Pediatric and Neonatal Critical Care
A.Y. 2024/2025
Learning objectives
- Know the methodology of the nursing care management, from data collection to the evaluation of actions and results, for the patient across the pediatric age range presenting with biophysiological, physiopathological, psychological and socio-cultural signs and symptoms related to the vital critical state;
- Recognize promptly the emergency clinical situations requiring first aid actions, in order to guarantee survival and adequate and effective nursing support;
- Acquire the knowledge necessary to manage emergency clinical situations and be able to develop specific supportive plans in situations of high complexity of care in the emergency room and intensive care;
- Know the main procedures and interventions in disaster situations
- Recognize promptly the emergency clinical situations requiring first aid actions, in order to guarantee survival and adequate and effective nursing support;
- Acquire the knowledge necessary to manage emergency clinical situations and be able to develop specific supportive plans in situations of high complexity of care in the emergency room and intensive care;
- Know the main procedures and interventions in disaster situations
Expected learning outcomes
Knowledge and understanding:
- general and clinical nursing issues for the understanding of pediatric nursing fields of intervention, clinical method leading to effective clinical approach intervention techniques and evidence supporting the decision making and the delivery of the pediatric nursing care;
- It and linguistic disciplines with particular focus on the English language for the understanding of the scientific nursing literature and for the exchange of general information.
Ability to apply knowledge and understanding:
- integrate the knowledge and skills stemming from the nursing discipline, from biomedical, psychological, socio-cultural and humanistic features to recognize the care needs of the newborn and the family and provide appropriate, effective and evidence-based pediatric nursing care;
- apply the nursing care on the basis of the reference disciplinary theoretical models to assess and diagnose health status and care needs in their physical, psychological and socio-cultural dimensions, plan goals, implement and evaluate the care provided and outcomes achieved;
- conduct a complete and systematic evaluation of data relating to the care needs of the newborn to facilitate growth, development and adaptation in health promotion, maintenance and recovery;
- analyze and accurately interpret the data collected through clinical reasoning;
- interpret and apply the results of research to nursing practice and link research paths to the theoretical development of the nursing discipline;
- provide nursing care in different care settings, both in- and out- of-hospital settings
- general and clinical nursing issues for the understanding of pediatric nursing fields of intervention, clinical method leading to effective clinical approach intervention techniques and evidence supporting the decision making and the delivery of the pediatric nursing care;
- It and linguistic disciplines with particular focus on the English language for the understanding of the scientific nursing literature and for the exchange of general information.
Ability to apply knowledge and understanding:
- integrate the knowledge and skills stemming from the nursing discipline, from biomedical, psychological, socio-cultural and humanistic features to recognize the care needs of the newborn and the family and provide appropriate, effective and evidence-based pediatric nursing care;
- apply the nursing care on the basis of the reference disciplinary theoretical models to assess and diagnose health status and care needs in their physical, psychological and socio-cultural dimensions, plan goals, implement and evaluate the care provided and outcomes achieved;
- conduct a complete and systematic evaluation of data relating to the care needs of the newborn to facilitate growth, development and adaptation in health promotion, maintenance and recovery;
- analyze and accurately interpret the data collected through clinical reasoning;
- interpret and apply the results of research to nursing practice and link research paths to the theoretical development of the nursing discipline;
- provide nursing care in different care settings, both in- and out- of-hospital settings
Lesson period: Second semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course can be attended as a single course.
Course syllabus and organization
Single session
Responsible
Prerequisites for admission
In order to ensure a balanced career progression consistent with professional training, in order to obtain enrollment in the second year, the student must have passed at least three exams related to the courses taught, including:
- Human Anatomy and Physiology
- Fundamentals of maternal and child care
To obtain enrollment in the third year, the student must have passed at least eight exams, of which, in addition to the exams required to obtain enrollment in the second year:
- Pharmacology and Anesthesiology
- Pediatric Sciences II
- Neonatology I
Passing the annual internship examination is a necessary and mandatory condition for obtaining enrollment in the following year
- Human Anatomy and Physiology
- Fundamentals of maternal and child care
To obtain enrollment in the third year, the student must have passed at least eight exams, of which, in addition to the exams required to obtain enrollment in the second year:
- Pharmacology and Anesthesiology
- Pediatric Sciences II
- Neonatology I
Passing the annual internship examination is a necessary and mandatory condition for obtaining enrollment in the following year
Assessment methods and Criteria
Written examination consisting of a test with different types of multiple-choice questions with one or two correct answers. It is considered passed if all modules are found to be sufficient.
In the oral examination, the main criteria to be considered in evaluating the answer are clarity of exposition, completeness and correctness of content, ability to connect knowledge
In the oral examination, the main criteria to be considered in evaluating the answer are clarity of exposition, completeness and correctness of content, ability to connect knowledge
Paediatric surgery
Course syllabus
Transplants
Thoracic Urgencies
Neonatal emergencies
Abdominal emergencies (occlusion, appendicitis, Meckel, peritonitis, IBD)
Traumas
Thoracic Urgencies
Neonatal emergencies
Abdominal emergencies (occlusion, appendicitis, Meckel, peritonitis, IBD)
Traumas
Teaching methods
15 lessons of frontal teaching
Teaching Resources
"Pediatric Surgery" J.L. Grosfeld, J.A.O'Neill , E.W.Fonkalsrud and A.G. Coran - Mosby Ed. -Sixth Edition - 2006"
General and subspecialty paediatrics
Course syllabus
Principles of Resuscitation, from intrauterine life to extrauterine life: physiological changes
Initial resuscitation Stages
Use of Resuscitation Tools to Perform Positive Pressure Ventilation (PPV)
Chest compressions
Endotracheal intubation
Neonatal resuscitation drugs
Resuscitation of the preterm infant
Ethics and assistance at the end of life
Tutorials on the following aspects:
from the first resuscitation maneuvers to positive pressure ventilation
chest compressions, correct coordination with positive pressure ventilation
endotracheal intubation - execution and assistance to the maneuver in order to perform the tracheo aspiration in the case of meconium-stained amniotic fluid or to perform pressure ventilation
positive
preparation of drugs for resuscitation, facilities and methods of administration
Emergency neonatal transport
Initial resuscitation Stages
Use of Resuscitation Tools to Perform Positive Pressure Ventilation (PPV)
Chest compressions
Endotracheal intubation
Neonatal resuscitation drugs
Resuscitation of the preterm infant
Ethics and assistance at the end of life
Tutorials on the following aspects:
from the first resuscitation maneuvers to positive pressure ventilation
chest compressions, correct coordination with positive pressure ventilation
endotracheal intubation - execution and assistance to the maneuver in order to perform the tracheo aspiration in the case of meconium-stained amniotic fluid or to perform pressure ventilation
positive
preparation of drugs for resuscitation, facilities and methods of administration
Emergency neonatal transport
Teaching methods
Frontal presentations and activities of an exercise and interactive nature
Teaching Resources
Linee guida dell'American Academy of Pediatrics e dell'American Heart Association.
Anaesthesiology
Course syllabus
Respiratory system:
- Paediatric respiratory failure
- Monitoring: pulse oximetry, capnografy, EGA
- Oxygen therapy
- Non invasive ventulation
- Airway management
- Mechanical ventilation
- Surfactant, NO, Helium
- Brochoscopy
- Thoracic dreinage
Cardiovascular system
- Invasive monithoring (CVP, AP, PAP, CO, PICCO and SG Catheter)
- Central vascular access
- Intraosseus line
- Cardiovascular failure and shock
- Vasopressor and inotropes
- CPR
Renal system
- Infusions and fluid balance
- Renal replacemet therapy
Neurologic system
- Sedation and analgesia
- Alterated states of onsciousness
- Lumbar puncture
- Cerebral death
Gastrointestinal
- Enteral and parenteral feeding
- Acute abdomen
- Intra abdominal pressure
Protected medical transport
Trauma
- Paediatric respiratory failure
- Monitoring: pulse oximetry, capnografy, EGA
- Oxygen therapy
- Non invasive ventulation
- Airway management
- Mechanical ventilation
- Surfactant, NO, Helium
- Brochoscopy
- Thoracic dreinage
Cardiovascular system
- Invasive monithoring (CVP, AP, PAP, CO, PICCO and SG Catheter)
- Central vascular access
- Intraosseus line
- Cardiovascular failure and shock
- Vasopressor and inotropes
- CPR
Renal system
- Infusions and fluid balance
- Renal replacemet therapy
Neurologic system
- Sedation and analgesia
- Alterated states of onsciousness
- Lumbar puncture
- Cerebral death
Gastrointestinal
- Enteral and parenteral feeding
- Acute abdomen
- Intra abdominal pressure
Protected medical transport
Trauma
Teaching methods
15 lessons of frontal teaching
Teaching Resources
Roger's textbook of Pediatric Intensive Care. Editor DG Nicholas. Fourth edition 2008
Textbook of Pediatric Emergency Procedures. Editors C King , FM Henreting. Second edition 2008
Principles and Practice of Mechanical Ventilation. Editor MJ Tobin. Second edition 2006
Oh's Intensive Care Manual. Edited by AD Berson, N.Soni,Sixth edition 2009
Fluid and Electolytes in Pediatrics. A Comprehensive Handbook. Edited by LG Feld, FJ Kaskel
Linne guida ACC dell'American Heart Association 2015
Textbook of Pediatric Emergency Procedures. Editors C King , FM Henreting. Second edition 2008
Principles and Practice of Mechanical Ventilation. Editor MJ Tobin. Second edition 2006
Oh's Intensive Care Manual. Edited by AD Berson, N.Soni,Sixth edition 2009
Fluid and Electolytes in Pediatrics. A Comprehensive Handbook. Edited by LG Feld, FJ Kaskel
Linne guida ACC dell'American Heart Association 2015
Nursing sciences: general, clinical and paediatric
Course syllabus
- The concept of emergency/urgency
- ABCs of noninvasive ventilation in emergency in the ER and ICU:
- Hight frequency ventilation
- CPAC in mask and CASCO
- Care of the child undergoing noninvasive ventilation
- Care of the child undergoing mechanical ventilation
- Care of child with ARDS (supine/prone positioning, use of nitric oxide)
- Management of the child with tracheotomy
- Invasive monitoring
- Care of the child with endocranial hypertension
- Care of the child with PIC carrier
- Care of the child with bacterial menengitis and with DIC ((disseminated intravascular coagulation))
- Brain death and organ donation
- Care of the child with acute renal failure in resuscitation (hemofiltration techniques)
- Pressure injuries (prevention and treatment)
- The Organization of the Emergency Room: types of emergency rooms, application regulations, emergency management
- Triage systems. From international models to the Lombardy Region Model Triage system.
- The assessment of the child in emergency
o the PAT (Pediatric Assessment Triangle)
o the CRS (Clinical Respiratory Score)
o the CDS (Clinical Dehidratation Scale)
o AVPU vs. PGCS
o the Broselow Pediatric Emergency Tape vs Pediatric Card
o the PEWS
- Pediatric emergency toxicology concepts: care taking and management
- Urgencies of the adolescent in emergency:
o Neuropsychiatric problems
o The new psychoactive substances
- Trauma:
o Head trauma and major trauma: care taking
o Burns
- The maxi-emergency: from the territory to the hospital
- ABCs of noninvasive ventilation in emergency in the ER and ICU:
- Hight frequency ventilation
- CPAC in mask and CASCO
- Care of the child undergoing noninvasive ventilation
- Care of the child undergoing mechanical ventilation
- Care of child with ARDS (supine/prone positioning, use of nitric oxide)
- Management of the child with tracheotomy
- Invasive monitoring
- Care of the child with endocranial hypertension
- Care of the child with PIC carrier
- Care of the child with bacterial menengitis and with DIC ((disseminated intravascular coagulation))
- Brain death and organ donation
- Care of the child with acute renal failure in resuscitation (hemofiltration techniques)
- Pressure injuries (prevention and treatment)
- The Organization of the Emergency Room: types of emergency rooms, application regulations, emergency management
- Triage systems. From international models to the Lombardy Region Model Triage system.
- The assessment of the child in emergency
o the PAT (Pediatric Assessment Triangle)
o the CRS (Clinical Respiratory Score)
o the CDS (Clinical Dehidratation Scale)
o AVPU vs. PGCS
o the Broselow Pediatric Emergency Tape vs Pediatric Card
o the PEWS
- Pediatric emergency toxicology concepts: care taking and management
- Urgencies of the adolescent in emergency:
o Neuropsychiatric problems
o The new psychoactive substances
- Trauma:
o Head trauma and major trauma: care taking
o Burns
- The maxi-emergency: from the territory to the hospital
Teaching methods
Frontal presentations and interactive activities
Teaching Resources
1. Pierluigi Badon Gian Domenico Giusti: Assistenza infermieristica in area critica e in emergenza
2022 ISBN: 9788808980076
2. DECRETO N. 16147 Del 11/11/2022 Oggetto RETE REGIONALE DEI PRONTO SOCCORSO - APPROVAZIONE DEL MANUALE E DEL REGOLAMENTO PER L'ATTUAZIONE DEI CORSI DI FORMAZIONE SUL NUOVO MODELLO DI TRIAGE INTRAOSPEDALIERO DI REGIONE LOMBARDIA
2022 ISBN: 9788808980076
2. DECRETO N. 16147 Del 11/11/2022 Oggetto RETE REGIONALE DEI PRONTO SOCCORSO - APPROVAZIONE DEL MANUALE E DEL REGOLAMENTO PER L'ATTUAZIONE DEI CORSI DI FORMAZIONE SUL NUOVO MODELLO DI TRIAGE INTRAOSPEDALIERO DI REGIONE LOMBARDIA
Lab 3
Course syllabus
- The application of the Lombard triage model: clinical cases
- The finalized response system and teamwork
- Ventilation and cardiac massage: the use of self-expanding balloons
- The principals of trauma: immobilization
- The territorial rescue
- The finalized response system and teamwork
- Ventilation and cardiac massage: the use of self-expanding balloons
- The principals of trauma: immobilization
- The territorial rescue
Teaching methods
Frontal presentations and activities of an exercise and interactive nature
Teaching Resources
Trauma pediatrico. Moppett IK, Br J Med, 2007
The association between hospital overcrowding and mortality among patients admitted via Western Australian Emergency Departments Peter C Sprivulis et al. The Medical Journal of Australia Volume 184 Number 5 · 6 March 2006
Early outcome prediction in severe head injury comparison between children and adult. Facco Zuccarello, Pittoni, Zanardi, Chiaranda, Davia and Giron Department of Anesthesiology and Intensive Care and Dept. of neurosurgery. Università di Padova.
Assessing the counsciuous level in infants and paediatric version of the Glasgow coma Scale. Reilly. Simpson. Sprod, Thomas. Adelaide Children Hospital. 2006 Australia
Cheerio, Laddie! Bidding Farewell to the Glasgow Coma Scale. Green
Pillole dell'Emergenza n° 40 SIMEUP Febbraio 2012
Abderhalden C., et al. Predicting inpatient violence in acute psychiatric wards using the Brøset-Violence-Checklist: a multicentre prospective cohort study.. 4, 2004, Journal of psychiatric and mental health nursing, Vol. 11, p. 422 -427 .
Larke, D. E., Brown, A.-M. Griffith, P. The Brøset Violence Checklist: clinical utility in a secure psychiatric intensive care setting. C. 7, 2010, Journal of Psychiatric and Mental Health Nursing, Vol. 17, p. 614-620.
Almvik R, Woods P. Short-term risk prediction: the Brøset Violence Checklist.. 2, 2003, J Psychiatr Ment Health Nurs. , Vol. 10, p. 236-8.
Linee-Guida del ministero della sanità per il sistema urgenza-emergenza in applicazione al dpr 27/3/92: funzioni di triage
IL PAZIENTE CRITICO : Clinica e assistenza Infermieristica in Anestesia e Rianimazione. (casa editrice Ambrosiana Milano)
L'ABC della ventilazione meccanica non invasive in urgenza( Mc Graw Hill)
NURSING PEDIATRICO : linee guida e procedure per l'ospedale e il territorio (McGraw-Hill)
CHILDREN'S RESPIRATORY NURSIN (edited by Janice Mighten) Wiley-Blackwell
IL PAZIENTE CRITICO: protocolli e procedure di assistenza generale e specialistica (ed.Italiana a cura di Loredana Pasquot - Paola Zappa) MASSON
OH MANUALE DI TERAPIA INTENSIVA (Quinta Edizione) edizione italiana a cura di Giorgio Conti.
www.gavecelt.info; BUNDLE GAVeCeLT per la prevenzione delle infezioni da accesso venoso centrale.
O'Grady N, Alexander M, Dellinger E, Gerberding J, Heard O, Maki D, "et al"; Guidelines for the Prevention of Intravascular Catheter-Related Infections; Pediatrics; 2004
O'Grady P, Alexander M, Burns A, Dellinger E, Garland J, Heard S, "et al" Guidelines for the Prevention of intravascular Catheter-Related Infection,2011.
Guidelines for proventing infection associated with the insertion and maintenance of central venous catheters; Journal of Hospital Infection 2001
Guideline for prevention of intravascular catheter-related infections,CDC-HICPAC, 2002.
Centres for Disease and Control. Linee guida per la prevenzione delle infezioni associate a catetere intravascolari. Giornale italiano delle infezioni ospedaliere
Piano Nazionale Linee Guida (PNLG)WWW.SNLG-ISS.IT
Mazzufero Fabio www.GAVeCeLT.org "Gli Accessi Venosi Centrali a Lungo Termine", 2006
Irving V, et Al: Neonatal wound care.Wounds UK. 2006
P.J.McGrath. Core outcome domains and measures for pediatric acute and chronic/ recurrent pain clinical trial: PedIMMPACT recommendations. The Journal of Pain 2008;
Terapia del Dolore nel Bambino "Collana Specialistica Pediatrica" (SEE-FIRENZE)
Pediatric Advanced Life Support Advanced Trauma Life Support
Journal of the American Association of Nurse Anesthetists.
The association between hospital overcrowding and mortality among patients admitted via Western Australian Emergency Departments Peter C Sprivulis et al. The Medical Journal of Australia Volume 184 Number 5 · 6 March 2006
Early outcome prediction in severe head injury comparison between children and adult. Facco Zuccarello, Pittoni, Zanardi, Chiaranda, Davia and Giron Department of Anesthesiology and Intensive Care and Dept. of neurosurgery. Università di Padova.
Assessing the counsciuous level in infants and paediatric version of the Glasgow coma Scale. Reilly. Simpson. Sprod, Thomas. Adelaide Children Hospital. 2006 Australia
Cheerio, Laddie! Bidding Farewell to the Glasgow Coma Scale. Green
Pillole dell'Emergenza n° 40 SIMEUP Febbraio 2012
Abderhalden C., et al. Predicting inpatient violence in acute psychiatric wards using the Brøset-Violence-Checklist: a multicentre prospective cohort study.. 4, 2004, Journal of psychiatric and mental health nursing, Vol. 11, p. 422 -427 .
Larke, D. E., Brown, A.-M. Griffith, P. The Brøset Violence Checklist: clinical utility in a secure psychiatric intensive care setting. C. 7, 2010, Journal of Psychiatric and Mental Health Nursing, Vol. 17, p. 614-620.
Almvik R, Woods P. Short-term risk prediction: the Brøset Violence Checklist.. 2, 2003, J Psychiatr Ment Health Nurs. , Vol. 10, p. 236-8.
Linee-Guida del ministero della sanità per il sistema urgenza-emergenza in applicazione al dpr 27/3/92: funzioni di triage
IL PAZIENTE CRITICO : Clinica e assistenza Infermieristica in Anestesia e Rianimazione. (casa editrice Ambrosiana Milano)
L'ABC della ventilazione meccanica non invasive in urgenza( Mc Graw Hill)
NURSING PEDIATRICO : linee guida e procedure per l'ospedale e il territorio (McGraw-Hill)
CHILDREN'S RESPIRATORY NURSIN (edited by Janice Mighten) Wiley-Blackwell
IL PAZIENTE CRITICO: protocolli e procedure di assistenza generale e specialistica (ed.Italiana a cura di Loredana Pasquot - Paola Zappa) MASSON
OH MANUALE DI TERAPIA INTENSIVA (Quinta Edizione) edizione italiana a cura di Giorgio Conti.
www.gavecelt.info; BUNDLE GAVeCeLT per la prevenzione delle infezioni da accesso venoso centrale.
O'Grady N, Alexander M, Dellinger E, Gerberding J, Heard O, Maki D, "et al"; Guidelines for the Prevention of Intravascular Catheter-Related Infections; Pediatrics; 2004
O'Grady P, Alexander M, Burns A, Dellinger E, Garland J, Heard S, "et al" Guidelines for the Prevention of intravascular Catheter-Related Infection,2011.
Guidelines for proventing infection associated with the insertion and maintenance of central venous catheters; Journal of Hospital Infection 2001
Guideline for prevention of intravascular catheter-related infections,CDC-HICPAC, 2002.
Centres for Disease and Control. Linee guida per la prevenzione delle infezioni associate a catetere intravascolari. Giornale italiano delle infezioni ospedaliere
Piano Nazionale Linee Guida (PNLG)WWW.SNLG-ISS.IT
Mazzufero Fabio www.GAVeCeLT.org "Gli Accessi Venosi Centrali a Lungo Termine", 2006
Irving V, et Al: Neonatal wound care.Wounds UK. 2006
P.J.McGrath. Core outcome domains and measures for pediatric acute and chronic/ recurrent pain clinical trial: PedIMMPACT recommendations. The Journal of Pain 2008;
Terapia del Dolore nel Bambino "Collana Specialistica Pediatrica" (SEE-FIRENZE)
Pediatric Advanced Life Support Advanced Trauma Life Support
Journal of the American Association of Nurse Anesthetists.
Anaesthesiology
MED/41 - ANAESTHESIOLOGY - University credits: 1
Lessons: 15 hours
Professor:
Scalia Catenacci Stefano
General and subspecialty paediatrics
MED/38 - PAEDIATRICS - University credits: 1
Lessons: 15 hours
Professor:
Cavallaro Giacomo
Lab 3
MED/45 - NURSING - University credits: 1
Lessons: 15 hours
Professor:
Salvato Mauro
Nursing sciences: general, clinical and paediatric
MED/45 - NURSING - University credits: 2
Lessons: 30 hours
Professor:
Madeo Mario
Paediatric surgery
MED/20 - PAEDIATRIC SURGERY - University credits: 1
Lessons: 15 hours
Professors:
Leva Ernesto, Pelizzo Gloria