Emergency Medicine and Toxicology

Study Course Description

Course Description Statuss:Approved

Course Description Version:1.00

Study Course Accepted:15.04.2024 08:50:18

Study Course Information
Course Code:		AURK_056		LQF level:		Level 7
Credit Points:		2.00		ECTS:		3.00
Branch of Science:		Clinical Medicine; Oral Medicine		Target Audience:		Dentistry
Study Course Supervisor
Course Supervisor:		Sigita Kazūne
Study Course Implementer
Structural Unit:		Department of Anaesthesiology and Intensive Care
The Head of Structural Unit:
Contacts:		Riga, Pilsoņu Street 13, VSIA P.Stradiņa KUS, Building 32, arkrsu[pnkts]lv, +371 67069452
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		6	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		12
Classes (count)		10	Class Length (academic hours)		2	Total Contact Hours of Classes		20
Total Contact Hours								32
Study course description
Preliminary Knowledge:
A background in first aid, pharmacology and physiology is required.
Objective:
To prepare students to provide emergency medical care in various urgent situations that can occur in dentistry. Promote the acquisition of knowledge about the basics of disaster medicine, as well as acquire knowledge about acute poisonings, their epidemiology, toxicokinetics and treatment characteristics, the clinical course of certain types of poisoning, recommended treatment principles and more relevant poisonous substances.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	ACLS algorithm. Basic life support in adults. Basic life support in pediatrics. Usage of automated external defibrillator. Hypoxia. Choking. Airways – how to establish airways and how to provide manual ventilation with the mask.			Classes		1.00	clinical base
2	Emergency care in dentistry.			Lectures		1.00	auditorium
3	Acute cardiac emergencies – stable and unstable angina. Acute coronary syndrome, acute lung edema. Life-threatening arrhythmias, ECG diagnostic principles. First aid – MONA.			Classes		1.00	clinical base
4	Acute neurologic emergencies – epileptic seizures, status epilepticus, hemorrhagic and ischemic stroke, subarachnoid hemorrhage, migraine. First aid.			Classes		1.00	clinical base
5	Acute respiratory emergencies – asthma, status asthmaticus, chronic obstructive pulmonary disease (COPD), pneumothorax, hemothorax. First aid – oxygen administration, thoracostomy.			Classes		1.00	clinical base
6	Anaphylaxis. Hyperglycemia and hypoglycemia. Orthostatic collapse, vasovagal collapse. Emergency care.			Classes		1.00	clinical base
7	Acute pediatric emergencies – epistaxis, severe epiglotitis, stridor, febrile seizures, agitated child. Emergency care.			Classes		1.00	clinical base
8	Clinical scenarios for emergency situations in dentistry.			Classes		1.00	clinical base
9	General characteristics and types of disasters, definitions. Legislation. Description of the forces involved in the elimination of the disaster consequences. Principles of disaster management (on accident site, during transportation to hospital, hospital level)			Lectures		1.00	auditorium
10	Consequences of chemical disasters. Protection equipment for rescuers. Decontamination – indications, procedures and methods			Lectures		1.00	auditorium
11	Triage and treatment options of casualties on different levels of care, protection principles. START triage method. Implementation of ABCDE protocol in disasters.			Lectures		1.00	auditorium
12	Toxicological epidemiology. Mechanisms of poisoning (routes of contamination, toxicokinetics, toxicodynamics). Clinical manifestations and diagnosis of acute poisoning - symptoms and syndromes.			Lectures		1.00	auditorium
13	General principles of treatment of acute poisoning. Elimination methods, antidotes and principles of their use			Lectures		1.00	auditorium
14	ABC of poisoning care. Resuscitation.			Classes		1.00	clinical base
15	Drug poisoning (opioids, amphetamines, benzodiazepines, antipsychotics).			Classes		1.00	clinical base
16	Poisoning with specific substances - paracetamol, carbon monoxide, local anesthetics			Classes		1.00	clinical base
Assessment
Unaided Work:
Preparation of presentations based on a thematic plan using recommended literature and Internet sources, followed by evaluation and analysis in practical classes. Preliminary preparation of the subject of the relevant lesson, followed by practical application in class. In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal.
Assessment Criteria:
Testing method: exam. Each student receives two theoretical questions. Practical demonstration of the acquired skills. Multiple choice test in toxicology.
Final Examination (Full-Time):		Exam (Written)
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		As a result of learning the study course, students will be able to perform basic resuscitation, use an external defibrillator. Action in case of choking. Assess and provide first aid in emergency situations in cardiology, pulmonology, neurology and pediatrics. They will acquire basic knowledge of the principles of liquidation of the medical consequences of disasters, providing emergency aid to as many victims as possible in the shortest possible time, observing the principle of priority, and will also acquire basic knowledge in clinical toxicology - routes of entry of toxic substances into the body, toxicokinetic considerations, clinical course of poisoning and treatment options and peculiarities.
Skills:		Perform the basic life support algorithm, recognise signs of clinical and biological death, first aid in the event of aspiration of a foreign body, ventilation with a manual ventilator and inhalation of oxygen. Students will be able to triage victims at the scene and in hospitals, support vital functions and will be able to use personal protective equipment according to the nature of the disaster and injury; provide first aid in case of acute intoxication.
Competencies:		Providing first aid, situation analysis, applying the basic resuscitation algorithm and other first aid action guidelines. On the evaluation of the medical consequences caused by the disaster and possible threats, on the classification of the victims and the amount of emergency aid in the various stages of the liquidation of the medical consequences of disasters, in the presence of limited medical resources; competencies to make individual action decisions, according to the situation, while working in a team and following general disaster management instructions; competences on the risk factors of acute exogenous intoxications, epidemiology, drawing up an immediate action plan and far-reaching action tactics for an acute toxicological patient, based on arguments, relating it to a specific clinical situation and demonstrating an individual attitude towards the patient.
Clinical Skills:
No.	Skill					Level
1	Bag-mask ventilation					B1 - Basic level
2	Cardiopulmonary resuscitation (basic)					B1 - Basic level
3	Defibrilation					B1 - Basic level
4	High O2 concentration mask placement					B1 - Basic level
5	Nasopharyngeal airway insertion					B1 - Basic level
6	Oropharyngeal airway insertion					B1 - Basic level
Bibliography
No.	Reference
Required Reading
1	Krieviņš, D. 2004. Neatliekamā medicīniskā palīdzība. Atdzīvināšana. Rīga: NMPC
2	Krieviņš, D. 2001. Neatliekamā medicīniskā palīdzība. Traumas. Rīga: NMPC
3	Soar J., Böttiger B.W., Carli P., Couper K., Deakin C.D., et all. European Resuscitation Council Guidelines 2021: Adult advanced life support. Resuscitation. 2021 Apr;161:115-151. doi: 10.1016/j.resuscitation.2021.02.010. Epub 2021 Mar 24. Erratum in: Resuscitation. 2021 Oct;167:105-106.