university: Alexandria Faculty : Medicine Program ......2 052009010 Advanced Medical Physiology For...

واالعتمادهيئة القومية لضمان جودة التعليم ال

1

university: Alexandria

Faculty : Medicine

Program Specifications

(Academic year: 2015/ 2016)

A. Basic Information: 1. Program title: Doctorate Degree of Anaesthesia and Surgical Intensive Care 2. Department (s) offering the program; Anaesthesia and surgical intensive care. 3. Program Coordinator: Prof Wafaa Shafshak.. 4. External evaluator(s): Prof Khaled Yassen 5. Type of the program: Single. 6. Date of program specifications approval: 7.

B. Professional Information:

1- Program Aims: The aim of this program is to upgrade the candidate abilities in:

1.1. The anatomy applied to anaesthesia, intensive care and pain management

1.2. The practical aspects of the administration of anaesthetics and adjuvant drugs and

drug/drug interaction.

1.3. The impact of physiology change on patient management

1.4. Managing difficult airway situations and emergency airway scenarios.

1.5. Role of physical principles in anaesthesia practice

1.6. Technical skills related to anaesthesia, intensive care and pain management

1.7 Preoperative management of patient in elective, emergency and outpatient settings

1.8. Perioperative management of patient with medical problems

1.9. Perioperative management of different surgical and other interventions under anaesthesia

1.10. Caring for the special needs of patients during ICU period

1.11. The specific modalities for pain management.

1.12. Resuscitation

1.13. Team work and leadership

1.14. Ethical and medicolegal aspect of anaethesia

2- Academic reference standards (ARS) & ILOs:

Academic reference standards of Doctor Degree in Anaesthesia and surgical intensive care are

designed and approved by Department of Anaesthesia and surgical intensive care, Faculty of

Medicine. Alexandria University. Based on:

Generic Academic Reference Standards (ARS): Postgraduate Medical Education, Egypt

(2009). Published by National Authority for Quality Assurance and Accreditation of

Education (NAQAAE) National

[http://naqaae.org/main/php/book/index.php]

Benchmarks:

The university of Edinburgh, Degree regulations & programmers of study 2005/2006

http://www.drps.ed.ac.uk/05-06/course.php?code=P01798

The Royal College of Anaesthetists advanced Level training

http://www.rcoa.ac.uk/docs/AnnexEAdvanced%20level%20training_PMETB.pdf


2

Domain Academic Reference

Standards

ILOs

A. Knowledge and

understanding

Graduate of this program must

acquire knowledge about:

• Recent advances in

pharmacology of drugs

related to anaesthetic

practice.

• Anatomy related to

anaesthesia

• Physiologic derangement

due to anaesthesia.

• Physics applied to

anaesthesia

• Preoperative preparation

.

• Management of patient

during the intraoperative

period.

• Postoperative care

• Management of pain in

complicated cases.

Graduate of this course must

acquire knowledge to:

A.1 Describe advanced

pharmacological principles of

drugs.

A.2. Discuss the toxic drug effect

A.3 Explain the mechanism of

drug-drug interaction

A.4. Relate applied anatomy to to

anaesthetic practice

A.5. Describe the impact of

physiologic derangement on the

course of anaesthesia

A.6. List the physical principles

relevant to anaesthesia

A.7. Mention the principles

underling anaesthetic and

monitoring equipment

A.8.. Describe specific points

stressed upon during taking

history from the patient

A.9. List steps of physical

examination in medically

compromised patient

A.10. State specific points in

relation to surgical procedure

A.11. List needed laboratory

investigations perioperative.

A.12. Discuss perioperative

complications

A.13. Mention special patient’s

needs during postoperative period

A.14. Define possible causes of

resistant acute pain

A.15 Describe the criteria of

persistent chronic pains.

A.16. Describe specific pain

syndromes and their management


3

• Resuscitation.

A.17. Explain admission and

discharge criteria for intensive

care unit

A.18. Mention needed steps for

management of patient during

intensive care unit stay

A.19. Describe resuscitation of

life threatening conditions

B. Intellectual skills Graduate should be competent

to:

• Use information to access

the patient's wellbeing

during and post

anaesthesia.

• Impact of physiologic

derangement on surgery

• Apply proper anaesthetic

technique according to

patient condition.

• Apply advanced

pharmacologic principles

.

Graduate should be competent to:

B.1. Select necessary

investigations according to

situation

B.2. Assess potential problems

from history and clinical

examination.

B.3. Evaluate which patient is in

need for further workup before

admission to surgery

B.4. Modify anaesthetic plane

according to surgery

B.5.. Predict intra and

postoperative events according to

intervention

B.6. Relate events to underlying

clinical condition

B.7. Select proper drugs according

to patient condition.

B.8. Suggest therapeutic

management for drug reaction

B.9. Detect drug-drug interactions

B.10. Select suitable anaesthetic

technique in common and

complicated cases.

B.11. Decide to start resuscitation

at proper time.

B.12. Design strategies for acute

and chronic pain management


4

C. Professional

skills

Student should develop the

appropriate skills in order to:

• Vascular cannulation.

• Airway management

• Monitoring

• Regional blocks

• Resuscitation

• Pain management

Student should develop the

appropriate skills in order to

C.1. insert central cannulation for

difficult cases.

C.2. Diagnose difficult airway

C.3. perform advanced airway

devices and techniques to

maintain patent airway

C.4. Connect patients to advanced

monitoring devices

C.5. Perform difficult regional

blocks guided by advanced

devices

C.6. Connect patients to

mechanical ventilator

C.7. Use advanced ventilation

modes.

C.8. Select correct fluid therapy.

C.9. Lead cardiopulmonary

resuscitation team

C.10. Use advanced pain

management techniques

C.11. Write precise patient records


5

D. General and

transferrable

skills

Graduate should be competent

in the following:

• Network search for topics

retaliated to his work.

• Computer skills.

• Teaching and research

activities.

Graduate should be competent

in the following:

D.1. Demonstrate ability to get

recent knowledge.

D.2. Use information technology

to prepare lectures and research

D.3. Design research protocols

and co-operate in

multidisciplinary research teams

D.4. Demonstrate skills to present

scientific talks.

D.5. Conduct teaching and

training sessions.

D.6. Perform as a team.

E. Attitudes and

ethical

behavior

Graduate should be able to:

• Follow ethical

regulations during

performance.

• Appraise medico-legal

rules.


E.1. Explain anaesthetic events to

patients.

E.2. Include any choices of

anaesthetic technique.

E.3. Deal gently with patients and

their families.

E.4. Appraise the importance of

patient consent for intervention

during management &/or

enrollment in research.

E.5. Check drugs, machines and

equipments.


6

Program courses ILOs Matrix

ILOs

Course title

A

1

A

2

A

3

A

4

A

5

A

6

A

7

A

8

A

9

A

1

0

A

1

1

A

1

2

A

1

3

A

1

4

A

1

5

A

1

6

A

1

7

A

1

8

A

1

9

Advanced Clinical

Pharmacology For

Anaesthesia

x x x

x

Advanced Medical

Physiology For

Anaesthesia

x x

Physics and Clinical

Measurement For

Doctorate Of

Anaesthesia

x x

Anaestheia For General

Surgery, Vascular

Doctorate

x x

x x

Cardio – Thoracic

Anaesthesia For

Doctorate Degree

x

x x

x x x

x x x

Neuro and Ophthalmic

Anaesthesia For Doctor

x x

x x

x x x x

x x x

ENT Anaesthesia For

Doctorate

x

x

x

x

x

Maxillofacial and Plastic

Anaesthesia For

Doctorate

x x

x x x

Obstetric Anaesthesia

For Doctorate Degree

x x

x x x

x

Pediatric Anaesthesia

For Doctorate Degree

x

x x

x

x x

Hepato-renal

Anaesthesia

x

x x

x

x x x

x x

Trauma, Ortopaedic,

Emergency, burn And

Outpatient Anaesthesia

For Doctorate

x x x x

x x x x x

x x

Pain Management and

Regional Analgesia For

Doctorate Degree Of

Anaesthesia

x

x

x x x x

x

x x x x

Intensive Care For

Anaesthesia (III)

x x x x x x

x x

x

x x


7

Intensive Care For

Anaesthesia (IV)

x

x x x

x x X

Intensive Care For

Anaesthesia (V)

x x x

x

x x x

x x

Intergraded Anaesthesia

for Doctorate Degree

x x

x x x

x

ILOs

Course title

B1 B2 B3 B4 B5 B6 B7 B8 B9 B10 B 11 B12

Advanced Clinical

Pharmacology For

Anaesthesia

x x x x

Advanced Medical

Physiology For

Anaesthesia

x

x x


Measurement For

Doctorate Of Anaesthesia

x x

Regional Analgesia x

x


Surgery, Vascular

Doctorate

x x

x

x x x x

Cardio – Thoracic

Anaesthesia For

Doctorate Degree

x x

x

x

x



x x x

x x

ENT Anaesthesia For

Doctorate

x

x x x

x


Anaesthesia For

Doctorate

x x x x

x

Obstetric Anaesthesia For

Doctorate Degree

x x x x x

x

Pediatric Anaesthesia For

Doctorate Degree

x

x

x

x

Hepato-renal Anaesthesia x x x x x

x x x

Trauma, Ortopaedic,

Emergency, burn And


For Doctorate

x x

x x

x x x x

Pain Management and


x

x

x x


8

Doctorate Degree Of

Anaesthesia

Intensive Care For

Anaesthesia (III) x x

x x X x

x

Intensive Care For Anaesthesia (IV)

x

x

Intensive Care For

Anaesthesia (V)

x



x x

x x x x

ILOs

Course title

C1 C2 C3 C4 C5 C6 C7 C 8 C 9 C10 C 11

Advanced Clinical

Pharmacology For

Anaesthesia

Advanced Medical

Physiology For Anaesthesia


Measurement For


x


Surgery, Vascular

Doctorate

x

x

x

x

Cardio – Thoracic

Anaesthesia For Doctorate

Degree

x x

x x

x

x



x x x x

x x

ENT Anaesthesia For

Doctorate

x x x

x x



x x

x x x


Doctorate Degree

x x

x x x


Doctorate Degree

x

x x x x x x

Hepato-renal Anaesthesia x

x x x

x

Trauma, Ortopaedic,

Emergency, burn And


For Doctorate

x x x x

x x x

Anaesthetic Implications

Of Diseases For Doctorate

x

x x x x


9

Pain Management and


Doctorate Degree Of

Anaesthesia

x x

x x

Intensive Care For

Anaesthesia (III)

x

x

x x x

x

Intensive Care For

Anaesthesia (IV)

x

x x

x x x x

Intensive Care For

Anaesthesia (V)

x

x

x x x

x



X x

x x x

ILOs

Course title

D1 D2 D3 D4 D5 D6 E1 E2 E3 E4 E5

Advanced Clinical

Pharmacology For

Anaesthesia

x x

Advanced Medical

Physiology For Anaesthesia

x

X


Measurement For Doctorate

Of Anaesthesia

x x

x


Surgery, Vascular

Doctorate

x x x x x

x x X x x

Cardio – Thoracic


Degree

x x

x x x x



x x x x x x

ENT Anaesthesia For

Doctorate

x x

x x x x x



x

x x

x x


Doctorate Degree

x

x x x

x x


Doctorate Degree

x

x

x x

Hepato-renal Anaesthesia x

x x

x x x

Trauma, Ortopaedic,

Emergency, burn And

Outpatient Anaesthesia For

Doctorate

x

x

x

x x


10

Pain Management and


Doctorate Degree Of

Anaesthesia

x

x x x

x x

Intensive Care For

Anaesthesia (III)

x

x x x

x x x x

Intensive Care For

Anaesthesia (IV)

x x

x x

x x

Intensive Care For

Anaesthesia (V)

x x

x

x x



x

x x

x x

3- Curriculum Structure:

-Program duration: This program is fulfilled in 3 - 7 academic years

-Program structure:

Total hours: 52Credit Hours

1. Obligatory subjects: 30Credit Hours. 2. Thesis: 20 Credit Hours.

3. Elective Subjects: Two, one Credit Hour Each.

-Program Content:

A. Obligatory Courses: Code

Course

Credit

Hours

Contact hours

Lectures Clinical Others

1 050609010 Advanced Cinical Pharmacology For Anaesthesia 2 28

2 052009010 Advanced Medical Physiology For Anaesthesia 1 14

3 05010901 Physics and Clinical Measurement II 2 28

4 05010902 Anaestheia For General Surgery, Vascular Doctorate 2 14 28

5 05010903 Cardio – Thoracic Anaesthesia II 2 14 28

6 05010904 Neuro and Ophthalmic Anaesthesia For Doctor 2 14 28

7 05010905 ENT Anaesthesia For Doctorate 1 7 14

8 05010906 Maxillofacial anesthesia 1 7 14

9 05010907 Obstetric Anaesthesia 1 7 14

10 05010908 Pediatric Anaesthesia 1 7 14

11 050109009 Hepato-renal Anaesthesia 2 14 28

12 05010910 Trauma, Ortopaedic, Emergency, burn And Outpatient


2 14 28

13 05010911 Pain Management and Regional AnalgesiaFor Doctorate

Degree Of Anaesthesia

3 21 42

14 05010912 Intensive Care For Anaesthesia (III) 2 14 28

15 05010913 Intensive Care For Anaesthesia (IV) 2 14 28

16 05010914 Intensive Care For Anaesthesia (V) 2 14 28

17 05010915 Intergraded Anaesthesia for Doctorate Degree

2 14 28

B. Elective Courses: Course Title


11

Course

Code

No of

Hours/Week

` Biostatistics & Computer 1

0511805 Medical Ethics 1

05160832 Molecular Biology 1

05180813 Hospital Associated Bacterial Infection 1

051409010 Advanced Anatomy For Doctorate Degree Of Anaesthesia 1

4- Program Admission Requirements:

According to the regulations of the credit hour bylaws of the Faculty of Medicine

Alexandria University (annex).

5- Regulations for Progression and Program Completion:

According to the regulations of the credit hour bylaws of the Faculty of Medicine

Alexandria University (annex).

6- Methods of student assessment:

Methods Intended Learning outcomes to be assessed

1. Written Exam a1-a19, b1-b12, d1, d3, e2, e4

2. Clinical Exam b1-b10, c1-c11, e1, e5

3. Oral Exam a1-a19, b1-b12, d3, d4, e1, e2, e4,

4. Assignments d1-d6,e1-e4

5. Thesis A1-a19, b1-b12, c1-c11,d1, d2, d3, d6, e3-e4

7- Methods of program evaluation:

Evaluator Tool Sample

1. Students enrolled in the program Questionnaires.

2. Alumni --------

3. Stakeholders (Employers) Focus group

4. External Evaluator (s) -----------

5. Others:

Program Coordinator: Prof Wafaa Shafshak

Program Director: Prof Nader El Gamal


12

COURSE DESCRIPTION

1 Code Credit hours (2) Course Prerequisites

050609010 Lectures Practical Advanced Clinical

Pharmacology for

Anaesthesia

2 -

General Pharmacology. Receptors, pharmacodynamics, pharmacokinetics. Drug

interaction. Autonomic nervous system: sympathomimetics, sympathetic depressants.

Parasympathomimetics, parasympathetic depressants.

Skeletal Muscle Relaxants. Autacoids. Central nervous system: sedatives & hypnotics.

Non-narcotic & narcotic analgesics. Anticonvulsant drugs. Cardiovascular system:

antiarrhythmics, antihypertensives, inotrop, vasopressors & vasodilators. Plasma expanders

& substitutes: colloids, crystalloids. Coagulants & Anticoagulants. Kidney: diuretics.

Respiratory system: bronchodilators & mucolytics. Endocrine system: antidiabetic drugs,

thyroid & antithyroid drugs, corticosteroids. Inhalation anaesthetics, IV Anaesthetics.


052009010 Lectures Practical Advanced Meddical

Physiology for

Anaesthesia

2 -

The cell structure and function. Recent advances in internal environment control. Transport

through cell membrane. New concepts in physiology cardiovascular system, respiratory

system, nerve & muscle. Neuro-muscular junction. Blood transfusion, Haemostasis &

coagulation. Body fluids and the kidneys, including water-electrolyte and acid-base

balance. CNS: Organization of the nervous system. Pain: physiology of pain, modern

theories. Activation of the brain; wakefulness and sleep.

The autonomic nervous system; stress response. GIT lower oesphageal sphincter. Emptying

of the stomach, liver functions. Vomiting, regurgitation. Metabolism and temperature

regulation: metabolic rate, respiratory quotion. Physiology of endocrine glands, pituitary,'

thyroid, supra-renal & pancreas (hyper & hypo function).


05010901 Lectures Practical Physics And Clinical

Measurement For


2 -

Units of measurements, pressure, fluid flow, volume and flow measurement. Arterial blood

pressure & central venous pressure measurement. Cardiac performance, measurement of

blood flow, cardiac output & pulmonary capillary wedge pressure, pulmonary function

tests. The gas laws. Natural exponential functions. Solubility, diffusion and osmosis. Work,

energy and power. Temperature, heat capacity and latent heat of vaporization, vaporizers.

Humidity & humidification.

The sine wave and wave patterns, electricity, fires and explosions, biological electrical

potentials: their display and recording electrical safety, oxygen measurement, hydrogen ion

and carbon dioxide measurement. Central nervous system monitoring. Gas analysis: gas

chromatography & mass spectrometry. Gas supplies, breathing and scavenging systems.

Isotopes and radiation. Presentation and handling of data


13


05010902 Lectures Clinical Anaestheia For General

Surgery, vascular and

plastic

1 1

Laparoscopic surgery: ventilation & haemodynamic problems. Endocrinal surgeries:

diabetic patient, Hypo & hyperthyroidism, pheochromocytoma, adrenal gland disorders,

parathyroid disease. Transplant surgery: transplantation immunology, preoperative

preparation of donor & recipient, perioperative management of renal, hepatic, heart & lung

transplantation.

Vascular surgery: Atherosclerosis, preoperative assessment & optimization. Aortic

aneurysm & reconstruction. Lower extremities revascularization, regional versus general

anaesthesia. Carotid endartrectomy. Burn & plastic surgery.

Scientific Activities for Doctor of Anaesthesia. included in this course


05010907 Lectures Clinical Cardiothoracic

Anaesthesia for Doctorate

Degree

1 1

Anaesthesia for cardiac surgery & cardio-pulmonary bypass, myocardial preservation,

anaesthetic management of pre, bypass & post bypass periods, complications. Anaesthetic

consideration for thoracic surgery, pre, intra & postoperative management of patients

undergoing thoracic surgery, thoracotomy position, one lung anaesthesia & double lumen

tubes.



05010908 Lectures Clinical Neuro and Ophthalmic

Anaesthesia for Doctorate

Degree

1 1

Anaesthetic managements of craniotomies, posterior fossa surgery, intracranial aneurysm,

& subarachnoid haemorrhage, brain protection, head trauma.

Anatomy and physiology of the eye. Anaesthesia and intraocular pressure. Penetrating eye

injury. Ocular pathology and systemic disease. Anaesthetic ramification of ophthalmic

drugs. Regional blocks. Special ophthalmic procedures and their anaesthetic management.

Outpatient ophthalmic surgery. Ophthalmic complications of anesthesia and surgery.



05010905 Lectures Clinical ENT Anaesthesia for

Doctorate Degree

0.5 0.5

Elective, emergency surgeries and complications of ear, nose and throat surgery. Traumatic

conditions. Difficult airway, paediatric airway problems and foreign body aspiration.

Endoscopic procedures and laser surgery of airway. Skull base surgery and free flaps.



14


05010906 Lectures Clinical Maxillofacial Anaesthesia


0.5 0.5

Outpatient dental anaesthesia. Exodontia, Craniofacial abnormalities and orthognathic

Surgery. Tumors. Maxillofacial trauma. Management of the difficult airway, patient

position, blood loss. Paediatric dental practice, with special reference to disabled children.

Scientific Activities for Doctor of Anaesthesia. included in this course.


05010907 Lectures Clinical Obstetric Anaesthesia

0.5 0.5

Physiologic changes in pregnancy, uterine blood flow & placental transfer of anaesthetics,

special problems related to childbirth: normal labor, caesarean section, high risk obstetric

patient. Obstetric analgesia: systemic, regional blocks. Anaesthesia for surgeries during

pregnancy.



15


05010908 Lectures Clinical Paediatric Anaesthesia for

Doctorate Degree

0.5 0.5

Physiologic changes in pregnancy, uterine blood flow & placental transfer of anaesthetics,

special problems related to childbirth: normal labor, caesarean section, high risk obstetric

patient. Obstetric analgesia: systemic, regional blocks. Anaesthesia for surgeries during

pregnancy. Anatomic, physiologic & pharmacologic differences between pediatrics &

adults. Anaesthetic implications in neonates, child: congenital anomalies, paediatric

neoplasm, emergencies of paediatric patient. Sedation, analgesia and fluid therapy in

paediatrics.



05010910 Lectures Clinical Trauma, Orthopaedic,

Emergency And


For Doctorate

1 1

Trauma centers, scoring systems, transportation of trauma patients. Mechanism of injury.

Trauma in relation to anatomical region. Resuscitation. Anaesthesia and common

perioperative problems.

Benefits of ambulatory surgery. Patient and procedures selection. Drugs and anaesthetic

techniques, contraindications to outpatient anaesthesia.

Orthopaedic surgery: positioning, choice of anaesthesia. Major procedures, blood loss, joint

replacement, spine & pelvic surgery. surgeries, graft surgery. Fractures. Regional

anaesthesia for the extremities. Complications of orthopaedic surgery. Scientific Activities for Doctor of Anaesthesia. included in this course


16


0501090909 Lectures Clinical Hepato-renal Anaethesia

For Doctorate

1 1

Acute and chronic parenchymal liver diseases. Assessment of liver function. Preoperative,

intraoperative and postoperative consideration. Cholystatic liver disorders. Postoperative

liver dysfunction.

Renal blood flow. Evaluation of renal function. Effect of drugs in patients with abnormal

renal function. Acute renal failure and dialysis. Renal and genitourinary procedures: TUR,

Laser, Laparoscopies, extracorporeal shock wave lithotripsy, Renal tumors, Radical

surgeries, inflammatory conditions, obstructive uropathy.



05010911 Lectures Clinical Pain Management And

Regional Anaesthesia

1.5 1.5

Definition, mechanism of chronic pain. Classification, anatomy & physiology of pain.

Assessment, different pain syndromes. Different approaches to management:

pharmacologic & non pharmacologic measures. Pain clinic. Preemptive analgesia, patient

controlled analgesia.

Pharmacology of local analgesic drugs. Techniques: surface analgesia, peripheral nerve

block, plexus, neuroaxial blocks. Techniques, indications, contra indications, toxicity.

Spinal: subarachnoid & epidural anaesthesia Indications & contra indications, The use of

vasopressors with local analgesics. Toxicity and complications of regional analgesia &

treatment. Sedation during regional analgesia.



05010912 Lectures Clinical Intensive Care for

Anaesthesia (III)

1 1

Gastro-intestinal disorders in the critically ill. Haematological emergencies renal failure in

the critically ill. Neurological disorders in the intensive care immune disorders in the

critically ill trauma: assessment, supportive measures & management. Clinical shock

syndromes: pathophysiology, types, management. Septic patient. Obstetric emergencies.

Brain protection & brain death: concept, mechanisms, diagnosis & management. CPR:

definition, causes, types, management & prognosis.



05010913 Lectures Clinical l Intensive Care for

Anaesthesia (IV)

1 1


17

Scoring systems of the critically ill. Oxygen therapy: indications, methods &

complications. Respiratory failure, types, mechanism, and treatment, mechanical

ventilation I: basic concepts, II: new modes. Nutritional support: energy & nutritional

requirements, enteral & parentral nutrition. Regulation of pH & acid base disorders. Fluid

& electrolyte therapy: water balance, sodium, potassium, calcium & phosphorus.

Monitoring & diagnostic procedures. The use of analgesia, sedation and skeletal muscle

relaxants for intensive care patient.



05010914 Lectures Clinical l Intensive Care for

Anaesthesia (V)

1 1

Intensive care management of polytrauma patient, extracorporeal and Intrcorporial support,

Cardiopulmonary resuscitation of pregnant women, ventilator graphics, Temperature

disorders in the critically ill, Intra=aortic ballon and counterpulsation, Percutaneous

tracheostomy, Neurologic and Intra-cranial pressure monitoring, chest tube placement and

Endoscopic feeding tube placementInvasive venous and arterial catheter placement



05010915 Lectures Clinical l Integrated Anaesthesia

course II)

1 1

The practical aspects of the administration of anaesthetics and

adjuvant drugs and drug/drug interaction.The impact of different,

marked physiology change on patient management. Technical skills

related to anaesthesia and intensive care. Preoperative management of

patient in elective, emergency and outpatient complex settings.

Perioperative management of patient with compromised medical

problems. Perioperative management of different surgical and other

interventions under anaesthesia and postoperative period.

Postoperative and intensive care management.

`Course Specifications

University: Alexandria

Faculty: Medicine

Department: Anaesthesia and surgical Intensive Care

Course InformationCourse Code: 05010904 Course Name: Neuro and Ophthalmic

Anaesthesia for Doctor Degree

Program in which the Course is Given to Doctorate Degree of Anaesthesia and surgical IntensiveCare

Number of Credit Hours 2 Theoretical Clinical

Course Aims, the aim of this course is to upgrade the candidate abilities in:1. Anaesthesia and intraocular pressure.2. Penetrating eye injury.3. Ocular pathology and systemic disease.4. Anaesthetic ramification of ophthalmic drugs.5. Regional blocks.6. Special ophthalmic procedures and their anaesthetic management.7. Outpatient ophthalmic surgery.8. Ophthalmic complications of anesthesia and surgery.9. Strategies for brain protection.10. Intracranial hypertension (monitoring and control).11. Infratentorial masses and brain stem.lesions12. Management of head injury.13. Anaesthesia for neurovascular surgery & Spinal surgery (anaesthesia).14. Anaesthesia for stereotactic surgery & supratentorial mass.

Intended Learning Outcomes (ILOs)Program ILO (refer to programmatrix)

Course ILOs

A. KnowledgeandUnderstanding

Graduate of this course mustacquire knowledge to:A.1. Describe advancedpharmacological principles ofdrugs.A.2. Discuss the toxic drug effect

Graduate of this course must acquireknowledge to:

A.1. Describe the importance of anatomicalvariations on airway

management.

1 H1 H

A.4. Revise clear workingknowledge of anatomy applied inanaesthetic practice.A.8. Describe specific pointsstressed upon during taking historyfrom the patientA.9. List steps of physicalexamination in medicallycompromised patient

A.10. State specific points inrelation to surgical procedureA.11. Define special laboratoryinvestigationsA.17. Explain admission anddischarge criteria for intensive careunit

A.18. Cite steps for managementof patient during intensive care unitstayA.19. Describe resuscitation of lifethreatening conditions

A.2. List the anatomical differences in theairway between the adult versus the childrenand neonates.A.3 State airway management strategies.A.4 Describe the pathology of endocrine, liveror Renal problems ).A.5 Discuss points stressed upon during takinghistory from patients with tumors.A.6 Describe the examination of traumapatients.A.7 Enumerate radiological investigation forhead trauma patients.A.8 Describe the examination of pediatric andneonates neurosurgical

patients.A.9 Describe the criteria for admission ofpatients to postoperative neurosurgical ICU.A.10 Describe when to discharge patients fromICU.A.11. Cite neurosurgical scoring system.A.12 Cite first aid management.A.13. List recent advances in advanced cardiaclife supportA.14 List recent advances in prolonged lifesupportA.15 State t the basic concepts of the eyeanatomy and its application for deliveringregional eye blocks.A.16 Describe the effect of anaesthetic drugson intraocular pressure, papillary size and tearproduction.A.17 Discuss the effect of the eye drops onanaesthesia and their interaction withanaesthetic drugsA.18 State the effect of topical adrenaline onpatients and their interaction with anaestheticdrugs.A.19 State the formation and excretion ofaqueous humor and its circulation.A.20. State the basic knowledge's formanagement of penetrating eye injuriesA.21State the basic knowledge's formanagement of pediatrics with congenital eyeproblemsA.22 State the anesthetic problems ofstrabismus surgery.

B. Intellectualskills

Graduate should be competent to:B.1. Select necessary investigationsaccording to situationB.2. Identify potential problemsfrom history and clinicalexamination.B.4. Modify anaesthetic planaccording to surgery.B.10. Select suitable anaesthetictechnique in common andcomplicated cases.B.11.Deside to start resuscitation atproper time.

Graduate should be competent to:B.1. Suggest points stressed uponpreoperatively.B.2. Detect points from history of previousanesthesia that may have impact on currentsituation.B.3. Predict the cases of cardiac arrestB.4. Plan a resuscitation management strategyB.5. Decide time to start resuscitation.B.6 Decide when to end resuscitation effortsB.7.Plan a strategy for management of postcardiac arrest.B.8 Select investigations for paediatrics withcongenital eye diseases.B.9 Select investigations and strategy formedically compromised geriatric patientsscheduled for ophthalmic surgery undergeneral anaesthesia..B.10 Design an anaesthetic protocol formanagement during strabismus surgeryB. 11 Organize the indications of generalanaesthesia in eye surgery “when to usegeneral anaesthesia, monitored anaesthesiacare and local anaesthesia”.B.12 Select anesthetic techniques forpaediatrics with congenital anomaliesundergoing ophthalmic surgery.B.13Plan for the management of somecomplication during ophthalmic anaesthesia

C. ProfessionalandPractical Skills

Student should develop theappropriate skills in order toC.1. Practice central cannulationfor difficult cases.C.2. Diagnose difficult airwayC.3. Apply advanced airwaydevices and techniques to maintainpatent airwayC.4. Connect patients to advancedmonitoring devicesC.6. Connect patients tomechanical ventilationC.8. Select correct fluid therapy.

Student should develop the appropriate skillsin order toC.1 Select appropriate anesthesia protocol.C.2 Apply measures to diagnose difficultairway.C.3 Use different routes for central cannulationC.4Perform blind nasotracheal intubationC.5 Diagnose pulmonary embolismC.6 conduct management plan for pulmonary

embolismC.7 Apply an extubation algorithmC.8 Apply suitable ventilator modeC.9 Prescribe fluid requirement duringpostoperative period

D. General Skills Graduate should be able to:D.1. Demonstrate ability to getrecent knowledge.D.4. Demonstrate skills to presentscientific talks.D.5. Conduct teaching and trainingsessions.

Graduate should be able to:D.1 Demonstrate ability to network search for

recent advancesD.2. Apply recent knowledge to improvepracticeD.3Demonstrate ability to network search forrecent advances in the field of ophthalmicneuro-anaesthesiaD.4 Acquire skills for presenting lecturesD.5Lead team working under supervision

Graduate should be able to:E.1. Explain anaesthetic events topatients.

E.3. Deal gently with patients andtheir families.

E.4. Appraise the importance ofpatient consent for interventionduring management &/orenrollment in research

Graduate should be able to:E.1. Demonstrates effective communicationskills with patients and relativesE.2. Allay anxiety in patients with severerecognize that their surgical/medical conditionE.3. Appraise the importance of patientconsent for planned interventionduring management

E.4. Appraise the importance of patientconsent for emergency andunexpected events

Course Content (Units/Topics)

Teaching/Learning MethodsLectures self

learningPractical/Clinical

Smallgroupdiscussion

Others

Effect of anaesthesia on cerebral andspinal cord physiology &neurophysiologic monitoring.

Cerebral protection and resuscitation. Anaesthesia for supratentorial tumors. Anaesthesia for posterior fossatumors.

Anaesthetic management ofintracranial aneuryzm.

Anaesthetic management of headtrauma.

Neuroendocrine procedures. Anaesthesia in spinal cord injury. Anaesthetic management ofdiagnostic and therapeuticneuroradiological procedures.

Anatomy and physiology of the eye IOP Local techniques for ophthalmicsurgery

Systemic effect of ophthalmicmedications

Anaesthesia for penetrating eye injury Anaesthesia for strabismus surgery Sedoanalgesia and monitoringanaesthesia care

Please check () the appropriate method.

Student Assessment

Methods of Assessment Essay Objective questions

Case OSCE/OSPE

Assignment Logbook fulfillment

Others

Schedule of Assessment Mid-term %

End of term 100 %Distribution of Marks Written Exam 70 %

Practical/Clinical Exam 20 %Others 10 %

List of Textbooks and ReferencesLecture Notes

Course Text Books Miller, textbook of anaethesia.

Suggested Extra Reading Handbook of neuroanaesthesia.

Journals and Periodicals, others British journal of Anaesthesia

Course InstructorName: prof. Wafaa Rady Signature:

Program CoordinatorName: Prof Wafaa Shafshak Signature:

Program Director (Head of Department)Name: Prof Nader El Gamal Signature:

Course Specifications


Faculty: Medicine

Department: Anaesthesia and Surgical Intensive Care

Course Information ACourse Code: 05010905 Course Name: Ear, Nose and Throat Anaesthesia


Program in which the Course is Given: Doctorate Degree in Anaesthesia and Surgical IntensiveCare

Number of CreditHours: 1

Theoretical0.5

Clinical/0.5

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. The delivery of safe and effective perioperative anaesthetic care to patients undergoing

elective and emergency complex/major ear, nose , throat and head and neck surgery2. Undertaking the perioperative anaesthetic care to prematures, neonates and infants

undergoing different complex elective and emergency ear, nose and throat surgery3. The anatomy of normal and abnormal airways4. Knowledge, skills and experience treating complex clinical cases and challenging airway

situations5. Recent developments in perioperative anaesthetic care to this area of practice, to evaluate

these developments and to advise colleagues of useful changes in practice6. Providing teaching to less experienced colleagues of all grades

Intended Learning Outcomes (ILOs)Program ILO (refer toprogram matrix)

Course ILOs

A. Knowledgeand

Understanding

Graduate of this program mustacquire knowledge to:A.1 Describe advancedpharmacological principles ofdrugs.

A.4. Revise clear workingknowledge of anatomy appliedin anaesthetic practice

Graduate of this course must acquireknowledge to:A.1. Enumerate the physiological effects ofdifferent drugs on the airway

A.2. Describe the impact of anatomicalstructures on the airway managementA.3. Describe the impact of airway

A.8.. Describe specific pointsstressed upon during takinghistory from the patient

A.10. State specific points inrelation to surgical procedure

A.13. Mention special patient’sneeds during postoperativeperiod

pathology on the management of the airway

A.4. Discuss the principles of pre-operativeassessment.A.5. Describe different techniques ofhypotensive anesthesiaA.6. Discuss difficulties during inductionand recovery

A.7. Describe the scope of differentsurgeries on the nose, ear, larynx andtrachea and their anesthetic managementA.8. Enumerate different types of trachealstents and their applicationA.9. Enumerate congenital syndromesassociated with cochlear implantation andtheir managementA.10. Describe anesthesia for laser surgeryof the airway and its anesthetic problemsA.11. Describe anaesthesia plan foroutpatient ENT proceduresA.12. Explain obstructive sleep apnea,surgical intervention and anaestheticmanagementA.13. Describe strategy for extubation of thedifficult airway

A.14. Mention important points ofpostoperative care of patients undergoingENT surgeryA.15. List causes of post tonsillectomybleeding


Graduate should be competentto:

B.2. Identify potentialproblems from history andclinical examination.

Graduate should be competent to:B.1.Suggest points stressed uponpreoperativelyB.2.Detect points from history of previousanesthesia that may have impact on currentsituationB.3.Decide which patient not to admit tosurgeryB.4. Plan the investigation needed for eachindividual patientB.5. Assess patients with significantpathologyB.6. Assess patients with concomitant

B.4. Modify anaesthetic planeaccording to surgery

B.5. Predict intra andpostoperative events accordingto intervention

B.6. Relate events tounderlying clinical condition

B.10. Select suitableanaesthetic technique incommon and complicatedcases

diseaseB.7.Predict patient response to preoperativemeasures intended to improve his conditionB.8. Assess when the patient is in the bestpossible condition

B.9. Plan a strategy for managing complexENT surgeryB.10. Plan a strategy for managing airwayemergenciesB.11.Plan a strategy for managing simpleand complicated paediatric interventions

B.12.Predict excessive blood lossB.13 Predict pulmonary embolismB.14.Predict pneumothoraxB.15. Detect airway problemsB.16. Predict difficult extubationB.17, Predict readmission to surgeryB.18. Design proper intra and postoperativeanesthetic plan for long procedures

B.19. Detect difficult airwayB.20. Compare different techniques formanaging difficult airway.B.21. Advise airway management plans forelective and emergency airway problems

B.22. Assist colleagues in decision makingof the suitable anaesthetic techniques forsurgery in difficult situationsB.23. Design preventive strategies forpotential complications following nasal andoto-laryngeal surgery

C. Professionaland Practical

Skills

Student should develop theappropriate skills in order toC.2. Diagnose difficult airway

C.3. Apply advanced airwaydevices and techniques to

Student should develop the appropriate skillsin order toC.1.Treat properly adverse events associatedwith difficult airway

C.2.Perform awake intubationC.3.Intubate trachea by fiber optic

maintain patent airway

C.4. Connect patients toadvanced monitoring devices

C.7. Use advanced ventilationmodes

C.8. Select correct fluidtherapy

bronchoscopeC.4.Insert blind nasotracheal tubeC.5. Apply the technique of retrogradeintubationC.6. Administer jet ventilation inbronchoscopy procedures

C.7. Preserve facial nerve function duringparotid surgeryC.8.Diagnose pulmonary embolism

C.9. Ventilate patients who have hadcomplex laryngeal or tracheal surgeryC.10. Select suitable ventilator modeC.11.Initiate patients weaning

C.12. Select perioperative fluid required formajor ENT surgeryC.13. Prescribe fluid requirement duringpostoperative period

D. General Skills Graduate should be able to:D.1. Demonstrate ability to getrecent knowledge

D.5. Conduct teaching andtraining sessions.

Graduate should be able to:D.1. Demonstrate ability to get recentknowledge in the field of ear, nose,laryngeal and tracheal anaesthesia andintensive care

D.2.Give advice to junior staffD.3. Apply recent knowledge to improve

practiceD.4. Conduct frequent testing to more juniorteam membersD.5. Provide teaching to less experiencedcolleagues of all grades

E. Attitudes andethical behavior

Graduate should be able to:E.2. Include any choices ofanaesthetic technique.

E.3. Deal gently with patientsand their families.

Graduate should be able to:E.1 Explain possible choice for intubationunder regional blocksE.2 Explain possible disadvantages forintubation techniquesE.3. Discus anaesthetic plane\ with patientE.4. Answer any enquiries from patients andtheir families

Course Content (Units/Topics) Teaching/Learning Methods

Lectures selflearning

Practical/Clinical


Others

assignment

Anaesthesia for ear, cochlear implant& Skull base surgery

Anaesthesia for direct laryngoscopy,foreign body removal and Laser

Anaesthesia for nose surgery &F.E.E.S.

Anaesthesia for laryngeal tumours Anaesthesia for free vascular flapsurgery

Anaesthesia for adeno-tonsillectomy,bleeding tonsils and tracheal stentinsertion

Sleep apnea syndrome

Anaesthesia for deep neck infection

Please check () the appropriate method

Student Assessment

Methods of Assessment Essay Objective questions

Case OSCE/OSPE


Others


End of term 100 %

Distribution of Marks Written Exam 70 %

Practical/Clinical Exam 20 %

Others ( oral) 10 %

List of Textbooks and ReferencesLecture Notes Lectures delivered by staff members

Course Text Books -Clinical Anesthesiology. G Edward Morgan,M S Mikhail, J F Butterworth IV, D CMackey, J D Wasnick eds , 5th ed. LangMedical Books ,2013

Suggested Extra Reading -Hand Book of Clinical Anesthesia edPG.Barash,BC.Cullen, RK.Stoelting Seventhedition Lippencott Williams&Wilkns 2013-A Practical Approach to Anesthesiafor Emergency Surgery.ed Manju N Gandhi,Anila D Malde, Amala G Kudalkar , Hemangi SKarnik 1st Edition, Jaypee Brothers MedicalPublisher (P) LTD: New Delhi • Panama City •London ® 2011

Journals and Periodicals, others Anesthiology , British journal of Anaesthesia,ASA annual conference guidelines &Algorithms.

Course InstructorName: Prof Nagwa El kobbia Signature:


Program Director (Head of Department)Name: Prof Nader Elgamal Signature:



Faculty: Medicine


Course InformationCourse Code: 05010906 Course Name: Maxillofacial Anaesthesia For

Doctorate Degree



Theoretical0.5

Clinical0.5

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. Perioperative anaesthetic care to patients undergoing elective and emergency complex/major

oral, maxillo-facial and dental surgery2. Perioperative anaesthetic care to paediatric drntal surgical cases in maxillo-facial and dental

surgery areas3. Recent developments in perioperative anaesthetic care to this area of practice, to evaluate

these developments and to advise colleagues of useful changes in practice4. Ability to manage complex airway problems5. Providing teaching to less experienced colleagues of all grades


Course ILOs


Graduate of this course mustacquire knowledge to:

A.4. Revise clear workingknowledge of anatomy applied inanaesthetic practice


A.1. Describe the impact of anatomicalstructures on the airway managementA.2. Enumerate causes of difficult airway inpatients undergoing maxillofacial surgeryA.3. State airway management strategiesA.4. Mention in details the majorphysiologic problems among maxillofacialsurgical patients

A.5. Describe the impact ofphysiologic derangement on thecourse of anaesthesia

A.8. Describe specific pointsstressed upon during taking historyfrom the patient

A.9. List steps of physicalexamination in medicallycompromised patient


A.13. Mention special patient’sneeds during postoperative period

A.5. Describe optimizing patient generalcondition prior to surgeryA.6. Describe paediatric syndromesassociated with the need for anaesthesia formaxillofacial surgery

A.7. Discuss points stressed upon duringtaking history from patients with tumorsA.8. Enumerate points asked in case of

maxillofacioal traumaA.9. Enumerate questions asked for childrenwith disabilities

A.10. List steps for examining patients withchest problems scheduled for major tumorresectionA.11. Describe physical examination ofmaxillofacial trauma patientsA.12. Describe criteria of physicalexamination of disabled children

A.13. Enumerate steps provided for airwayprotectionA.14. Define problems related to prolongedsurgeryA.15. Describe proper patient positioningduring maxillofacial surgeryA.16. State methods of blood conservationA.17. Describe anaesthesia for orthognathicsurgeryA.18. Describes the range of proceduresperformed on infants and neonatesA.19.. Discuss anaesthetic problemscommon among patients scheduled formaxillofacial tumor resectionA.20.. Describe anesthesia for outpatientdental proceduresA.21. State diagnostic criteria of pulmonaryembolismA.22. Describe blind nasal and submentalintubation

A.23. Mention important points forpostoperative care of patients undergoingmaxillofacial surgery

A.24. Enumerate causes of delayedextubationA.25. Enumerate indications oftracheostomyA.26. Describe postoperative care after adultand paediatric maxillofacial and dentalsurgery


Graduate should be competent to:B.2. Identify potential problemsfrom history and clinicalexamination.

B.3. Judge which patient is in needfor further workup beforeadmission to surgery

B.4. Modify anaesthetic planaccording to surgery

B.5. Predict intra andpostoperative events according tointervention

B.10. Select suitable anaesthetictechnique in common andcomplicated cases.

Graduate should be competent to:B.1. Suggest points stressed uponpreoperativelyB.2. Detect points from history of previousanesthesia that may have impact on currentsituation

B.3. Judge which patient not to admit tosurgeryB.4. Identify further workup needed foreach individual patientB.5. Optimize patients with significantpathologyB.6. Optimize patients with concomitantdiseaseB.7. Predict patient response to preoperativemeasures intended to improve his conditionB.8. Recognize when the patient is in thebest possible condition

B.9. Plan a strategy for managing complexmaxillofacial surgeryB.10. Plan a strategy for managing

maxillofacial trauma and emergenciesB.11. Plan a strategy for managing simpleand complicated paediatric interventions

B.12. Predict excessive blood lossB.13 Predict pulmonary embolismB.14. Predict pneumothoraxB.15. Predict accidental extubationB.16. predict difficult extubationB.17, Predict readmission to surgery

B.18. Detect difficult airwayB.19. Advice airway device suitable fordifficult airway

B. 20. Assess the nutrition status in majorhead and neck surgeryB.21. Detect the pathophysiological effectsof chemotherapy and radiotherapyB.22. Assist colleagues in decisions thesuitable anaesthetic technique for surgery indifficult situations

C.Professionaland PracticalSkills

Student should develop theappropriate skills in order to

C.3. Apply advanced airwaydevices and techniques to maintainpatent airway

C.4. Connect patients to advancedmonitoring devices

C.6. Connect patients tomechanical ventilator

C.7. Use advanced ventilationmodes.

C.8. Select correct fluid therapy

Student should develop the appropriate skillsin order to

C.1. Treat properly adverse eventsassociated with difficult airwayC.2. Perform awake intubationC.3. Intubate trachea by fiber opticbronchoscopeC.4. Insert blind nasotracheal tubeC.5. Perform submental intubation

C.6. Diagnose pulmonary embolismC.7. Diagnose accidental intraoperativeextubation and obstructionC.8. Treat pulmonary embolism

C.9. Preserve facial nerve function duringparotid surgeryC.10. Monitor blood loss precisely

C.11. Apply an extubation algorithmC.12. Apply tube exchange catheterC.13. Connect patients indicated tomechanical ventilation

C.14. Select suitable ventilator modeC.15. Initiate patients weaningc.16. Use jet ventilation

C.17. Perfect selection of perioperative fluidrequired for major maxillofacial surgeryC. 18. Calculate precisely fluid required forpaediatrics scheduled for dental andmaxillofacial interventionC.19. Prescribe fluid requirement duringpostoperative period

D. GeneralSkills

Graduate should be able to:D.1. Demonstrate ability to getrecent knowledge.

D.4. Demonstrate skills to presentscientific talks.

D.5. Conduct teaching and trainingsessions.

.

Graduate should be able to:D.1. Demonstrate ability to network searchto get recent text, pictures and videos foradvances in the field of maxillofacial anddental practiceD.2. Apply recent knowledge to improvepractice

D.3. Use information technology to preparelecturesD.4. Acquire skills for presenting lecturesD.5. Prepare scientific talks

D.6. Observe team working under hissupervisionD.7. Give advice to junior staffD.8. Conduct frequent testing to more juniorteam membersD.9. Demonstrate the necessary multi-disciplinary leadership,

E. Attitudesand ethicalbehavior




Graduate should be able to:E.1 Explain detailed anaesthetic techniqueE.2. Provide idea about postoperative course

E.3. Demonstrates effective communicationskills with patients and relativesE.4. Allay anxiety in patients with severerecognize that their surgical/medicalcondition

E.5. Appraise the importance of patientconsent for planned intervention duringmanagementE.6. Appraise the importance of patientconsent for emergeny and unexpected events





Others

Craniosynostosis External maxillary distraction Anaesthesia and childhood disability General Considerations Maxillofacial trauma, Airwaymanagement

Maxillofacial tumorsRadical neck dissection

Odontogenic infection Surgery of the salivary glands Blind nasal intubation Submental intubation Extubation of difficult airway Postoperative management

Please check () the appropriate method.Student AssessmentMethods of Assessment Essay

Case

Assignment

Others

Objective questions

OSCE/OSPE

Logbook fulfillment

Schedule of Assessment Continuous Assessment 40 %


Oral 18 %


Course Text Books Miller’s Anesthesia

Suggested Extra Reading Oxford Textbook of Anaesthesia for Oral andMaxillofacial Surgery

Journals and Periodicals, others

Course InstructorName: Prof Wafaa Shafshak Signature:


Program Director (Head of Department)Name: Prof Nader El Gaamal Signature:



Faculty: Medicine


Course InformationCourse Code:05010907

Course Name: Obstetric Anaesthesia ForDoctorate Degree



Theoretical0.5

Clinical/0.5

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. The delivery of safe and effective perioperative anaesthetic care to patients undergoing

elective and emergency caesarean section.2. The perioperative anaesthetic care to a wide variety of complex elective and emergency

gynecology and obstetric cases.3. Acquire knowledge, skills and experience treating complex clinical cases and challenging

airway situations in pregnant and obese patients.4. Becoming familiar with recent developments in perioperative anaesthetic care to this area of

practice, to evaluate these developments and to advise colleagues of useful changes inpractice.

5. Ability to administer spinal,epidural and combined spinal epidural analgesia in obstetricpatients.

6. Conducting teaching to less experienced colleagues of all grades.


Course ILOs





A.1. Describe the impact of anatomicalstructures on the airway managementA.2. Enumerate causes of difficult airway inpregnant ladies.A.3. State airway management strategies





A.4. Mention in details the physiologicalproblems of pregnant females.A.5. Describe optimizing patient generalcondition prior to surgeryA.6. Describe obstetric complicationsneeding anaesthesia.

A.7. Discuss points stressed upon duringtaking history from pregnant patients.A.8. Enumerate points asked in case of

obstetric complications.A.9. Enumerate questions asked for pregnantpatients before undergoing caesarean sectionor normal labour

A.10. List steps for examining patients withmedical problems scheduled for caesareansection.A.11. Describe physical examination ofshocked patients .

A.12. Describe criteria of physicalexamination of neonates.

A.13. Enumerate steps provided for airwayprotection in patients with full stomach.A.14. Define problems related to bloodysurgeries.A.15. Describe proper patient positioning foradministration of regional analgesia.A.16. State methods of blood transfusion.A.17. Describe anaesthesia for pregnantpatient undergoing non obstetric surgery.A.18. Describe the range of proceduresperformed to the obstetric patient.A.19.. Enumerate anaesthetic problemscommon among delivering patients.A.20.. Describe anesthesia for evacuation ofuterine contents.A.21. State diagnostic criteria of pulmonaryembolismA.22. Describe algorithm for difficult airwayin pregnant ladies.


A.23. Mention important points forpostoperative care of patients after caesareansection.A.24. Enumerate causes of delayed recoveryfrom anaesthesia.A.25. Enumerate indications of changingpatients from heparin to oral anticoagulants.A.26. Describe postoperative care ofparturient with prosthetic heart valves.



B.3. Judge which patient is in needfor further workup beforeadmission to surgery



Graduate should be competent to:B.1. Suggest points stressed uponpreoperativelyB.2. Detect points from history of previousanesthesia that may have impact on currentsituation

B.3. Judge which patient not to admit tosurgeryB.4. Identify further workup needed foreach individual patientB.5. Assess patients with significantpathologyB.6. Assess patients with concomitantdiseaseB.7. Predict patient response to preoperativemeasures intended to improve her condition.B.8. Recognize when the patient is in thebest possible condition

B.9. Plan a strategy for managing regionaltechniques in obstetrics.B.10. Plan a strategy for managing

distressed neonates.B.11. Plan a strategy for managingamniotic fluid embolism.

B.12. Predict excessive blood lossB.13 Predict pulmonary embolismB.14. Predict haemothorax after centralvenous cannulation.B.15. Predict accidental dural puncture.B.16. predict extubation spasm.B.17, Predict readmission to surgery

B.18. Detect difficult airway


B.19. Advice airway device suitable fordifficult airwayB. 20. Discuss the importance of managingmechanical ventilation in aspirationpneumonia.B.21. Discuss the pathophysiological effectsof cardiac pregnant patients.B.22. Assist colleagues in decisions thesuitable anaesthetic technique for surgery indifficult situations






C.7. Use advanced ventilationmode.



C.1. Treat properly adverse eventsassociated with difficult airwayC.2. Perform regional analgesiaC.3. Treat postdural puncture headache.C.4. Perform epidural blood patch.C.5. Perform central venous cannulation.

C.6. Diagnose pulmonary embolismC.7. Diagnose amniotic fluid embolism.C.8. Treat pulmonary embolism

C.9. Resuscitate the newborn.C.10. Monitor blood loss precisely

C.11. Apply an extubation algorithmC.12. Apply epidural catheter.C.13. Connect patients indicated tomechanical ventilation

C.14. Select suitable ventilator modeC.15. Initiate patients weaningC.16. Demonstrates the ability to usecontinuous positive airway pressure.

C.17. Select perioperative fluid required forcaesarean section.C. 18. Calculate precisely fluid required forpre-eclamptic patients.C.19. Prescribe fluid requirement duringpostoperative period

D. GeneralSkills



D.5. Conduct teaching and trainingsessions

Graduate should be able to:D.1. Demonstrate ability to network searchfor recent advances in the field of obstetricanaesthesia and analgesia.D.2. Apply recent knowledge to improvepractice








E.3. Demonstrates effective communicationskills with patients and relativesE.4. Allay anxiety in patients with severesurgical or medical condition.

E.5. Appraise the importance of patientconsent for planned intervention duringmanagementE.6. Appraise the importance of patientconsent for emergency and unexpectedevents





Others

Physiological changes in pregnancy Placental transfer of drugs

Analgesia in normal labour Anaesthesia for caesarean section Anaesthesia for cardiac pregnantpatient

Anaesthesia for pre-eclamptic patient Anaesthesia for complicatedobstetrics

Resuscitation of the neoborn Embolism in pregnancy Anaesthesia during pregnancy Anaesthetic complications inobstetrics

Coagulopathy and postpartumhaemmorhageAnaesthesia for the pregnant patientwith neurological diseaseObesity and obstetric anaesthesia

x


Case

Assignment

Others

Objective questions

OSCE/OSPE

Logbook fulfillment



Practical/Clinical Exam 20 %Oral 10 %


Course Text Books Miller’s Anesthesia 2009,seventh edition

Suggested Extra Reading Oxford Textbook of Obstetric Anaesthesia

Journals and Periodicals, others British journal of anaesthesia,AnaesthesiaAnalgesia,Anesthesiology,www.sciencedirect,com

Course InstructorName: Professor Salwa Shaaban Shaarawy Signature:

Program CoordinatorName: Prof Wafaa Shafshak Signature:Program Director (Head of Department)Name: Prof Nader El Gamal Signature:



Faculty: Medicine


Course InformationCourse Code: 05010908 Course Name: Paediatric Anaesthesia For

Doctorate DegreeProgram in which the Course is Given: Doctorate degree of Anaesthesia and Surgicalintensive careNumber of Credit Hours 1 Theoretical 0.5 Clinical 0.5

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. Important anatomical considerations which impact on the delivery of anaesthesia for infants and

children.2. The important physiological principles associated with paediatric anaesthesia and how these

can affect anaesthetic management.3. Being proficient at critically assessing infants and children with complex medical and surgical

problems who present for surgery.4. Being proficient at conducting anaesthetia for complicated pediatric patients.5. Being able to manage short, rapid turnover paediatric outpatient cases.6. Being proficient in using the critical monitoring devices employed during paediatric

anaesthesia.7. Understanding the anaesthetic complications following paediatric anaesthetia.8. Being proficient in managing critical post-anesthetic care of the pediatric patient.

Intended Learning Outcomes (ILOs)Program ILO(refer to programmatrix)

Course ILOs



A.1 Describe advancedpharmacological principles ofdrugs.


A.1- Describe pharmacokinetics andpharmacodynamics of anaesthetheticdrugs in neonates and Infants.

A.2. Mention proper drug doses at this agegroup

A.3. Enumerate different routes for drugadministration at this special group

A.4. Revise clear working knowledge ofanatomy of the respiratory,



A.8. Describe specific pointsstressed upon during takinghistory from the patient



A.14. Define possible causes ofresistant acute pain

cardiovascular system and the spinalcord and brain of neonates, infants &children

A.5. Revise clear working knowledge ofsignificance of differences from adultson anesthetic techniques & management.

A.6. Describe the physiologic differencebetween paediatric and adult

A.7. Describe the physiologic limitationsof prematurity

A.8. Mention the impact of physiologicderangement in paediatric on the courseof anaesthesia.

A.9. Describe full history from the patientor guardians.

A.10. State specific points in relation tosurgical procedure

A.12. Enumerate special precautions relatedto elective paediatric surgeryA.13. Enumerate special precautions relatedto paediatric surgical emergenciesA.14. Mention postoperative nutritionalrequirementsA.15. Define post operative mishapsA.16. Describes therapeutic strategies forpostoperative complications

A.17. Define types of surgery associatedmore with postoperative painA.18. Define factors exaggerate painperceptionA.19. Define measures that lessens postoperative pain



Graduate should be competent to:B.1. Interpret symptoms and signs withdiagnosisB.2. Expect specific investigations

according to child condition

B.4. Modify anaesthetic planeaccording to surgery

B.7. Select proper drugadministration according topatient condition.

B.11. Decide to start resuscitationat proper time.

B.3. Differentiate various clinicalpresentations

B.4. Decide optimum time for admission tosurgery

B.5. Choose suitable anaesthetic techniqueB.6.Compaire possible options for airwaymanagement

B.7. Recognize proper drugs for each agegroupB.8. Suggest proper drug selectionaccording to underlying clinical conditionB.9. Choose drugs suitable for every type ofsurgical interventionB.10. Suggest treatment for abnormal drug

reaction

B.11. Recognize patients who needimmediate resuscitation. decide to startresuscitation at proper time.B.12 .Classify resuscitation strategiesaccording to cause of arrestB.13. Design resuscitation plan for each agegroup


Student should develop theappropriate skills in order toC.1. Practice central cannulationfor difficult cases.

C.3. Master application ofadvanced airway devices andtechniques to maintain patentairway

C.5. Perform difficult regionalblocks guided by advanceddevices

Student should develop the appropriateskills in order toC.1. Practice central venous cannulation forneonatesC.2. Practice central venous cannulation forinfantsC.3. Practice central venous cannulation forchildren

C.4. Intubate neonates safelyC.5. Apply proper airway device accordingto paediatric procedure

C.6. Perform regional block as the soleanaesthetic techniqueC.7. Perform regional blocks as adjunct togeneral anaesthesia

C.7. Select proper ventilationmode.


C.9. Lead cardiopulmonaryresuscitation team

C.10. Use advanced painmanagement techniques

C.8. Apply modes of ventilation designedfor paediatricC.9. Observe neonates, infants and childrenon mechanical ventilation

C.10. Calculate precisely the volume offluid requirementC.11. Select correct type of fluidC.12. Modify the type and volume of fluidaccording to clinical condition

C.13. Conduct basic life supportC.14. Conduct advanced paediatric cardiaclife support

C.15. Calculate accurately dose of systemicanalgesicsC.16. Use patient controlled analgesiatechniques

D. GeneralSkills


D.3. Design research protocolsand co-operate inmultidisciplinary research teams


Graduate should be able to:D.1. Demonstrate ability to get recentknowledge.D.2. Search web for relevant sites paediatricand neonatal anaesthesia

D.3. Acquire skills how to propose aresearch designD.4. Demonstrate the items to be fulfilled inresearch designD.5. Share in research team work

D.6. Provide instruction to residents,students,D.7. Provide instruction to nurses




Graduate should be able to:E.1. Explain anaesthetic events to the child& parents.E.2. Clarify for the parents any choices ofanaesthetic technique.

E.3. Assure parentsE.4. Explain facts that can happen duringoperation





Others

Anesthetic considerations inPediatrics.

Anesthetic considerations inNeonates.

Perioperative management ofNeonatal surgical procedure.

Tracheosophageal fistula. Diaphragmatic Hernia. Pyloric Stenosis. Omphalocele or

Gastroschisis.

Perioperative management ofChild undergoing:

Inguinal procedure Intussusceptions Laparoscopy

Perioperative management of achild having:

Sickle cell disease Congenital bleeding

disorder Neuromuscular disease

Airway management of Pediatricsincluding congenital syndromesthat include difficult airway e.g.,Pierre Robin, Treacher-Collins,etc.

Vascular Access in Pediatrics Peripheral venous

cannulation. Central venous

cannulation. Arterial Cannulation

Intravenous fluid Transfusion therapy

Regional Anesthesia includingNeuro-axial blocks in Pediatrics:

Caudal Spinal

EpiduralPostoperative Pediatric Problems Pediatric and neonatal intensivecare.

Ventilation. Trauma. CPR


Student AssessmentMethods of Assessment Essay Objective questions

Case OSCE/OSPE


Others

Schedule of Assessment End of term 100 %

Distribution of Marks Written Exam 70 %OSCE 20 %Oral 10 %

List of Textbooks and ReferencesLecture Notes Course Text Books Miller’s Anesthesia 7th Ed, 2009Suggested Extra Reading Clinical Anesthesia, 5th Edition, 2006Journals and Periodicals, others 1- Current Opinion in Anesthesia

2- Anesthesiology Clinics of NorthAmerica, 2005, Vol.23, Issues 4,Pediatric Anesthesiology

Course InstructorName: Prof. Ahmed El-Attar Signature:





Faculty: Medicine


Course InformationCourse Code: 05010909 Course Name: Hepatorenal Anaesthesia For

Doctorate DegreeProgram in which the Course is Given: Doctorate degree of Anaesthesia and Surgicalintensive careNumber of Credit Hours 2 Theoretical 1 Clinical 1

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. Upgrading the ability of the candidate in perioperative anaesthesia management of

genitourinary procedures either elective or emergency whatever the renal function is.2. Managing different age groups from newborns up to geriatric patients.3. Perfection of renal function protection to prevent further deterioration of the risky kidney.4. Ability of renal function monitoring.5. The delivery of safe anaesthesia to patients with hepatic diseases undergoing non hepatic

surgery.6. The perioperative anaesthetic care to patients undergoing liver surgery and transplantation7. Intensive care management of patients with liver failure.

Intended Learning Outcomes (ILOs)Program ILO(refer to programmatrix)

Course ILOs





A.1- Describe advanced pharmacologicalprinciples of the effects of drugs on liver& renal function.

A.2. Describe renal excretion of drugseither directly or in the form ofmetabolites

A.3. Mention recent advances in the role ofthe liver for anaesthetic drugspharmacokinetics.

A.4. Relate applied anatomy toanaesthetic practice


A.8. Describe specific pointsstressed upon during takinghistory from the patient

A.9. list steps of physicalexamination in medicallycompromised patient


A.11. List needed laboratoryinvestigations perioperative

A.4.Revise applied anatomy of the liver &renal system

A.5. Describe anatomical changes related toliver

A.6. Enumerate physiologic changesassociated with liver disorders

A.7. Describe the effect of impaired liverphysiology on surgical patients

A.8. Mention strategies for hepaticpreservation

A.9. Mention the renal geriatric physiologyand the effect on anaesthesia given onrenal function

A.10. Mention the paediatric renalphysiology and the effect on anaestheticson renal physiology

A.11. Describe history taking from thepatients with liver disorders undergoingnon hepatic surgery

A.12. Describe history taking from patientsundergoing liver surgery andtransplantation

A.13.Enumerate points asked in case ofchronic renal failure.A.14. Enumerate questions asked fordisabled children before anaesthesia.

A.15.List steps of physical examination ofthe liverA.16. List steps of systemic examination forpatients with hepatic disordersA.17. Discuss difficulty of handling renalfailure patients.

A.18. State haemostatic studiesA.19. State excretory functions of the liverA.20. List excretory functions of the liverA.21. List diagnostic test for hepaticencephalopathy


A.14. Define possible causes ofresistant acute pain

A.22. Discuss outpatient anaesthesia forendoscopy and shock wave lithotripsy.A.23. List factors leading to excessiveblood loss during genitourinary surgeryA.24. Discuss complications related tolaparoscopic radical and transuretheralsurgeries.

A.25. Describe post-operative care forpatient with liver diseasesA.26. Describe post-operative care ofpatient following renal or hepatic surgeryA.27. Explain post-operative care followingliver transplantA.28. Enumerate causes of delayedrecovery following renal surgery

A.29. List types of pain in patients withliver diseaseA.30. List pain relief modalities in hepaticpatientsA.31. Mention side effects associated with

measures conducted for pain relief



B.1. Select necessaryinvestigations according to thesituation

B.2. Assess potential problemsfrom history and clinicalexamination.

B.3. Evaluate which patient is inneed for further workup beforeadmission to surgery

Graduate should be competent to:B1. Identify problems related to drugexcretionB.2. Optimize renal patient in the bestpossible condition

B.3. Select investigations for detoxificationliver functionsB.4. Select coagulation function testsB.5. Select synthesis liver function testB.6. Interpret the results of laboratoryinvestigations

B.7.Decide if patients presented in theoptimum conditionB.8. Decide patient should not be admittedto surgery before improving their stateB.9. Relate events to the clinical conditionsB.10. Plan a suitable anaesthesia technique


B5. Predict intra andpostoperative events according tointervention

B.7. Select proper drugadministration according topatient condition.

B.8. Suggest therapeuticmanagement for drug reaction


B.11. Judge which patient not to admit tosurgeryB.12. Identify further workup needed foreach individual patientB.13. Optimize patients with significantpathologyB.14. Optimize patients with concomitantdiseaseB.15. Predict patient response topreoperative measures intended to improvehis conditionB.16. Recognize when the patient is in thebest possible condition

B.17. Detect maneuvers that should beavoided in patients with liver diseaseB.18. Select either regional or generalanaesthesia or even combined techniquesaccording the requirement of surgicalprocedure and general condition of thepatient.

A.19.Detect drugs that should be avoided inpatients with liver diseaseB.20. Suggest suitable drugs for thepatient’s condition e.g. renal failurepatients.

B.21. Predict excessive blood loss.B.22. Predict pneumothorax.B.23.Solve abnormal events as soon as theyhappenB.24. Predict readmission to surgery.

B.25. Plan management strategy forabnormal drug reactionB.26. Plan management strategy for druginteractions.

B.27. Interpret the importance of managingnutrition in radical renal and genitourinarysurgery and how this can be optimizedB28. Integrate the pathophysiologicaleffects of chemotherapyB.29. Integrate the pathophysiologicaleffects of radiotherapy



C.1. Practice central cannulationfor difficult cases.


C.5. Perform difficult regionalblocks guided by advanceddevices

C.6 Connect patients tomechanical ventilation


Student should develop the appropriateskills in order to

C.1. Insert central venous lineC.2. Insert arterial lineC.3. Insert pulmonary artery catheter inpatient with coagulation disorders

C.4. Measure central venous pressureC.5. Measure cardiac outputC.6. Measure pulmonary capillary wedgepressureC.7. Measure systemic vascular resistancein patients undergoing liver transplantation

C.7. Perform paravertebral blockC.8. Insert pleural catheter for postoperativepain management.C.9. Perform dorsal nerve of the penis blockfor hypospadius

C.10. Apply an extubation algorithm.C.11. Connect patients indicated tomechanical ventilation.

C.12. Select fluid therapy for cases of renaltransplantation or renal shut down.C13. Select proper perioperative fluidrequired for major renal surgeryC.14. Calculate precisely fluid required forpaediatrics.C.15. Prescribe fluid requirement duringpostoperative period.

D. General &transferrableSkills

Graduate should be competent inthe following:

D.1. Demonstrate ability to getrecent knowledge.



D.1. Innovate ways to improve clinicalpractice and plans to work efficiently toaccomplish targets set.D.2. Search updates and improveknowledge and skills.

D.3. Demonstrate ability to design aresearchD.4. Demonstrate the ability to put a planeto complete the research


D.8. Perform as a team.

D.5. Provide teaching to less experiencedcolleaguesD.6. Recognize the importance of providingoverall leadership of the multidisciplinaryteam.D.7. Utilize the time allocated to clinicalsessions effectively for patient care withoutcompromise.

D.8. Demonstrate the ability for team workD.9. Demonstrate the ability to lead livertransplantation teamD.10. Lead intensive care unit team




E.4. Appraise the importance ofpatient consent for interventionduring management &/orenrollment in research.

Graduate should be able to:E1. Explain detailed anaesthetic technique.E2. Explain the spinal and epiduralanalgesia.

E3. Allay anxiety in patients with severesurgical and medical condition.

E4. Appraise the importance of patientconsent for planned intervention duringmanagementE5. Appraise the importance of patientconsent for emergency and unexpectedeventsE.6. Explain the research aims to patients.E.7. Answer patient’s questions about theirenrollment in the researchE.8. Assure patients they will not behammed when enrolled in researchE.9. Respect patients request

Course Content(Units/Topics)

Teaching/Learning Methods


Practical/ Clinical

Small groupdiscussion

Others

Anatomical and physiologicconsiderations.

Pharmacology

Preoperative assessment

Anaesthesia for hepatic andbilliary surgery

Anaesthesia for livertransplantation

Postopestive management

Perioperative monitoring

Hepatic disorders in thecritically ill patients

Renal protection

Anaesthesia for cases ofchronic renal failure

Anaesthesia for TURP

Anaesthesia for radicalsurgery

Anaesthesia for renaltransplantation

Anaesthesia forpheochromocytoma

Urogenital pain syndromes



Case OSCE/OSPE


Others

Schedule of Assessment End of term 100 %

Distribution of Marks Written Exam 70 %OSCE 20 %Oral 10 %



Suggested Extra Reading

Journals and Periodicals, others Anesthesiology

Course InstructorName: Prof. Hussein Agamya Signature:





Faculty: Medicine


Course InformationCourse Code: 05010910 Course Name: Trauma, Orthopaedic, Emergency

and Outpatient Anaesthesia for Doctorate



Theoretical1

Clinical/1

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. Gaining mastery in the delivery of safe and effective perioperative anaesthetic care to patients

undergoing trauma and emergency surgical procedures as well as outpatient surgery2. Being capable of applying Advanced Trauma Life Support protocols and trauma scoring

systems3. Undertaking the perioperative anaesthetic care to a wide variety of complex elective and

emergency cases in orthopedic4. Determining the suitability of patients to outpatient procedures and the criteria for their

discharge5. Acquiring knowledge, skills and experience treating complex trauma and orthopedic cases,

resuscitation and challenging airway situations6. To acquire knowledge, skills and experience treating complex orthopedic clinical cases7. Becoming familiar with recent developments in perioperative anaesthetic care to this area of

practice, to evaluate these developments and to advise colleagues of useful changes in practice8. Managing extremely complex trauma problems9. Ability to manage extremely complex orthopedic problems10. Teaching to less experienced colleagues of all grades


Course ILOs



Graduate of this course must acquireknowledge to:A.1. Enumerate the drugs used in thecircumstances pertaining to


A.3. Explain mechanism of drug-drug interaction

A.4. Relate anatomy applied inanaesthetic practice




outpatient,orthopedic and emergencysurgeryA.2.List the modification in drugs dosage foroutpatient surgeryA.3. Enumerate safe drugs in trauma patient

A.4. List drugs avoided in case of poisoningA.5. state the antidote specific for eachpoisonA.6. Describe management for drug-druginteraction

A.7. Describe the impact of distortedanatomical structures on the airwaymanagementA.8. Enumerate causes of difficult airway inpatients undergoing trauma and emergencysurgeryA.9. State airway management strategies inpatients with suspected spine fractures

A.10. Describe optimizing patient generalcondition prior to emergency surgeryA.11. Describe the specific implications ofvarious types of trauma on patient,sphysiology

A.12. Enumerate important points duringtaking history from witnesses in case ofcomatose or disoriented patientA.13. Enumerate points asked in various

types of trauma and emergencyA.14. Describe a simple questionnaire foroutpatient surgical cases

A.15. List steps of examination of patientswith trauma as part of trauma triageA.16. Describe physical examination ofcervical spine trauma patientsA.17.Describe anatomy of brachial, lumberand cervical plexusA.18.Describe anatomy of vertebral canaland epidural space.A.19. Describe anatomy of peripheral nerves


A.11. Define special laboratoryinvestigations

A.12. Discuss perioperativecomplications


A.20. Describe an abbreviated physicalexamination of critical patients scheduledfor extremely urgent procedures

A.21. Enumerate steps required forhemodynamic stabilizationA.22. Enumerate steps provided for airwayprotectionA.23. State methods of blood conservationand how to deal with massive haemorrhageA.24. Enumerate anaesthetic problemscommon among patients scheduled fortrauma and emergency surgeryA.25.. Describe anesthesia for outpatientprocedures

A.26.Enumerate the intraoperativeinvestigations required for major traumapatientsA.27. Describe the role of serial blood gases,haematocrit, electrolytes and coagulationstudies in the intraoperative management inmajor traumaA.28Define air embolism.A.29. Define fat embolism.A.30. Describe control of haemorrhage.A.31. Explain cements reaction.

A.32. List potential complications inemergency surgical proceduresA.33. Describe the prophylaxis againstaspiration of gastric contents and venousthrombosisA.34. State the measures to counteract raisedICP and seizures in head injured patientsA.35. List the symptoms and signs oftension pneumothorax, cardiac tamponadeand abdomen compartment syndromeA.36. Describe criteria for admittingoutpatient surgical cases to the inpatientdepartment

A.17. Explain admission anddischarge criteria for intensivecare unit

A.18. Mention needed steps formanagement of patient duringintensive care unit stay

A.37. Cite important points for postoperativecare of patients undergoing trauma andemergency surgeryA.38. Enumerate causes of delayed recoveryA.39. Enumerate indications of ICUadmissionA.40. Enumerate indications ofpostoperative mechanical ventilation

A.41.Describe criteria for ICU admission inemergency casesA.42. Identify the indications of ventillatorysupport, use of vasopressors and fluidtherapyA.43.List the criteria of discharge from theICU

A.44.Describe a general plan formanagement of polytrauma patientsA.45. Describe prophylaxis and treatment ofthromboemolic complicationsA.46. Identify the indications of consultingmembers of other medical specialtiesA.47. Describe options for the nutrition ofpatients


Graduate should be competent to:B.1. Select necessaryinvestigations according tosituation

B.2. Identify potential problemsfrom history and clinicalexamination.

Graduate should be competent to:B.1.Determine the most urgentinvestigations needed in the emergencysituationB.2. Judge the risk and benefit oftransferring trauma patient to undergoimaging testsB.3.Select the least and most relevant testsneeded for outpatient surgical cases

B.4. Suggest points stressed uponpreoperativelyB.5. Detect points from history of previousanesthesia that may have impact on currentsituationB.6. Predict the deficiencies in history ofdisoriented trauma patients by a welldirected physical examination



B.6. Relate events to underlyingclinical condition

B. 7. Select proper drugadministration according to patientcondition



B.7. Plan a strategy for managing complextrauma and orthopedic surgeryB.8. Plan a strategy for managing

emergency situationsB.9. Plan a strategy for managing simpleand relatively complicated outpatientsurgeries

B.10. Predict excessive blood lossB.11. Predict pneumothoraxB.12. Predict fat and air embolismB.13. predict difficult extubationB.14. Predict readmission to surgeryB.15. Predict haemodynamic instability andcardiac arrestB.16.Predict postoperative respiratoryinsufficiency and need for mechanicalventilation

B.17. Interpret the surgical technique toeffect on different organ systemsB.18. Relate the nature of trauma to possiblepathophysiologic events

B.19. Assess the suitable drugs according toindividual casesB.20. Predict emergency drugs inaccordance with patient condition

B.21. Interpret the specific antidotes neededto avert the effect of drugs and narcotics andreduce their interaction with anaestheticsB.22. Interpret factors which reduceinteraction with anaesthetics

B.23. Detect cervical spine fracture andapplyB.24. Detect haemodynamic compromiseB.25. Detect underlying abdominal andthoracic trauma with blunt injury



Student should develop the appropriate skillsin order toC.1.Practice different approaches to centralvenous lines insertion

C.2. Diagnose difficult airway






C.2.Employ various imaging modalities toassist in CVP insertion in difficult cases

C.3. Diagnose cases with cervical spinefracture and facial traumaC.4. Measure difficult airway indices

C.5. Treat properly adverse eventsassociated with difficult airwayC.6. Perform awake intubationC.7. Employ various airway managementdevices as needed (stylets, lightwand,intubating LMA,….)C.8. Intubate trachea by fiber opticbronchoscope

C.9. Monitor CVP and PCWP monitoringas neededC.10. Monitor TEE as neededC.11.Monitor intra abdominal pressure inabdominal traumaC.12. Calculate blood loss precisely

C.13. Connect patients indicated tomechanical ventilationC.14. Initiate patients weaning

C.15. Use suitable ventilator modeC.16. Use lung protective strategiesc.17. Use jet ventilation

C.18. Prescribe perioperative fluid requiredfor major trauma casesC. 19. Calculate precisely fluid required forpatients scheduled for outpatient proceduresC.20. Prescribe fluid requirement duringpostoperative period

D. GeneralSkills


Graduate should be able to:D.1. Demonstrate ability to network searchfor recent advances in the field ofmaxillofacial and dental practice



D.2. Apply recent knowledge to improvepractice








E.3. Demonstrates effective communicationskills with patients and relativesE.4. Allay anxiety in patients with severesurgical/medical condition






Others

Assessment and resuscitation Shock Triage, transfer and scoring system Airway management

Maxillofacial injury Thoracic trauma Acute abdomen (trauma) Acute abdomen (sepsis) Traumatic brain injury Spinal cord injury Trauma in pregnant women Anaesthetic management ofpolytrauma

Preoperative evaluation & monitoringfor spine surgery.

Anesthesia for spine surgery. Anesthesia for joint replacement. Complication of orthopedic surgery.


Case

Assignment

Others

Objective questions

OSCE/OSPE

Logbook fulfillment



Practical/Clinical Exam 20 %Oral 10 %



Suggested Extra Reading Barash’s Clinical anesthesia


Course InstructorName: Prof Ahmed Mansour Signature:


Program Director (Head of Department)Name: Prof Nader EL Gamal Signature:

Course SpecificationsUniversity: Alexandria

Faculty: MedicineDepartment: Anaesthesia and Surgical Intensive Care

Course InformationCourse Name: Pain Management andregional analgesia for Doctorate degree

Course Code: 05010911

Program in which Course is Given: Doctorate in Anaesthesia and SurgicalIntensive CareNumber of Credit Hours3 Theoretical 1.5 Clinical/Practical1.5

Course Aims :1. to gain proper knowledge for the delivery of safe and effective pain management care to and

regiomal amagesia for surgical patient patients with acute and chronic pain2. To acquire skills and experience for assessment and treating complex pain syndromes3. Becomes familiar with recent developments in pain management care to this area of practice, to

evaluate these developments and to advise colleagues of useful changes in practice4. Ability to develop pain clinic in whatever area of their practice5. Provide teaching to less experienced colleagues of all grades6. Use the different modalities available for proper pain management in different ahe groups7. to aquire skills and experience for free delivery of all techniques of regional amalgesia8. to gain proper kmowledge about local Amalgesic drugs and their pharmacology

Intended Learning Outcomes ( ILOs )Course ILOsProgram ILO (refer to program

matrix)Graduate of this course mustacquire knowledge to:A.1. Describe differentpharmacological analgesicdrugs and adjuvant drugsused in acute and chronicpain managementA.2. Enumerate the differentroutes for drug administrationand to mention how to use itin the field of painmanagementA.3. State the strategy ofpharmacological drugs

Graduate of this course mustacquire knowledge tot:A.1 Describe advancedPharmacological principles ofdrugs.A.4. Revise clear workingknowledge of anatomy applied inanaesthetic practice equipmentA.8. Describe specific pointsstressed upon during taking historyfrom the patient

A.9. List steps of physicalexamination in medically


escalationA.4. Describe the anatomyand physiology of painA.5. Mention the types ofnerve carrying the painsignalsA.7. Enumerate the points ofpain history taking from thepatientA.8. Describe the completephysical and neurologicalexamination of the chronicpain patientA.9. List the importantlaboratory and radiological ,thermography ,electromyograpgy andevoked potential forevaluation of pain patientA.10. Describe the strategy ofacute post operative painmanagementA.11. Describe the acute painserviceA.12. Discuss the possiblecauses of resistant acute painmanagementA.13. Discuss thedevelopment of chronicity ofpainA.14. Discuss managementplan for cancer painA.15. Describe what is aneuropathic painA.16. Discuss the complexregional pain syndromeA.17. Enumerate thecommonly seen chronic painsyndromeA.18. Define the electricstimulation analgesia andtheir role in chronic painmanagement

compromised patientA.11. List needed laboratoryinvestigationsA.13. Mention spcial patient's needsduring postoperative periodA.14. Define possible causes ofresistant acute painA.15. Describe the criteria ofpersistent chronic painsA.16. Understand specific painsyndromes and their management

A.19. Describe theimplantable drug deliverysystem for chronic painmanagementA.20. Mention the nerveblock techniques for chronicpain managementA.21. Describe the otherulternative techniques forchronic pain managementA.22. Describe the anatomy,techniques, indications,contraindications andcomplications of spinal andepidural analgesics includingthe role of moderntechnology.A.23. Describe the anatomy,different techniques,medications, indications,contraindications andcomplications of caudalanalgesia considering the up-to-date role of moderntechnology.A.24. Describe the anatomy,different techniques,indications, contraindicationsand complications ofdifferent upper limb blocks.A.25. Discuss the anatomy,different techniques,indications, contraindicationsand complications of lowerlimb blocks.A.26 Mention the differenttypes of local analgesicdrugs.A.27. Describe thepharmacology of localanaesthetic drugs andpharmacokinetic andpharmacodynamic effects.

A.28. Mention the anatomy,different techniques,indications, contraindicationsand complications of headand neck blocks.

B1. Propose workup plan forpatients with chronic pain

B2. Interpret results ofinvestigation to reach toproper diagnosis / differentialdiagnosis of patients withchronic pain.

B3. Assess differentmanagement strategies andtechniques for nerve block.

B4. Evaluate differentanaethic drugs used in acutepain management.

B5. Plan a line ofmanagement for cases ofchronic pain and cancerouspatients.

B.1. Select necessary investigationsaccording to situation

B.4. Modify anaesthetic plane accordingto surgery

B.7. Select proper drugs according topatient condition.

B12. Design strategies for acute andchronic pain management


C1. Perform regional block

C2. Perform nerve block

C3 conduct epiduralanesthesia on adult patient

C4. Write thorough patientsrecord

Graduate should be able to:D.1. Demonstrate ability tonetwork search for recentadvances in the field ofprocedures and techniques inICU .D.2. Apply recent knowledgeto improve practice.

D.3. Demonstrate ability tosearch for recent researchesin the field of ICU.D.4. Apply recent knowledgeto understand researches inthe field of intensive caremedicine.

D.5. Acquire skills forpresenting lectures.D.6. Use informationtechnology to preparelectures.D.7. prepare scientific talks.

D.8. Observe team workingunder supervision.D.9. Give advice to juniorstaff.


C.5. Perform difficult regional blocksguided by advanced devices



D.1. Demonstrate ability to get recentknowledge.

D.3. Design research protocols and co-operate in multidisciplinary researchteams


D.5. Conduct teaching and trainingsessions.

C. Clinical andprofessionalskills

D. Generalskills

D.10. Conduct frequenttesting to more junior teammember.D.11. Demonstrate thenecessary multi-disciplinaryleadership.

Graduate should be able to:E.1. Explain intensive care unitprocedures and techniques topatientsE.2. Explain intensive care unitprocedures and techniques topatient/s familyE.3. Explain possiblecomplications

E.4. Explain the details of everychoiceE.5. Explain the benefits andcomplications of every choice.E.6. Demonstrate effectivecommunication skills with patientsand relatives.

E.7. Appraise the importance ofpatient or relative consent forplanned intervention duringmanagement.E.8. Appraise the importance ofpatient or relative consent foremergency and unexpected events.

E.9. Prepare and revise check listsfor drugs machines andequipments.


E.2. Include any choices ofanaesthetic technique.

.E.4. Appraise the importance ofpatient consent for interventionduring management &/orenrollment in research.

E.5. Check drugs, machines andequipments.


Teaching/Learning Methods

Course Content(Units/Topics)


Practical/Clinical

Smallgroup

discussion

Others

1- Development and organizationof pain centers.

2- Pain mechanisms , anatomyand physiology.

3- Evaluation of chronic painpatient.

4- Diagnostic tools for painmanagement.

5- Nerve block techniques for painmanagement.

6- Pharmacological therapy forpain management.

7- Implantable drug deliverysystems and electric stimulationanalgesia and other nervetechniques for pain management.

8- Neuropathic pain. 9- Acute pain service. 10- Cancer pain. 11- Commonly seen painsyndromes.

12- Pain in children 13- Spinal & Epidural analgesiaCaudal blocks

14- Upper limb blocks 15- Lower limbs blocks 16- Local anesthetic drugs 17-pharmaclogy 18-Head & neck blocks


Case OSCE/OSPE


Others




Course InstructorName : Prof Dr.Tarek Sarhan Signature :

Program CoordinatorName : Pro Dr. Wafaa Shafshak Signature :

Program Director (Head of Department)Name : Prof Dr. Nader El Gamal Signature :


Melzac in chronic pain , nerve blocktechniques for chronic painRaj : practical management of chronic PainMiller's Anesthesia pain

Course Text Books

IAS refresher coursesSuggested Extra ReadingPain JournalJournals and Periodicals,others



Faculty: Medicine

Department: Anaesthesia and Surgical Intensive Care.

Course InformationCourse Code: 05010912 Course Name: Intensive care for anesthesia

III

Program in which the Course is Given: Doctorate degree in Anaesthesia and Surgical Intensive Care

Number of Credit Hours: 2 Theoretical Clinical

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. Gaining mastery in performing different procedures and techniques in intensive care

medicine safely and effectively.2. Becoming familiar with recent developments in diagnostic and interventional tools used in

ICU.3. Acquiring knowledge, skills and experience in treating circulatory and respiratory failure.4. Taking the decision of renal replacement therapy and good management of the general

condition of the patient.5. Ability to use and prescribe antimicrobial therapy safely and according to the guidelines of

the infection control unit.6. Providing teaching to less experienced colleagues of all grades.


Course ILOs


Graduate of this course mustacquire knowledge tot:A.1. Describe advancedpharmacological principles ofdrugs.

A.2. Discuss the toxic drugeffect

Graduate of this course must acquireknowledge to:A.1. Describe different classes of drugs usedin ICU.A.2. Enumerate different drugs in each class.A.3. Describe in details the impact of thesedrugs on the patient in the ICU.

A.4. List the impact of over dosage onpatients in the ICU.A.5. Enumerate the side effects of each drug.A.6. State the management strategies fordrugs side effects

11

A.3. Explain mechanism of drug-drug interaction.

A.4. Revise clear workingknowledge of anatomy applied inICU practice.

A.5. Describe the impact ofphysiologic derangement on ICUpatient.

A.6. List the physical principlesrelevant to anaesthesia.

A.8. Describe specific pointsstressed upon during takinghistory from the patient.

A.9. List steps of physicalexamination in medicallycompromised patient.

A.11. List needed laboratoryinvestigations.

A.7. Describe the impact of drug-druginteraction on the different systems.A.8. Enumerate drug interactions for eachdrug.A.9. Describe in details how to avoid andmanage these interactions.

A.10. Cite the impact of anatomical structureson different practical skills performed in theICU.A.11. Enumerate anatomical causes ofdifficulties in performing practical skills inthe ICU.A.12. State management strategies foranatomical difficulties during performingeach practical skill.

A.13. Describe optimum patient condition forevery procedural intervention.A.14. Define the effect of differentprocedures on the patient’s general condition.

A.15. State the physical principals of theprocedures done in ICU.A.16. Identify the proper technique for eachintervention

A. 17. Define the impact of history taking onthe patient’s course in the ICU.A.18. Discuss points stressed upon duringhistory taking from ICU patients or theirrelatives.A.19. Enumerate questions asked in case oforgan dysfunction.

A.20. List steps for examining patients withorgan dysfunction in the ICU.A.21.Describe the physical examination ofpatients’ candidate for support of circulation,temporary cardiac pacing, renal replacementtherapy and pulmonary embolism.

A.22. Enumerate special laboratoryinvestigations for the diagnosis of infectionand organ dysfunction.

A.18. Cite steps for managementof patient during intensive careunit stay.

A.19. Describe resuscitation oflife threatening conditions.

A.23. Describe the specific laboratoryinvestigations required before antimicrobialtherapy in the ICU.A.24. Describe the different laboratoryinvestigations required before anyinterventional procedure in the ICU.A.25. Describe the laboratory investigationsneeded before renal replacement therapy.

A.26. enumerate the steps for management ofpatients with organ dysfunction in need ofspecific diagnostic or interventionalprocedure.

A.27. Enumerate the steps of resuscitation oflife threatening conditions caused by anyinterventional procedure in the ICU.


Graduate should be competentto:B.1. Select necessaryinvestigations according tosituation.


B.6. Relate events to underlyingclinical condition.

B.7. Select proper drugsaccording to patient condition.


.


B.1. Suggest specific investigations toconfirm diagnosis.B.2. Suggest further investigations to giveprognostic value.

B.3. Expect previous conditions that lead topresent situationB. 4. Detect points from history of previousICU admission that may have impact oncurrent condition.

B.5. Integrate the sequence of events that leadto the underlying clinical condition.B.6. Interpret abnormal responses to itspossible causes

B.7. Select the suitable drug management forthe clinical condition.B.8. Plan an alternative drug managementaccording to the condition.

B.9. Plan therapeutic strategies for sideeffects of common medicationsB.10. Optimize doses to avoid side effectB.11. Suggest alternative routes to lessen sideeffects

B.9. Detect drug-druginteractions

B.11. Decide to startresuscitation at proper time..

B.12. Predict drug-drug interactions.B.13. Suggest drugs not to be administeredsimultaneouslyB.14. Plan alternative medications strategy

B.15. Detect the need for early resuscitationB.16. Plan resuscitation strategy for eachconditionB.17. Decide when to stop resuscitationb.18. Decide when not to startcardiopulmonary resuscitation

C. Professionaland PracticalSkills

Student should develop theappropriate skills in order to:C.1. Practice central cannulationfor difficult cases.




C.9. Lead cardiopulmonaryresuscitation team.

C.11. Write precise patientrecords.

Student should develop the appropriate skillsin order to:C.1. Perform central venous cannulationusing different approaches.C.2. Insert pulmonary artery catheter throughdifferent routes.

C.3. Use echo cardiograph to monitormyocardial performanceC.4. Use endtidal capnographiagnosepulmonary embolism and circulatory failure.C.5. Treat pulmonary embolism and performcirculatory support.

C.6. Use optimum ventilation mode for eachcaseC.7. Use ventilation in the prone position.C.8. Use differential lung ventilation

C.9. Administer precisely fluids required inpatients with renal replacement therapy.C.10. Administer precisely fluids required forsupport of circulation.

C.11. Demonstrate CPR leadership.C.12. Apply CPR leadership in differentcases.

C.10. write price admission sheetC.11. Record data during intensive care unitstayC.12. Write precise discharge sheet

D. GeneralSkills

Graduate should be able to: Graduate should be able to:



D.4. Demonstrate skills topresent scientific talks.

D.5. Conduct teaching andtraining sessions..

D.1. Demonstrate ability to network searchfor recent advances in the field of proceduresand techniques in ICU.D.2. Apply recent knowledge to improvepractice.

D.3. Demonstrate ability to search for recentresearches in the field of ICU.D.4. Apply recent knowledge to understandresearches in the field of intensive caremedicine.

D.5. Acquire skills for presenting lectures.D.6. Use information technology to preparelectures.D.7. prepare scientific talks.

D.8. Observe team working undersupervision.D.9. Give advice to junior staff.D.10. Conduct frequent testing to more juniorteam member.D.11. Demonstrate the necessary multi-disciplinary leadership.


Graduate should be able to:E.1. Explain anaesthetic eventsto patients.


.E.4. Appraise the importance ofpatient consent for interventionduring management &/orenrollment in research.


Graduate should be able to:E.1. Explain intensive care unit proceduresand techniques to patientsE.2. Explain intensive care unit proceduresand techniques to patient/s familyE.3. Explain possible complications

E.4. Explain the details of every choiceE.5. Explain the benefits and complicationsof every choice.E.6. Demonstrate effective communicationskills with patients and relatives.

E.7. Appraise the importance of patient orrelative consent for planned interventionduring management.E.8. Appraise the importance of patient orrelative consent for emergency andunexpected events.

E.9. Prepare and revise check lists for drugsmachines and equipments.




Smallgroup

discussion

Others

1- Catheterization in ICU 2- Positioning in ICU 3- Bronchoscopy in ICU 4- Endoscopic procedures in ICU 5- Ultrasonography in the critically ill 6- Support of circulation 7- Temporary cardiac pacing,

cardioversion and defibrillation

8- Percutaneous dilatationaltracheostomy at bedside

9- Renal replacement therapy incritically ill

10- Antimicrobial therapy in ICU 11- Pulmonary embolism and DVT



Case OSCE/OSPE


Others





Course Text Books Principals of Critical Care

Suggested Extra Reading Procedures and techniques in intensive caremedicine. The practice of clinicalEchocardiography.

Journals and Periodicals, others Journal of Critical Care, Journal of IntensiveCare Medicine

Course InstructorName: Prof. Nader El Gamal Signature:

Program CoordinatorName: Prof. Wafaa Shafshak Signature:

Program Director (Head of Department)Name: Prof. El Gamal Signature:



Faculty: Medicine


Course InformationCourse Code: 05010913 Course Name: Intensive Care For Anaesthesia

(IV)

Program in which the Course is Given to Doctorate Degree of Anaesthesia and surgicalIntensive Care

Number of Credit Hours Two Theoretical Clinical/Practical

Course Aims, the aim of this course is to upgrade the candidate abilities in:1. Dealing with traumatic head and spinal injuries.2. Managing endocrinal emergencies.3. Managing renal and liver failure.4. Nutrition in ICU.5. Fluids in ICU.


Course ILOs





A.11. Define special laboratory


A.1. Discuss points stressed upon duringtaking history from patients with tumors.A.2. Enumerate points asked in case oftrauma.A.3. List history of endocrinal emergencies.A.4. List history of any renal or liverdisease.

A.5. Enumerate the steps of clinicalexamination of trauma patients.A.6. Enumerate the steps of clinicalexamination of paediatric and neonates.

A.7. Define routine laboratory investigation

1 Hr1 Hr

investigations

A.17. Explain admission anddischarge criteria for intensivecare unit

A.18. Cite steps for managementof patient during intensive careunit stay

A.19. Describe resuscitation oflife threatening conditions

in postoperative surgical intensive care unit.A.8. Define the renal and liver functions.A.9. Define radiological investigation forpostoperative surgical intensive carepatients.

A.10. Describe the criteria for admission ofpatients for ICU.A.11. Describe when to discharge patientsfrom ICU.

A.12. Cite the scoring systems in intensivecare.A.13. Cite first aid intensive care measureson intensive care admissionA.14. Describe actual treatment andmanagements.

A.15. Describe recent advances in basic lifesupport.A.16. Describe recent advances in advancedlife support.



B.11. Decide to start resuscitationat proper time.

Graduate should be competent to:B.1. Suggest points stressed uponpreoperatively.B.2. Detect points from history that mayhave impact on current situation in ICU.

B.3. Predict the cases of arrestB.4. Plan a strategy for resuscitationaccording to recent standard guidelinesB.5. Recognize when to start theresuscitation.B.6. Plan management strategy for postcardiac arrest.

C. ProfessionalandPractical Skills


Student should develop the appropriateskills in order toC.1. Use new guidelines for antisepticmeasures for central line insertion.C.2. Use different routes for centralcannulation.C.3. Prevent problems associated withcentral line.C.4. Use Pulmonary artery catheter to



C.6. Connect patients tomechanical ventilation




withdraw mixed venous samples to takesamples.

C.5. Treat properly adverse eventsassociated with difficult airway.C.6. Perform awake intubationC.7. Use fiberoptic bronchoscope forinsertion .C.8. Perform blind nasotracheal intubation.C.9. Use supraglottic devices in ICUemergencies.

C.10. Diagnose early deep vein thrombosis.C.11. Diagnose pulmonary embolismC.12. Treat pulmonary embolism

C.13. Apply an extubation algorithm in ICUC.14. Apply tube exchange catheterC.15. Connect patients indicated tomechanical ventilationC.16. Perform patients weaning frommechanical ventilation according to weaningcriteria

C.17. Select suitable ventilator modeC.18. Choose differential lung ventilation inselected cases

C.19. Choose correct type of fluid accordingto patient condition.C.20. Choose infusion volume and rateaccording to patient conditionC. 21. Apply paeditric intensive careguidelines for fluid therapy.C.22. Treat postoperative fluid andelectrolyte disorders.

C.23. Perform basic life supportC.24. Perform advanced cardiac life supportC.25.Perform prolonged life supportaccording to recent guidelines

D. GeneralSkills


Graduate should be able to:D.1. Demonstrate ability to network search

for recent advances

D.2. Use information technologyto prepare lectures and research



D.2. Apply recent knowledge to improvepractice

D.3. Search for new updates.D.4. Use Microsoft power point

D.5. Use information technology to preparelecturesD.6 Acquire skills for presenting lecturesD.7. Prepare scientific talks

D.8. Observe team working under hissupervisionD.9. Give advice to junior staffD.10. Conduct frequent testing to morejunior team membersD.11 Demonstrate the necessary multi-disciplinary leadership


Graduate should be able to:E.3. Deal gently with patients andtheir families in ICU.


Graduate should be able to:E.1. Demonstrate effective communicationskills with patients and relativesE.2. Allay anxiety in patients with severesurgical and medical condition






Others

ICU Performance, Quality assurance andpatient safety

ICU design and requirements Measurement Hemodynamic parametersCOP and tissue perfusion

Invasive and minimally invasive

Fluid Responsiveness Infection control in ICU . Antibiotic Policy

The Septic patients update and recenttrendsRespiratory Failure I Theory andmanagement

Respiratory Failure II MechanicalVentilation updates ,new modes

Respiratory Failure III WeaningProcedure

Nutrition support for the critically illpatient.Titration and modification of Nutritionaccording to patient diagnosis

Endocrinal disorder in ICU and itsmanagement

Renal Replacement therapy Type and care of patient in Obstetric ICU Multiple trauma patient and Neuro-criticalcare

Hepatic disorder, and coagulation disorderin ICU and its management

common disorder in Pediatric ICU , Please check () the appropriate method.


Case OSCE/OSPE


Others

Schedule of Assessment Mid-term 40 %


Practical/Clinical Exam 20 %Others



Suggested Extra Reading Manual of Intensive Care.

Journals and Periodicals, others Anaesthesia and Intensive Care Journal

Course InstructorName: prof. Assem Abdel Razek Signature:


Program Director (Head of DepartName: Prof. Nader El Gamal Signature:



Faculty: Medicine

Department: Anaesthesia and Surgical Intensive Care.

Course InformationCourse Code: 05010914 Course Name: Intensive care for anesthesia

V

Program in which the Course is Given: Doctorate degree in Anaesthesia and Surgical Intensive Care

Number of Credit Hours: 2 Theoretical Clinical

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. Gaining mastery in treating sepsis and community-acquired infections in ICU.2. Becoming familiar with recent developments in organ transplantation in critically ill patient.3. Acquiring knowledge and skills in diagnosing and treating agitation and delirium in ICU.4. Ability to diagnose and mange acute kidney injury in critically ill patient.5. Becoming familiar with ethical issues and transportation in ICU practice.6. Acquiring knowledge about recent developments in immunonutrition and specific nutritional

support.7. Gaining mastery in diagnostic approach of fever in ICU.8. Acquiring knowledge about re-perfusion injury, oncological emergencies, and acute

compartment syndrome in ICU practice.9. Providing teaching to less experienced colleagues of all grades.


Course ILOs


Graduate of this course mustacquire knowledge to:A.1. Describe advancedpharmacological principles ofdrugs.

Graduate of this course must acquireknowledge to:A.1. Describe different classes of drugs usedin Intensive care unit.A.2. Enumerate different drugs in each class.A.3. Describe the impact of these drugs onthe patient in the ICU.

A.4. List the impact of over-dosage in ICU.A.5. Enumerate the side effects of each drug.A.6. State the management strategies fordrugs side effects.

11


A.8.. Describe specific pointsstressed upon during takinghistory from the patientA.9. List steps of physicalexamination in medicallycompromised patient

A.11. List needed laboratoryinvestigations perioperative.

A.18. Mention needed steps formanagement of patient duringintensive care unit stay

A.19. Describe resuscitation oflife threatening conditions.

A.7. Describe the impact of drug-druginteraction on the different systems.A.8. Enumerate drug interactions for eachdrug.A.9. Describe in details how to avoid andmanage these interactions.

A.10. Enumerate questions asked in case oforgan dysfunction.

A. 11. Define the impact of history taking onthe patient’s course in the ICU.A.12. Discuss points stressed upon duringhistory taking from ICU patients or theirrelatives.

A.13. List steps for examining patients withorgan dysfunction in the ICU.A.14. Describe the physical examination ofpatients’ candidate for support of circulationand renal replacement therapy.

A.15. Enumerate special laboratoryinvestigations for the diagnosis of infectionand organ dysfunction.A.16. Describe the laboratory investigationsneeded before renal replacement therapy.

A.17. Describe in details steps formanagement of patient during ICU stay.

A.18. Enumerate the steps of resuscitation oflife threatening conditions in the ICU.

A.19. Discuss diagnostic approach of fever incritically ill patient.

A.20. Describe charts and scales used fordiagnosis of delirium and agitation in ICU.A.21. Describe management plan for deliriumand agitation in ICU.


Graduate should be competentto:


B.1. Select necessaryinvestigations according tosituation.


B.3. Relate events to underlyingclinical condition.

B.4. Select proper drugsaccording to patient condition.

B.5. Suggest therapeuticmanagement for drug reaction.

B.6. Detect drug-druginteractions

B.7. Decide to start resuscitationat proper time..

B.1. Suggest specific investigations toconfirm diagnosis.B.2. Suggest further investigations to giveprognostic value.

B.3. Expect previous conditions that lead topresent situationB. 4. Detect points from history of previousICU admission that may have impact oncurrent condition.

B.5. Integrate the sequence of events that leadto the underlying clinical condition.B.6. Interpret abnormal responses to itspossible causes

B.7. Select the suitable drug management forthe clinical condition.B.8. Plan an alternative drug managementaccording to the condition.

B.9. Plan therapeutic strategies for sideeffects of common medicationsB.10. Optimize doses to avoid side effectB.11. Suggest alternative routes to lessen sideeffects

B.12. Predict drug-drug interactions.B.13. Suggest drugs not to be administeredsimultaneouslyB.14. Plan alternative medications strategy

B.15. Detect the need for early resuscitationB.16. Plan resuscitation strategy for eachconditionB.17. Decide when to stop resuscitationB.18. Decide when not to startcardiopulmonary resuscitation


Student should develop theappropriate skills in order to:

C.1. Insert central cannulationfor difficult cases.

Student should develop the appropriate skillsin order to:C.1. Perform central venous cannulationusing different approaches.

C.2. Use echocardiograph to monitormyocardial performance.




C.9. Lead cardiopulmonaryresuscitation team.

C.11. Write precise patientrecords.

C.3. Perform circulatory support.C.4. Use different methods to measure intra-abdominal pressure.

C.5. Use optimum ventilation mode for eachcaseC.6. Use ventilation in the prone position.C.7. Use differential lung ventilation

C.8. Administer precisely fluids required inpatients with acute kidney injury.C.9. Administer precisely fluids required forsupport of circulation.

C.10. Demonstrate CPR leadership.C.11. Apply CPR leadership in differentcases.

C.12. Write price admission sheet.C.13. Record data during ICU stay.C.14. Write precise discharge sheet.

D. GeneralSkills



D.3. Demonstrate skills topresent scientific talks.

D.4. Conduct teaching andtraining sessions..

Graduate should be able to:D.1. Demonstrate ability to network searchfor recent advances in the field of proceduresand techniques in ICU.D.2. Apply recent knowledge to improvepractice.

D.3. Demonstrate ability to search for recentresearches in the field of ICU.D.4. Apply recent knowledge to understandresearches in the field of ICU.

D.5. Acquire skills for presenting lectures.D.6. Use information technology to preparelectures.D.7. Prepare scientific talks.

D.8. Observe team working undersupervision.D.9. Give advice to junior staff.D.10. Conduct frequent testing to more juniorteam member.

D.11. Demonstrate the necessary multi-disciplinary leadership.


Graduate should be able to:E.1. Explain anaesthetic eventsto patients.




Graduate should be able to:E.1. Explain intensive care unit emergenciesto patient’s family.E.2. Explain possible complications.

E.3. Explain the details of every choiceE.4. Explain the benefits and complicationsof every choice.E.5. Demonstrate effective communicationskills with patients and relatives.

E.6. Appraise the importance of patient orrelative consent for planned interventionduring management.E.8. Appraise the importance of patient orrelative consent for emergency andunexpected events.

E.9. Prepare and revise check lists for drugsmachines and equipments.




Smallgroup

discussion

Others

1- Ethical issues in ICU clinicalpractice

2- Acute renal failure in critically illpatient

3- Diagnostic approach of fever inICU

4- Oncological emergencies in ICU 5- Sepsis: life-threatening

community infections

6- Acute compartment syndrome 7- Organ transplantation in critically

ill (Immunosuppression, rejectiondiagnosis and specific organ care)

8- Immunonutition and specificnutritional support

9- Agitation and delirium in ICU 10- Transportation of critically ill

11- Reperfusion injury syndromein ICU clinical practice



Case OSCE/OSPE


Others





Course Text Books Principals of Critical Care

Journals and Periodicals, others Journal of Critical Care, Journal of IntensiveCare Medicine

Course InstructorName: Prof. Hasan Osman Signature:


Program Director (Head of Department)Name: Prof. Nader Elgamal Signature:



Faculty: Medicine


Course InformationCourse Code: 05010915 Course Name: Integrated course II

Program in which the Course is Given to Doctorate Degree of Anaesthesia and surgicalIntensive Care

Number of Credit Hours Two Theoretical Clinical/Practical

Course Aims, the aim of this course is to help the candidates: To gain proper knowledge of qualityassurance program in anaesthetic practice.

1- To be following updates in various branches of anaesthesia.

2- To Know about research design and capable of research protocol design.

3- Full awareness of ethics of anaesthetic practice.

4- Capability of decision making in complicated cases.

5- Practicing techniques in difficult situations as airway, vascular access, ultrasound guided nerve blocksand CT guided pain management.

6- Capability of disaster situation management.

7- To enhance teaching abilities of junior staff and operation theater control.

Intended learning outocmes

A. Knowledge andunderstanding

A1 knowledge of four disastermanagement phases

A1. Describe the concepts ofMitigation

A2. Discuss the phase ofPreparedness

A3. Describe Response

A4. Discuss the concept ofRecovery.

1 Hr1 Hr

A5. Recently introduced drugsrelated to emergency and electiveanaesthesia and resuscitation

A5. Describe advancedpharmacological principles ofdrugs.

A8. To get enough knowledge ofdiagnostic radiologicaltechniques

A6. Discuss the toxic drugeffects

A7. Explain mechanism ofdrug-drug interaction

A8. Mention the precautionsneeded during imagingtechniques.

A9. Discuss ultrasoundappearance of differenttissues.

A10. Describe CT picture ofdifferent organs.

A14. Efforts to improve qualityof Anaesthesia administration

A11. Evaluation of individualpatient.

A15. Health care incident toimprove quality.

A16. Evidence regardingquality of care improvementfor groups of patients

A17. Combining evidencebased medicine and qualityimprovement.

A18. Types of measures ofimprovement effects (processversus outcome, writingmeasure specification and howto analyse performance data)

A19. Future directions forimproving quality

A20. Ethical and legal aspects ofAnaesthesia care

A20. How to deal gently withthe patient

A21. Components of informedconsent

A22. Controversies of consent

A23. The demand for lifesustaining therapies

B. Intellectual skills B1. Operating theatermanagement

B1. Scheduling and turnovers

B2. Conflict resolution in theoperating room

B3. Pre and postoperativeorganization

B4. Operating roomsinformation systems

B5. Ability of following newanaesthesia news on differentsites

B5. Knowledge of internetsites related to updates ofanaesthesia and surgicalintensive care

B6. Good command to reachthese sites rapidly on thecomputer

B7. Capability of decisionmaking in complicated cases

B7. Expecting difficulty

B8. Using international scalesto calculate risk.

B9. Applying protocolsfollowed in complicatingcases

B10. Select proper drugs and

techniques for the situation

B11. Decide to startresuscitation at proper time

B12. Disaster management skill B12. Development of the planto reduce the impact of futuremass causality incident (MCI)

B13. Development of plansand activities to strengths theability to respond to a MCI

B14. Acute care is provided topreserve life immediatelyfollowing an MCI.

B15. Reestablishment of thecommunity and instilling asense of normality into thelives of survivors.

C. Professional skills C1. Vascular annulation C1. Ability to use differenttypes of catheters and infusionsystems.

C2. Ability to use radiologicaltechniques for central vascularcommutation

C3. Difficult airway diagnoses C3. Applying scales fordiagnosing and expectingdifficulty of airwaymanagement

C4. Use of recently introduceddevices for difficult airway

C5. Advanced monitoring C5. Advanced monitorsapplication

C6. Experience in datainterpretation

C6. Regional blocks C6. Use of ultrasound andnerve stimulator guided tools

for identifying site for regionalblocks

C7. Using CT guidedtechniques for neurolyticprocedures of chronic painrelief

D. Transferable skills D1. Teaching and researchactivities

D1. Demonstrate skills topresent scientific talks

D2. Conduct teaching andtraining sessions

D3. Perform as a team.





Others

ICU Performance, Quality assurance andpatient safety

ICU design and requirements Measurement Hemodynamic parametersCOP and tissue perfusion

Invasive and minimally invasive

Fluid Responsiveness Infection control in ICU . Antibiotic PolicyThe Septic patients update and recenttrends

Respiratory Failure I Theory andmanagement

Respiratory Failure II MechanicalVentilation updates ,new modes

Respiratory Failure III WeaningProcedure

Nutrition support for the critically illpatient.Titration and modification of Nutritionaccording to patient diagnosis

Endocrinal disorder in ICU and itsmanagement

Renal Replacement therapy Type and care of patient in Obstetric ICU Multiple trauma patient and Neuro-critical

careHepatic disorder, and coagulation disorderin ICU and its management

common disorder in Pediatric ICU , Please check () the appropriate method.


Case OSCE/OSPE


Others






Suggested Extra Reading Manual of Intensive Care.

Journals and Periodicals, others Anaesthesia and Intensive Care Journal

Course InstructorName: prof. Assem Abdel Razek Signature:


Program Director (Head of DepartName: Prof. Nader El Gamal Signature:

Course SpecificationsUniversity: Alexandria

Faculty: Medicine


Course InformationCourse Code: 050609010 Course Name:

Advanced Clinical Pharmacology ForAnaesthesia

Program in which the Course is Given: Doctorate Degree of Anaesthesia and Surgical IntensiveCare

Number of Credit Hours: 2 Theoretical Clinical/Practical

1- Course Aims: The aim of this program is to upgrade the candidate abilities in:1. The practical aspects of the administration of anaesthetics and adjuvant drugs2. The pharmacokienetics and pharmacodynamics of drugs which affect the course of

anaesthesia3. Drug – drug interaction


Course ILOs


Graduate of this course mustacquire knowledge tot:A.1 Describe advancedpharmacological principles ofdrugs.

A.2. Discuss the toxic drug effect

A.3 Explain mechanism of drug-drug interaction

Graduate of this course must acquireknowledge tot:A.1. Define pharmacodynamics of drugsused in surgical patients that have impact onanaesthetic courseA.2.State the effect of anaesthesia onabsorption, distribution and elimination ofother drugsA.3. Mention the mechanism of action of thestudied drugs

A.4. Enumerate factors modifying drugpharmacodynamicsA.5. Mention factors that increase incidenceof drug toxicityA.6. Mention diagnostic criteria of drugtoxicity

A.7. State the possible mechanisms of drug-drug interaction

2


A.8 Describe diagnosis of drug-druginteractionA.9.State examples of drugs interacting withanaesthetic drugs

A.10. Enumerate drugs used in resuscitationA.11. Mention doses of these drugsA.12. Mention root of administrationA.13. Describe mechanism of action ofthese drugs



B. 7. Select proper drug accordingto patient condition.



B.12. Design strategies for acuteand chronic pain management


B,1. Select anaesthetic regimen and adjuvantdrugs according to patient general statusB.2. Modify choice of drugs according tosurgical procedureB.3 Detect dug side effect

B.4. Relate abnormal response to drugsadministeredB.5. Instruct plan for management forabnormal events related to drugs

B.6. Suggest further workup to confirmdrug-drug interactionB.7. Suggest therapeutic plan for drug-druginteraction

B.8 Classify drugs used for painmanagementB.9. Compare mechanism of action of eachgroupB.10. Assess the suitable strategy of painmanagement according to situation


D. GeneralSkills


Graduate should be able to:D.1 Read recent text books

D.2. Search for new related papers

D.3. prepare lectures for the studied topics

D.2. Use information technologyto prepare lectures and research .

D.4. Present lectures






Others

Drug absorption, distribution andelimination

Pharmacokienetcs Drug action Drug interaction Variability in drug effect Adverse drug reation Analgesic drugs Drugs used in premedication,antiemetic agents

Drugs and the autonomic nervoussystem

Antihypertensive agents, drugs usedto induce hypotension

Corticosteroids and hypoglycaemicagents

Respiratory medications Intravenous fluids Non opioid intravenous anaesthesia



Case OSCE/OSPE


Others


End of term %Distribution of Marks Written Exam 100 %

Practical/Clinical Exam %

Others %


Course Text Books Drugs in anaesthetic practice



Course InstructorName: Prof Tharwat Ghoneim Signature:





Faculty: Medicine


Course InformationCourse Code: 052009010 Course Name:

Advanced Physiology For AnaesthesiaProgram in which the Course is Given: Doctorate Degree of Anaesthesia and Surgical IntensiveCare

Number of Credit Hours: 1 Theoretical Clinical/Practical

Course Aims: The aim of this course is to upgrade the candidate abilities in:1. Understanding the impact of physiologic change on patient management2. Optimizing the patient condition before surgery3. Modifying anaesthetic technique according to patient condition


Course ILOs


Graduate of this course mustacquire knowledge tot:


Graduate of this course should acquireknowledge to:

A.1. Identify the concept of internalenvironment and homeostasis.A.2. Discuss the different transportmechanisms through the cell membrane.A.3. Explain the control of cardiovascularsystem.A.4. Discuss the cardiac performance andfactors controlling.A.5.Discuss the cardiac reserve and itsmechanisms .A.6.Discuss the mechanisms of respiratorygases transport .A.7.Differentiate between different types ofhypoxia.A.8.Analyze the nervous and chemicalcontrol of breathing .

1


A.9. Explain the organization and its basicfunctions.A.10. discuss the mechanism of brainactivation ( wakefulness and sleep ) .A.11. Describe the body response to stress .A.12. Discuss the physiology of pain andpain control mechanism .

A.13. Describe the body fluid and the waterbalance.A.14. Explain the normal acid base balanceand its disturbance .A.15. discuss the hypovolemic shock on aphysiological basis .A.15. Discuss body temperature regulationand its disturbance .


Graduate should be competent to:B.1. Select necessaryinvestigations according tosituation



Graduate should be competent to:B.1.Assess physiologic derangement insurgical patientB.2. Plan proper line of investigationnecessary for perioperative B.3. Interpretresults of laboratory investigations to patientcondition

B.4. Differentiate abnormal symptoms andsigns of physiologic abnormalitiesB.5. Detect changes related tocardiovascular disordersB.6. Detect abnormal respiratory mechanicsB.7. Assess acid base and water andelectrolyte disorders during the perioperativeperiodB.8. detect signs and symptoms ofendocrinal crisis

B.9. Interpret the clinical situation using thephysiological informationB.10. Correlate the clinical physiologicalmeasurement to solve the clinical problem


D. GeneralSkills


D.6. Perform as a team..

Graduate should be able to:D.1. Demonstrate effective written and oralskills for presentation of scientificinformation to different audiences in thefield of anesthesia and intensive care .

D.2. Perform as a team and co-operate withcolleagues and seniorsD.3. Demonstrate commitment to lifelonglearning and professional service includingactive participation in professionalorganization.






Others

1. Cardiac cycle 2. Ventricular performance 3. Coronary circulation

physiology

4. Control of the circulation 5. Regulation of respiration 6. Pulmonary circulation 7. Mechanism of ventilation 8. Ventilation/perfusion

relationship

9. Gas exchange and transport 10 . Renal circulation 11.Urine formation 12. Water balance 13. Control of plasma osmolarity 14. Maintenance of acid base balance 15. Cerebral circulation 16. EEG evoked potential 17. Brain protection 18. Maternal physiology 19. Maternal physiology 20. Neonatal physiology 21. Temperature control

22. Molecular bases of musclecontraction

23. Homeostasis 24. Hepatic physiology 25. Pituitary hormones andhypothalamic control

26. Adrenocortical hormones 27. Insulin and glucagon 28. Calcium and phosphorusregulation



Case OSCE/OSPE


Others



Practical/Clinical Exam %Others %


Course Text Books Review of medical physiology



Course InstructorName: Prof Sobhy El Kafay Signature:



Course SpecificationsUniversity: AlexandriaFaculty: MedicineDepartment: Anaesthesia and Surgical Intensive Care

Course InformationCourse Code: 05010901 Course Name: Physics and Clinical

Measurements II


Number of Credithours: 3 hr

Theoretical1.5 hr

Clinical1.5 hr

Course Aims: The aim of this course is to upgrade the candidate abilities in:Physics in:

1. Understanding and safe use of anaesthesia equipment and monitoring systems2. The advances in the scope of physical knowledge applied to modern anaesthetic practice which

includes mathematics, machines, electronics, biomedical engineering and radioisotopes.Clinical measurements in:

1. Outlining the scientific principles underlying the design and function of the most commonly usedmonitors

2. Discussing the great and rapid advances in patient monitoring, interpret data from monitors and toanticipate errors associated with their use to optimize patient safety.

Intended Learning Outcomes (ILOs) for physics:Program ILO (refer toprogram matrix)

Course ILOs


Graduate of this course mustacquire knowledge tot:

A.6. List the physical principlesrelevant to anaesthesia

Graduate of this course must acquireknowledge tot:

A.1. Enumerate measurement of physicalquantitiesA.2. Describe mechanics including- force and motion – velocity andacceleration – work and energy – power –Newton lawsA.3. Mention exponential functionA.4. Describe structure and physical state ofmatterA.5. Define physical properties of matterA.6. State gas law

A.7. Mention the principlesunderling anaesthetic machinesand monitoring equipment

A.7.. Define heat and temperatureA.8.. Describe humidityA.9. Cite flow of fluidA.10..Describe pressureA.11. Describe electricity and electronicsA.12.Mention physical principles ofultrasound






C.1. Use recent anaesthesia machineC.2. Use Modern ventilatorsC.3. Employ recent monitoring devicesC.4. Infuse fluids using syringe and infusionpumps

D. GeneralSkills





D.1. Search the net for recent topics relatedto physicsD.2. Specify recent topics that helpsimproving his work

D.3. Present lecturesD.4. Organize seminarsD.5. Plan teaching strategy





E.1. Record the condition of anaesthesiamachineE.2. Record the available monitoring devicesE.3. Realize the availability of resuscitationequipment

Intended Learning Outcomes (ILOs) for clinical measurements:

Program ILO (refer to programmatrix)

Course ILOs


Graduate of this course mustacquire knowledge to

A.6. List the physical principlesrelevant to anaesthesia

A.7. Mention the principlesunderling anaesthetic monitoringequipment

Graduate of this course must acquireknowledge to

A.1. Describe basic principles ofmeasurements accuracyA.2. Cite principles of soundA.3. State principles of lightA.4 Identify principles of temperature

measurement

A.5. List principles of pressure measurement(mass, force and energy).A.6. Enumerate principles of flowmeasurement (volume flow meters, velocity,flow)



B.1. Select necessary investigationsaccording to situation



B.1. Specify the patient need for invasivemonitoringB.2. Select specific monitoring according topatient conditionB.3. Select special monitoring according tothe type of surgical procedureB.4. Interpret blood gas analysisB.5. Interpret acid base balance data

B.6.Relate cerebral function monitoring todepth of anaesthesiaB.7. Relate electromyography to degree ofneuromuscular blockB.8. Detect temperature disturbanceB. 9. Match serum electrolyte data withanaesthesia technique


Student should develop theappropriate skills in relation to



C.1. Record recent sophisticated monitoringequipmentsC.2. Diagnose using pulmonary arterycatheterizationC.3. Measure direct arterial blood pressureC.4. Employ anaesthetic technique for laserand surgical implicationsC.5. Record ECG monitoring

C.6. Measure respiratory function tests

D. GeneralSkills

Graduate should be able to:D.3. Design research protocols andco-operate in multidisciplinaryresearch teams.


Graduate should be able to:D.1. Demonstrate ability to app[y recentknowledge in the field of clinicalmeasurement to design research protocolsD.2. Demonstrate the necessary multi-disciplinary leadership to complete researchworkD.3. Use information technology to preparelectures and research

D.4. Teach less experienced colleagues ofall gradesD.5. Perform continuous evaluation sessions

Physics course Content(Units/Topics)




Others

Pressure and Gas laws Fluid flow-volume and flowmeasurement

Exponential function – SI units Physical properties of matters Heat and temperature – Humidity Electricity – Electric device inmonitoring

Sine wave and wave pattern Ultra-sound and monitoring

Clinical measurements courseContent (Units/Topics)




Others

Monitoring cardiovascular system Monitoring respiratory system Patient's safety. Serum electrolytes. Volume replacement Electrolytes replacement Nutritional support Patient's oxygenation Sepsis markers

Laser and surgical problems Co2 related problems Postoperative care


Case

Assignment

Others

Objective questions

OSCE/OSPE

Logbook fulfillment



Practical/Clinical Exam 20 %Others: Oral 10 %


Course Text Books 1. ParBrook Basic physics andmeasurements in anaesthesia

2. Miller's anaesthesia 7th edition


Journals and Periodicals, others British J of AnaesthesiaAnesthesiology

Course InstructorName: Prof. Hesham Fouad Shaaban Signature:


Program Director (Head of Department)Name: Prof. Nader El gaml Signature:



Faculty: Medicine


Course InformationCourse Code:05010902

Course Name:Anesthesia For General Surgery, Vascular andPlastic

Program in which the Course is GivenDoctorate Degree in Anaesthesia and Surgical Intensive CareNumber of Credit Hours 2 Theoretical Clinical/Practical

1- Course Aims: The aim of this course is to upgrade the candidate abilities in:1. The practical aspects of the administration of anaesthetics and adjuvant drugs and drug/drug

interaction.2. Management of difficult airway situations and emergency airway scenarios.3. Caring for the special needs of patients during ICU period.4. The specific modalities for pain management.5. Resuscitation


Course ILOs


Graduate of this program mustacquire knowledge about:A.4. Revise clear workingknowledge of anatomy applied inanaesthetic practice


A.8.. Describe specific pointsstressed upon during taking historyfrom the patientA.9. List steps of physicalexamination in medicallycompromised patient

Graduate of this program should be able toA.1.Identify basic anatomy of different partsof the endocrine system,

A.2. Review basic concepts of endocrine andtransplantation physiology,A.3.List the impact of physiologicderangements of different endocrinepathologies on the course of anesthesia.A.4. Enumerate basic knowledge necessaryto identify possible problems in geriatricpatients and patients subjected to endoscopicsurgery.

A.5. Describe full history taking fromgeriatric patientsA.6. List difficulties possible to happenduring anesthesia of geriatric patients

11


Graduate should be competent to:B.1. Select necessary investigationsaccording to situation



B.7. Select proper drugs accordingto patient condition.



Graduate should be competent to:B.1. Recognize different problemsanticipated in patients with endocrinedisorders

B.2. Integrate physiology with the clinicalconditions of geriatric patients.B.3. Analyze clinical and lab data amongpatients undergoing organ transplantation.

B.4. Interpret pharmacological principlesconcerned with drug application duringanesthesia endocrine surgery.

B.5. Solve problems of drug-druginteractions.B.6. Use clinical judgment to selectappropriate anesthetic techniques intransplant surgery

B.7. Interpret abnormal findings andanticipate problems.B.8. Anticipate potential complicationsduring surgery of the endocrine glNDS.B.9. Predict occurrence of problems.B.10. Design preventive strategies forpotential complications.

Student shoulddevelop theappropriateskills in orderto:C. ProfessionalandPractical Skills

Student should develop theappropriate skills in order to:C.1. Practice central cannulationfor difficult cases.



.

Student should develop the appropriate skillsin order to:C.1. Apply invasive monitoring devices.C.2. insert central venous cannula indifficult situations.

C.3. Perform different advanced airwaymanagement skills to solve airway problemsof such patient populations.

C.4. Determine the hydration status of suchpatients.C.5. Determine patients need of differenttypes of fluid management.

D. GeneralSkills

Graduate should be competent inthe following:

Graduate should be competent in thefollowing:D. 1. Develop skills in reading and research.


D.3. Design research protocols andco-operate in multidisciplinaryresearch teams


to be aware of recent advances in eachspecific field.D.2. Use modern computing resources fordata handling, information retrieval,document preparation, presentation andcommunicationD.3.Develop skills in communication.

D.4. Use various sources of information todesign research protocols.D.5. Develop team work.D.6. Use information from network search tocomplete scientific research

D.7. Design power point presentationD. 8. Present clearly and effectivelyscientific topics.



Graduate should be able to:E.1. Demonstrate professionalism and highethical standards specifically competence,honesty , integrity, compassion, respect forothers, professional responsibility and socialresponsibility.E.2. Contribute appropriately to patientmanagement.





Others(casestudies)

Laparoscopic surgery: ventilation &haemodynamic problems.

√ √ √

Endocrinal surgeries: diabetic patient,Hypo & hyperthyroidism,pheochromocytoma, adrenal glanddisorders, parathyroid disease.

√ √ √

Transplant surgery: transplantationimmunology, preoperativepreparation of donor & recipient,perioperative management of renal,hepatic, heart & lung transplantation.

√ √ √ √



Case OSCE/OSPE


Others




List of Textbooks and ReferencesLecture Notes Presentations and Assignments

Course Text Books MillarLongneck

Suggested Extra Reading Online different anesthesia websites.

Journals and Periodicals, others BJA, EJA,Anesthesiology, Anesthesia Analgesia.

Course InstructorName: Prof Hossam El-Din Fouad Rida Signature:

Program CoordinatorName: Prof Wafaa Shafshak..

Signature:

Program Director (Head of Department)Name: Prof. Naer El Gamal Signature:

√ √

√ √

√ √

Course SpecificationsUniversity : Alexandria

Faculty: Medicine


Course InformationCourse Code: 05010903 Course Name: Cardiothoracic Anesthesia II


Number of Credit Hours : 2h Theoretical Clinical

Course Aims :The aim of this course is to upgrade the candidate abilities in:

1. Conducting safe and effective perioperative anaesthetic care to patients undergoing electiveand emergency complex/major thoracic and cardiac surgery.

2. The design of anaesthetic plan for different scenarios of intra-operative as well aspostoperative problems in pediatric and adult surgical cases in cardiothoracic surgeryareas.

3. Acquiring knowledge, skills and experience in dealing with patients undergoing cardiac andthoracic surgery.

4. Becoming familiar with recent developments in perioperative anesthetic care to this area ofpractice.

5. Providing teaching to less experienced colleagues of all grades.


Course ILOs





A. 1. Discuss the pharmacological effects ofdifferent cardiovascular drugs especially theinotropic drug support during and after opencardiac surgery.A. 2. Discuss the pharmacological effects ofdifferent anesthetic drugs on cardiacperformance during and after open cardiacsurgery.

11

A.5. Describe the impact ofphysiologic derangement on thecourse of anesthesia

A.7. Mention the principlesunderling anesthetic machines andmonitoring equipment.



A.11. Define special laboratoryinvestigations

A.18. Cite steps for managementof patient during intensive careunit stay.

A.3. Describe the physiology of pulmonarycirculation.A.4. Describe the physiology of different

cardiac lesion especially congenital heartlesions.A.5. Mention the physiology and describeanesthetic and perfusion strategies ofcardiopulmonary bypass during open cardiacsurgery.

A.6. List the principles of invasivecardiovascular monitoring during opencardiac surgery.A.7. List the components ofcardiopulmonary bypass systemA.8. List physical principles of coolingmeasures

A.9. Explain cardiac history, heart failure,myocardial infarction, hypertension,diabetes mellitusA.10 Explain the importance of history ofprevious cardiac and non cardiac surgeryprevious cardiac surgeries.

A.11. Explain cardiovascular examination ofpatients scheduled for cardiac surgeryA.12. Explain examination of respiratorysystemA.13. Mention the importance of extremitiesexamination. before thoracic surgeryA.14. Describe signs of heart failure andmediastinal syndrome.

A.15. Enumerate cardiac enzymeA. 16. Define coagulation profile,A.17. Describe echocardiography studiesA.18. Explain cardiac catheterization.

A.19. List indications of ventilation aftercardiothoracic surgeryA.20. Mention precautions beforeadministration of inotropic drug,A.21. Enumerate measures for temperatureregulationA.22. List steps for control of bleeding


A.23. List steps for pain management.

A.24. Describe resuscitation of bleeding,A.25. Mention resuscitation guide fordifferent types of cardiac arrhythmiasA.26. List recent guidelines for advancedcardiac life support



B.1. Select necessaryinvestigations according tosituation.



B. 7. Select proper drugadministration according to patientcondition

.

B.12. Design strategies for acuteand chronic pain management


B.1. Detect advanced renal function tests incase of renal impairment,B.2. Predict effects of heparin antibodies incase of HIT syndromeB.3.Interpret markers of inflammatoryresponse in case of sepsis

B.4. Identify liability of bleeding in cases ofredoes surgeries.B.5.expect liability of IABP use in case ofpoor LV function.

B.6. Predict prolonged inotropic supportB.7. Predict patients requiring mechanicalventilation.B.8.Predict bleeding problems after

prolonged CPB & concomitant valve CABGsurgery.

B.9. Design strategies for use of inotropicdrugs.B.10.Design strategies for use ofvasodilators according to the condition ofthe myocardium after CPB.

B.11. Interpret the use of multimodalanalgesia for acute postoperative paincontrolB.12.Interpret the use of patient controlledanalgesia for postoperative pain.


Student should develop theappropriate skills in order to:

C.1. Practice central cannulationfor difficult cases.

Student should develop the appropriateskills in order to:

C.1. Perform arterial cannulation.



C.7. Use advanced ventilationmodes

.

.




C.2.Perform central venous cannulation inelective as well as emergency situations inboth adult and pediatric patients.

C.3. Monitor invasive arterial BPC.4.Monitor pulmonary & systemic vascularresistance with monitors including .C.5.Monitor myocardial performance usigtransoesophageal echocardiography.

C.6.Apply advanced modes of mechanicalventilation.C.7. Wean patient from mechanicalventilation according to the standard criteriaafter cardiac surgeryC.8. Re ventilate patient whenever needed.

C.9. Apply the proper ventilation mode inthe ICU for adult.C.10.Apply the proper ventilation modes in

pediatric patientsC.11.Apply the new methods of ventilation.

C.12. Administer correct types and volumeof iv fluids.C.13.Infuse blood and blood productsguided by the blood loss, hemodynamics,CVP, in both adult & pediatric patients aftercardiac & thoracic surgeries.

C.14. Lead cardiopulmonary resuscitation incases of life threatening situations in theoperating room and ICU.

C.15. Write operating room sheetC.16.Write ICU records

D. GeneralSkills



Graduate should be able to:D.1. Demonstrate ability to network search

for recent advances in the field ofcardiothoracic and open heart anesthesia.D.2. Apply recent knowledge to improvepractice

D.3. Use information technology to preparelecturesD.4. Acquire skills for presenting lectures


D.5. Prepare scientific talks

D.6. Observe team working under hissupervisionD.7. Advice to junior staffD.8. Conduct frequent testing to more juniorteam membersD.9. Demonstrate the necessary multi-disciplinary leadership,






Graduate should be able to:E.1 Explain detailed anesthetic techniqueE.2. Provide idea about postoperative course

E.3. Demonstrates effective communicationskills with patients and relativesE.4. Allay anxiety in patients with severeanxiety and stress.


E.7. Check of anesthesia machines andequipments as wellE.8. Check all drugs, blood and bloodproducts.





Others

Physiology of pulmonary circulation Anesthesia for mediastinal syndrome Anaesthesia for lung volumereduction surgeries

Anesthesia for congenital heartdisease undergoing closed cardiacsurgery

Anesthesia for congenital heartdisease undergoing open cardiacsurgery

Anesthesia for valvular heart diseases Anesthesia for CABG surgery Cardiopulmonary bypass Recent trends in cardiac anesthesia One lung anesthesia and anesthesiafor thoracoscopic surgery

Anesthesia for tracheal resection&esophageal surgery.

Preoperative assessment for cardiacsurgery.



Case OSCE/OSPE


Others

Schedule of AssessmentEnd of term 100 %

Distribution of Marks Written Exam 70 %Practical/Clinical Exam 20 %Others 10 %

List of Textbooks and ReferencesLecture Notes All lecture notes included in the course

Course Text Books Miller MD, Anesthesia.Morgan ’s clinical anesthesiology.

Suggested Extra Reading Kpplan’s cardiac anesthesia.

Journals and Periodicals, others BJA- Aesthesiology- Aneshtesia Analgesia

Course InstructorName: Prof Dr: Said Mohamed Elmedany. Signature:

Program CoordinatorName: Prof Dr: Wafaa Shafshak Signature:Program Director (Head of Department)Name: Prof Dr: Nader El Gamal Signature:

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