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Course, academic year 2023/2024
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Anaestesiology and Intensive Medicine - DA0110313
Title: Anaestesiology and Intensive Medicine
Guaranteed by: Department of Anaesthesiology and ICM (13-383)
Faculty: Second Faculty of Medicine
Actual: from 2023
Semester: winter
Points: 3
E-Credits: 3
Examination process: winter s.:
Hours per week, examination: winter s.:0/30, C+Ex [HT]
Extent per academic year: 2 [weeks]
Capacity: unknown / unlimited (unknown)
Min. number of students: unlimited
4EU+: no
Virtual mobility / capacity: no
Key competences:  
State of the course: taught
Language: English
Teaching methods: full-time
Teaching methods: full-time
Guarantor: prof. MUDr. Tomáš Vymazal, Ph.D.
Classification: Medicine > Clinical Disciplines
Pre-requisite : DA0108363, DA0108369, DA0108370
This course explores the fundamental principles of securing vital functions, along with how anesthesia and various medical conditions can impact them. We will delve into topics such as circulatory failure, ventilation, disorders of consciousness, internal environment, and sepsis. To offer a comprehensive educational experience, we will provide clinical placements in operating rooms and resuscitation departments, as well as interactive workshops in the morning. During internships in inpatient wards, students will gain knowledge about critical care principles, the significance of monitoring and influencing circulation, UPV basics, ATB therapy, the importance of nutrition in critical care, and manipulation of the internal environment. We will also emphasize the significance of intensive care in relation to surgical, traumatic, and infectious organism damage. During their stay in operating rooms, students will have the opportunity to learn about anesthesia administration, securing airways, pre-operative preparation, the anesthesia course, and post-operative care. Workshops will focus on life-threatening conditions through CBL, while interactive workshops will cover basic skills. The course is predominantly practical, with some theoretical preparation required by self-study. Active participation and discussion are essential. Although internships, workshops, and seminars provide a foundational curriculum and opportunities for discussion, they do not encompass all AIM-related topics due to time constraints. Thus, acquiring additional knowledge through self-study is necessary.
Last update: Bureš Jan, MUDr. (11.09.2023)
Aim of the course

Our aim is to provide students with a solid foundation in anesthesia care, covering individual techniques, perioperative and resuscitation principles, and pain management.

Our objectives are to help you develop:

The ability to evaluate a patient's condition in the context of surgery.

Understanding of safe anesthesia practices and risks associated with vital function manipulation.

Mastery of central and peripheral blockade techniques.

The skills to identify and address life-threatening situations.

Knowledge of the differences between circulatory and respiratory failure and their treatments.

Expertise in intensive care, including admission standards and initial management.

Recognition, treatment, and prevention of respiratory insufficiency.

The skills to manipulate circulation to ensure comprehensive care for patients in the hospital setting.

Last update: Bureš Jan, MUDr. (11.09.2023)
Course completion requirements

Successful completion of the course requires passing the oral exam, which necessitates fulfilling all clinic internships and seminars, as well as active participation in solving typical situations. Attendance is governed by Dean's Measure No. 4/2022 in case of illness.

The exam terms will be at the beginning of the week following the course.

Places are open on the second Monday of the course.

The oral exam comprises of two questions, the first of which focuses on analyzing case history, laboratory findings interpretation, and designing a treatment plan. The second question is theoretical. Answering both questions is necessary to pass the exam, with the first question carrying more weight at 60%. The exam requires adequate knowledge of circulation and breathing pathophysiology, internal environment, pharmacology, laboratory methods, and risk assessment before surgery.

Last update: Bureš Jan, MUDr. (21.09.2023)
Barash, P.: Clinical Anesthesia, 6th Ed. 2009

Civetta, Taylor, & Kirby's Critical Care, 2008, 4th Ed., Pub.: Lippincott Williams & Wilkins (LWW)

Last update: Filaun Martin, MUDr., CSc. (12.09.2022)
Requirements to the exam

Exam questions AIM 5. year

1. ALS - initial approach, procedure, pharmacotherapy, 4H, 4T, defibrillation, for both adults and children.

2. Respiratory insufficiency - pathophysiology of ventilation, perfusion, diffusion, blood gases, pH, clinical manifestations such as ARDS and COPD.

3. Oxygen therapy and ventilation - invasive and non-invasive methods, basic principles, indications, and adverse effects on the organism.

4. Hypovolemic shock - manifestations, initial therapy, and principles of therapy such as volume therapy and anaemia/coagulopathy.

5. Sepsis and septic shock - manifestations and initial management.

6. Determinants of CO and DO2 - lactate, SvO2, their significance, and interpretation.

7. Acute heart failure - manifestations and causes concerning Anaesthesia and Intensive care, Arrhythmias in intensive care (most common, significance)

8. Thromboembolic disease - perioperative risks, manifestations, initial management, and prevention.

9. Allergic reactions, anaphylactic shock, and acute intoxication – manifestation, management

10. Drugs affecting the autonomic nervous system – Indications, side reactions

11. Volume therapy - crystalloids, colloids, blood products, and blood derivatives.

12. Metabolic acidosis - types, clinical and laboratory signs, therapy.

13. Disorders of consciousness and their assessment - Basic neurological examination in intensive care

14. Craniocerebral injury - brain oedema, intracranial hypertension syndrome, basic therapeutic approach.

15. Hemocoagulation disorders in intensive care and their therapy - dilutional and consumptive coagulopathy, DIC, anticoagulants, and their antidote.

16. Multiple trauma (Polytrauma) in resuscitation care, triage positive patient, initial management, hemorrhagic shock, Life-threatening bleeding and its therapy

17. SIRS and multiorgan dysfunction syndrome, AKI in intensive care and its therapy

18. Types of anaesthesia - basic terms, general, SAB, EPID, RA, differences (advantages and disadvantages of each method)

19. Complications in Anaesthesia – aspiration, difficult airway management, hypotension, postoperative adaptation – a residual effect of anaesthetics, temperature management

20. Pharmaceuticals used during anaesthesia, circulation and breathing affection

21. Monitoring in anaesthesia and intensive care - methods, meaning, interpretation of basic values

22. Pre-operative and pre-anaesthetic examination and preparation – significance, risk assessment, fasting

23. Local anaesthetics - methods of use, types of adverse reactions and their therapy

24. Pain – principles of approach, possibilities of perioperative analgesia

Last update: Bureš Jan, MUDr. (12.09.2023)

The course is structured as a 2-week block, with the first day dedicated solely to theory from 8:00 a.m. to 2:30 p.m.

The remaining days involve smaller group work, with students participating in practical lessons from 7:45-11:30 a.m.

These sessions include internships in operating rooms and resuscitation departments, as well as morning workshops that explore life-threatening conditions.

Active participation and pre-learning are expected, and practical teaching utilizes interactive simulators and real medical aids.

Theoretical seminars, which run from 12:30 to 2:15 p.m., are common to the entire study group and serve as a springboard for deepening knowledge and findings in subsequent practical workshops.

These seminars cover a range of topics, including basic anesthesiology concepts and procedures, advanced CPR, issues of circulatory failure, basics of monitoring, approaches to the vascular bed, pharmacology of blood circulation, respiratory system failure, disorders of consciousness, brain edema, intracranial hypertension, issues of brain death, sepsis and MOF, polytrauma, renal failure, ABR disorders, and electrolyte balance

Last update: Bureš Jan, MUDr. (11.09.2023)
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