1
Lections on Intensive therapy and Reanimatology
Xth semester 5th course General Medicine Faculty
1. Evaluation of vital body functions during resuscitation: Electroencephalography (normal, in state of
general anesthesia, signs of hypoxia, hypercapnia, hypocapnia). Evaluation of respiratory function.
Hemodynamic evaluation. ECG. Assessment of blood loss and the volume of circulating blood. Blood gases
analysis and acid-base balance. Evaluation of water and electrolyte balance. Evaluation of excretory functions.
Assessment of risks for anesthesia.
2. Hemostasis. Acute coagulopathy. DIC-syndrome. Intensive care for patients with DIC due to sepsis.
Literature list:
1.The ICU Book Paul L. Marino 1998. – ISBN 5-88816-025-3 (book 1);
2. Emergency Medicine Scott H. Plantz and J.N. Adler 1998. 780 p. (book 2).
Subject plan of practical training on intensive care and resuscitation
for V course students medical faculty.
№
1.
Theme
The object and purpose of intensive care and resuscitation.
Terminal state. Clinical, biological, social death.
Pathophysiology, clinical signs. Pathogenesis of death with
electric shock and drowning. Methods of recovery of the body.
Cardiopulmonary resuscitation. Practical skills of resuscitation:
work with phantom. Familiarity with the organization and
equipment of the ICU.
Hours
4
Home task to the lesson.
Book №1part IV chapter 17,18 р. 260-298.
Book № 2 chapter. 1 p. 3-31; chapter. 21 р.
662-663; р. 666-667.
2.
Acute respiratory failure. Etiology, pathogenesis, clinical picture, diagnostics. Lung ventilation. Intensive care in case of a
4
Book №1 part 1 р. 19-49, part 4 chapter. 2125р. 339-481
2
3.
4.
5.
6.
7.
foreign body in the upper respiratory tract, asphyxia, laryngeal
stenosis, angioedema, status asthmaticus, respiratory distress
syndrome, massive pneumonia. Tracheostomy. Inhalation therapy.
Acute cardiovascular failure. Special features of intensive care.
Left ventricular failure: acute coronary syndrome. Acute myocardial infarction. Cardiac asthma. Pulmonary edema. Arrhythmic complications of AMI. Drug defibrillation. Indications for cardioversion. Right ventricular failure: pulmonary
thromboembolism. Circulatory collapse.
Critical care in shock of various etiologies (cardiogenic, hemorrhagic, traumatic, burn, septic, anaphylactic shock). Supervision of patients (case studies to produce a prescribing sheet for
ICU patients).
Coma. Types (traumatic, seizures, due to poisoning, dysmetabolic coma). Pathogenesis, clinical picture, diagnosis. Specifics
of intensive care in case of diabetic coma, uremic coma, hepatic coma, chlorhydropenic coma, epileptic coma, acute cerebrovascular accident, cerebral edema. Correction of the acid-base
balance, fluid and electrolyte balance.
General principles of continuous infusion therapy. Technique.
Infusion mediums. Infusion program. Blood substitutes.
Transfusion of blood and blood products. Parenteral nutrition.
Enteral nutrition. Prevention of infectious and trophic
complications.
Critical care in case of exogenous (acute poisoning) and en-
Book № 2 chapter 3 р. 109-135; chapter. 10
р. 295-302
4
Book №1 part 4 chapter 16 р. 242-259; part
5 chapter 19-20 р. 301-335; part 2 chapter 7
р. 106-120.
Book № 2 chapter 2 р. 37-106.
4
Book №1 part 4 chapter 14 р. 207-227
Book № 2 р. 49-50; chapter 10 р. 295-300;
chapter. 17 р. 521-523; р. 528; р. 191-194.
4
Book №1 part 12 chapter 50 р. 779-818; part
10 chapter 39 р. 619-630; part 9 chapter 37
р. 592-607; chapter 38 р. 608-616; chapter
52 р. 806-818.
Book № 2 chapter 7 р. 229-245; chapter 8 р.
247-262; chapter 9 р. 263-283.
Book №1 part 4 chapter 15 р. 228-241; part
11 chapter 44-45 р. 691-718; part 12 chapter
46-48 р. 691-765; part 10 chapter 40-43р.
631-688.
Book № 2 chapter 16 р. 491-495.
Book №1 part 14 chapter 53 р. 821-847;
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4
3
8.
dogenous (acute hepatic and renal insufficiency) poisoning.
Antidotes. Extracorporal deintoxication (hemodialysis, hemodialysis and limfosorbtion, plasmapheresis). Transumbical infusion therapy. Endolymphatic therapy. At the end of the class
students should perform prescribing sheets for ICU patient (1
day treatment).
Preoperative preparation in patients with concomitant diseases.
Intensive
therapy
in
postoperative
period.
part 9 chapter 37 р. 592-607; part 10 chapter. 39 р. 619-630
Book № 2 chapter 20 р. 605-642; chapter 5
р. 173-175.
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Final thematic tests: Computer testing of theoretical training in
intensive care and reanimatology. Control of lecture notes.
Test on tickets.
Total hours of practical training:
34
Book №1 part 2 chapter 8 р. 121-139
Book № 2 chapter 19 р. 585-601.