyond the Diagnosis. JAMA. 2018 Jun 12;319(22):2267-2268.
· Adrogué HJ, Madias NE: Hypernatremia. N Engl J Med. 2000 May 18;342(20):1493-9.
· Adrogué HJ, Madias NE: Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.
· Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, Lobban T, Dayer M, Vickery J, Benger J; REVERT trial collaborators: Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015 Oct 31;386(10005):1747-53.
· Ahmed A, Graber MA: Evaluation of the adult with dyspnea in the emergency department. UpToDate 2019.
· Simpkin AL, Schwartzstein RM: Tolerating Uncertainty - The Next Medical Revolution? N Engl J Med. 2016 Nov 3;375(18):1713-1715.
· Sterns RH: Etiology, clinical manifestations, and diagnosis of volume depletion in adults. UpToDate 2017
More papers will be provided during classes
Chiara O, Ed: Trauma Centers and Acute Care Surgery, Springer 2021 (eBook https://doi.org/10.1007/978-3-030-73155-7).
Examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. Intensive Care Med. 2014 Apr;40(4):484-95.
· Chang MP, Idris AH: The past, present, and future of ventilation during cardiopulmonary resuscitation. Curr Opin Crit Care. 2017 Jun;23(3):188-192.
· Nichol G, Leroux B, Wang H, Callaway CW, Sopko G, Weisfeldt M, Stiell I, Morrison LJ, Aufderheide TP, Cheskes S, Christenson J, Kudenchuk P, Vaillancourt C, Rea TD, Idris AH, Colella R, Isaacs M, Straight R, Stephens S, Richardson J, Condle J, Schmicker RH, Egan D, May S, Ornato JP; ROC Investigators: Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015 Dec 3;373(23):2203-14.
· Abella BS: High-quality cardiopulmonary resuscitation: current and future directions. Curr Opin Crit Care. 2016 Jun;22(3):218-24.
· Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P; Resuscitation Outcomes Consortium Investigators: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016 May 5;374(18):1711-22.
· Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O'Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R; PARAMEDIC2 Collaborators: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018 Aug 23;379(8):711-721.
· Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, Callaway C, Clark RS, Geocadin RG, Jauch EC, Kern KB, Laurent I, Longstreth WT, Merchant RM, Morley P, Morrison LJ, Nadkarni V, Peberdy MA, Rivers EP, Rodriguez-Nunez A, Sellke FW, Spaulding C, Sunde K, Hoek TV: Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008 Dec;79(3):350-79.
· Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99.
· Soar J, Nolan JP, Böttiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, Sunde K, Deakin CD; Adult advanced life support section Collaborators: European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015 Oct;95:100-47.
· Maas AIR, Menon DK, et al: Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16: 987- 1048.
· Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Peter Smielewski P, Zoerle T, Menon DK: Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol 2017; 16: 452-64.
· Fencl V, Leith DE: Stewart's quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol. 1993 Jan;91(1):1-16.
· Langer T, Ferrari M, Zazzeron L, Gattinoni L, Caironi P: Effects of intravenous solutions on acid-base equilibrium: from crystalloids to colloids and blood components. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):350-60.
· ACLS Provider Manual Supplementary Material. American Heart Association. 2016; 1-76
· Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377.
· B. Taylor Thompson, Rachel C. Chambers, and Kathleen D. Liu. Acute Respiratory Distress Syndrome. N Engl J Med 2017;377:562-72. DOI: 10.1056/NEJMra1608077
· O'Driscoll BR, Howard LS, Earis J, et al. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 2017;4: e000170. doi:10.1136/bmjresp-2016-000170
· Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
· Hotchkiss RS1, Karl IE: The pathophysiology and treatment of sepsis. N Engl J Med. 2003 Jan 9;348(2):138-50.
· Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology: Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65.
· Miller TE, Myles PS: Perioperative Fluid Therapy for Major Surgery. Anesthesiology. 2019 May;130(5):825-832.
· Nieman LK: Clinical manifestations of adrenal insufficiency in adults. UpToDate 2018.
· Nieman LK: Treatment of adrenal insufficiency in adults. UpToDate 2019.
· Hollander JE, Chase M: Evaluation of the adult with chest pain in the emergency department. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. UpToDate 2018.
· Hirsch IB, Emmett M: Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. UpToDate 2018.
· Prutkin JM: Overview of the acute management of tachyarrhythmias. UpToDate 2019.
· Shane E: Clinical manifestations of hypercalcemia. UpToDate 2019.
· Shane E, Berenson JR: Treatment of hypercalcemia. UpToDate 2019.
· Varon J, Elliott WJ: Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. UpToDate 2019.
· Elliott WJ, Varon J: Evaluation and treatment of hypertensive emergencies in adults. UpToDate 2018.
· Gaieski DF, Mikkelsen ME: Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock. UpToDate 2019.
· Cook DA, Sherbino J, Durning SJ: Management Reasoning: Beyond the Diagnosis. JAMA. 2018 Jun 12;319(22):2267-2268.
· Adrogué HJ, Madias NE: Hypernatremia. N Engl J Med. 2000 May 18;342(20):1493-9.
· Adrogué HJ, Madias NE: Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.
· Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, Lobban T, Dayer M, Vickery J, Benger J; REVERT trial collaborators: Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015 Oct 31;386(10005):1747-53.
· Ahmed A, Graber MA: Evaluation of the adult with dyspnea in the emergency department. UpToDate 2019.
· Simpkin AL, Schwartzstein RM: Tolerating Uncertainty - The Next Medical Revolution? N Engl J Med. 2016 Nov 3;375(18):1713-1715.
· Sterns RH: Etiology, clinical manifestations, and diagnosis of volume depletion in adults. UpToDate 2017
More papers will be provided during classes
Chiara O, Ed: Trauma Centers and Acute Care Surgery, Springer 2021 (eBook https://doi.org/10.1007/978-3-030-73155-7).
Anesthesiology
MED/41 - ANAESTHESIOLOGY - University credits: 4
Lessons: 32 hours
: 16 hours
: 16 hours
General surgery
MED/18 - GENERAL SURGERY - University credits: 2
Lessons: 16 hours
: 8 hours
: 8 hours
Professors:
Chiara Osvaldo, Cimbanassi Stefania
Internal medicine
MED/09 - INTERNAL MEDICINE - University credits: 2
Lessons: 16 hours
: 8 hours
: 8 hours
Professor:
Costantino Giorgio Massimiliano
Professor(s)
Reception:
To be arranged by e-mail
Istituto di Anestesiologia - Padiglione Litta, via Commenda 16, Milano - Ospedale Policlinico
Reception:
Tue. 9-11 am; Wed. 3-5 pm
Litta build., first floor