Ateneo - UPO

The course aims to provide the students with general and specific notions on the most common symptoms and pathologies in the field of emergency/urgency to guide them on the diagnostic and therapeutic pathways that characterize the clinical activity of first aid and semi-intensive care. Particular attention is given to the method of clinical evaluation of the patient with identification of the patient's problems, determination of priorities and setting of a therapeutic diagnostic path based on a problem solving plan. These objectives assume a dominant role in the training activities, carried out both in the Emergency Department and the SIMNOVA simulation center, where the students are asked to participate in the discussion of simulated clinical cases, also with the use of dedicated software, and carry out practical exercises on specific invasive maneuvers, in order to learn the indications of several invasive maneuvers (thoracentesis, paracentesis, lumbar puncture), the effective communication to the patient in order to acquire informed consent, the maintenance of sterility and, through the use of special simulators, execution techniques.

Current emergency medicine diagnosis and treatment, Lange 8th edTitinalli's Emergency medicine: a comprehensive study guide McGraw-Hill, 9th ed

An emergency is commonly defined as any condition perceived by a technically trained person that requires immediate medical or surgical evaluation and treatment. Based on this definition, the American College of Emergency Physicians states that the practice of emergency/urgency medicine has the primary mission to evaluate, manage, and provide treatment for patients with unexpected illnesses and injuries. In this perspective, the awareness of time as a resource and as an element capable of hugely influencing the prognosis of various acute conditions (time-dependent pathologies) acquires particular importance. The objective of the module is to transmit the working method that applies to emergency, describe what a doctor must do if she/he is in emergency condition, illustrate the pathophysiology, diagnostics, and treatment of the main rapidly evolving acute conditions. A further objective of the module is to teach a particular clinical approach which may not necessarily lead to a limited diagnosis but rather to a mental process aimed at managing a disease which threatens the life or integrity of the patient. In conclusion, the module aims to teach how to make treatment decisions based on a real-time evaluation of the medical history, objective findings, and the results of diagnostic investigations. In this path, the practical and exercise activities carried out at the simulation center (SIMNOVA) and at the Emergency Department (a total of three weeks of training are foreseen) are of great importance.

Having succeeded the following examinations: medical pathology I and II and special pharmacology.

Lectures (partly delivered remotely and made available in podcasts), discussion of interactive clinical cases, resolution of simulated clinical cases using "Body Interact" software. Practical exercises concerning invasive maneuvers with dedicated simulators (thoracentesis, paracentesis, lumbar puncture). All the teaching material of the course, supplementary and in-depth material and the recordings of the lessons made available in podcasts can be found on the appropriate space of the University Moodle platform (Ditattica in Rete - DIR).

Written exam with multiple choice questions to be performed via computer interface using the DIR platform. The exam is always performed as a single quiz, including questions relating to the other modules of the Integrated Course.

1) Introduction to emergency medicine, triage and the emergency physician approach.2) Acute dyspnea and respiratory failure: acute pulmonary edema, exacerbation of COPD, acute asthma, acute pulmonary embolism.3) Shock, the cardiovascular triad, clinical pathophysiology of shock, hypovolemic shock, cardiogenic shock, distributive shock (septic and anaphylactic)4) Chest pain: STEMI and non-STEMI acute myocardial infarction, pericarditis, aortic dissection.5) Abdominal pain: "surgical abdomen, non-surgical abdomen", occlusions and pseudo-occlusions; renal and hepatic colic.6) The main toxidromes.7) Syncope.8) Hypertensive emergencies and urgencies.9) The ECG in emergency-urgency setting.10) Peri arrest rhythms.11) The ischemic and hemorrhagic stroke.12) Alterations of fluids and electrolytes and acid-base.13) The apparently stable trauma patient in the Emergency Department.14) The main endocrinological emergencies and urgencies.

It is expected that students, at the end of the course:1) know the emergency-urgency working method and the consequent organization of the emergency-urgency network, both extra- and intrahospital;2) are aware of the determining role of time, as a limited resource in emergency-urgency contexts and as a dominant prognostic factor in many acute conditions (time-dependent pathologies);3) recognize the modes of presentation of the main pathologies in emergency-urgency through an approach based on the main "signs and symptoms";4) know how to recognize the clinical elements that distinguish the critically ill patient with emergent-urgent conditions from the one with non-urgent conditions.5) be able to recognize and to know how to implement actions aimed at stabilizing the patient;6) demonstrate their ability to recognize the most serious potential causes that can justify the patient's clinical presentation;7) are able to correctly evaluate the presence of several causes that justify the patient's conditions (differential diagnosis) and to plan appropriate laboratory and/or instrumental diagnostic procedures to either exclude or confirm the diagnostic hypotheses with adequate accuracy;8) are able to understand how complete the intervention must be also for the purposes of diagnosis, identifying those patients who can be discharged even without a specific diagnosis;9) are able to set up appropriate pharmacological treatments for the main emergency-urgency pathologies;10) know the criteria for hospitalization of the patient and discharge from the Emergency Department, demonstrating awareness of the appropriate use of resources and the need to act with prudence, to protect the patient's health.