MEDICAL SCIENCES

Integrated educational activity

Course Sheet

Course code:

OD24

Academic Year of enrolment:

2020

Year of supply:

2023/2024

Degree:

Course of Single Cycle Degree 6 years in SCHOOL OF DENTAL MEDICINE

Language:

Italian

Moduls:

ANESTESIOLOGY AND - 6 credits
INTERNSHIP IN ANESTHESIOLOGY - 4 credits
GENERAL SURGERY - 5 credits

Location:

CHIETI

Credits:

Programme Year:

Cycle:

Single Annual Cycle

Hours of classroom activity:

210

Prerequisites:

As required by the academic regulations

Objectives

ANESTHESIOLOGY AND EMERGENCY TREATMENT
The teaching of Anesthesiology is included in the Integrated Course of Medical Sciences. The student must understand what are the fundamental principles at the basis of science which, defined as Anesthesia and Resuscitation, covers a very broad field of skills (general anesthesia, loco-regional anesthesia, pain therapy, hyperbaric therapy, intensive care, resuscitation). He will thus be able to realize what the role of the Anesthesiologist-Resuscitator Medical Specialist may be in the clinical path of a patient to undergo painful procedures in a broad sense. The student will know the basics of general and loco-regional anesthesia, the indications, the relative and absolute risks and the safety levels of the different techniques. The most commonly used analgesic protocols and the pharmacological indications applicable to dentistry will also be addressed. The main monitoring systems and the basics of respiratory and cardiocirculatory assistance, which are the basis of cardiopulmonary resuscitation (CPR), will be addressed. Because every healthcare professional should have the basics of the Basic Lite Support-Early Defibrillation (BLS-D), relevant lessons and seminars and a practical training session will be provided.

GENERAL SURGERY
Specific training objectives of General Surgery are: understanding the aspects of surgical anatomy, physical and instrumental semeiotics and the general elements of surgical therapy as well as etiology, pathogenesis, pathophysiology, clinical presentation, diagnosis and therapy of diseases of surgical interest; to define the general principles for the execution of a medical visit and to apply the right methods and techniques for collecting the medical history, to conduct physical examination, to prescribe instrumental exams to be able to make a differential diagnosis; to identify, assess and manage surgical emergencies; to understand the right methodological approach for dealing with the different clinical situations, providing the main notions for surgical therapies relating to the most frequently encountered pathologies; to understand the basis for an adequate communication with the patient, family members and colleagues

Contents

ANESTHESIOLOGY AND MANAGEMENT OF EMERGENCIES
- History of Anesthesiology, definition of the tasks and the current role of the Anesthesiologist-Intensivist
- Anesthesiological approach to surgery: the perioperative risk, the choice of technique, pre-anesthesia, the planning of pain control, the choice of the path (outpatient, day surgery, ordinary hospitalization)
- The satisfaction of the patient's needs: correct information, informed consent and legal implications; the medical record
- The preparation of the candidate for anesthesia: venous cannulation, monitoring of vital functions
- General anesthesia: techniques, inhalation anesthetics, intravenous anesthetics, complementary drugs of general anesthesia: analgesics, neuromuscular blocking agents
- The instruments: anesthesia machines and ventilators
- Phases of general anesthesia: induction, maintenance, awakening, etc.
- Complications of general anesthesia
- Airway management: indications, techniques and instruments, complications
- Anatomical and physiological aspects of nerve conduction
- Paths of pain of dental interest
- Pain: symptom and disease
- Treatment of pain in the outpatient patient: limits and indications
- Loco-regional anesthesia: techniques, fields of use, instruments for loco-regional anesthesia
- Characteristics of local anesthetics and classification
- Pharmacological aspects of local anesthetics: mechanism of action, metabolism, toxicity, main local anesthetics, and complementary agents
- Techniques of loco-regional anesthesia in dentistry and indications
- Complications of loco-regional anesthesia, prevention, and treatment
- Outpatient anesthesia: indications and limits, techniques, drugs, conscious sedation
- Risk in the dental clinic and prevention: assessment and monitoring of subjects, anxiety and psycho-pharmacological anxiolysis
- Particular patients (children, patients with handicap, patients with cardiovascular problems, etc.)
- Outpatient emergencies: lipotimia, acute respiratory failure, anaphylactic-anaphylactoid reactions, anginal crisis, convulsions, sepsis, etc.
- Drugs and emergency equipment
- Diagnostic and therapeutic guidelines in craniofacial pain syndromes

GENERAL SURGERY
The course aims to provide students with the knowledge of pathophysiology, diagnostics, and therapy of most common diseases during surgical procedures in the patient undergoing dental treatment.
Students will have to acquire a clinical preparation to recognize and treat diseases of surgical interest. In particular, based on the pathophysiology of organs, systems and elements of clinical semeiotics, students will be trained in a diagnostic methodology, also instrumental, aimed at recognizing specific diseases or functional alterations.
Notions of differential diagnostics and criteria for operative indication will be provided.
The program consists of two parts: a general and a special one. The first includes surgical topics not related to organ pathologies; the second part examines the main clinical syndromes related to organic pathologies of surgical interest.

INTERNSHIP
- Cardiac arrest and situations of risk. Cardiopulmonary resuscitation: BLS-D principles
- BLS-D theoretical and practical exercise and ALS principles
- Attendance in the Operating Room and in Intensive Care Unit

Extended Syllabus

ANESTHESIOLOGY AND MANAGEMENT OF EMERGENCIES
- History of Anesthesiology, definition of the tasks and the current role of the Anesthesiologist-Intensivist
- Anesthesiological approach to surgery: the perioperative risk, the choice of technique, pre-anesthesia, the planning of pain control, the choice of the path (outpatient, day surgery, ordinary hospitalization)
- The satisfaction of the patient's needs: correct information, informed consent, and legal implications; the medical record
- The preparation of the candidate for anesthesia: venous cannulation, monitoring of vital functions
- General anesthesia: techniques, inhalation anesthetics, intravenous anesthetics, complementary drugs of general anesthesia: analgesics, neuromuscular blocking agents
- The instruments: anesthesia machines and ventilators
- Phases of general anesthesia: induction, maintenance, awakening, etc.
- Complications of general anesthesia
- Airway management: indications, techniques and instruments, complications
- Anatomical and physiological aspects of nerve conduction
- Paths of pain of dental interest
- Pain: symptom and disease
- Treatment of pain in the outpatient patient: limits and indications
- Loco-regional anesthesia: techniques, fields of use, instruments for loco-regional anesthesia
- Characteristics of local anesthetics and classification
- Pharmacological aspects of local anesthetics: mechanism of action, metabolism, toxicity, main local anesthetics, and complementary agents
- Techniques of loco-regional anesthesia in dentistry and indications
- Complications of loco-regional anesthesia, prevention, and treatment
- Outpatient anesthesia: indications and limits, techniques, drugs, conscious sedation
- Risk in the dental clinic and prevention: assessment and monitoring of subjects, anxiety and psycho-pharmacological anxiolysis
- Particular patients (children, patients with handicap, patients with cardiovascular problems, etc.)
- Outpatient emergencies: lipotimia, acute respiratory failure, anaphylactic-anaphylactoid reactions, anginal crisis, convulsions, sepsis, etc.
- Drugs and emergency equipment
- Diagnostic and therapeutic guidelines in craniofacial pain syndromes

GENERAL SURGERY
GENERAL PART
Surgical infections: local and generalized
Injuries from traumatic agents.
Wound healing process.
Burns.
The body's reaction to trauma.
Shock : hypovolemic, septic and cardiogenic.
Hydro-electrolytic disturbances and acid-basic alterations of surgical interest.
Surgical intervention: metabolic changes, modifications of kidney, liver and respiratory function; assessment of operative risk.
Artificial nutrition: enteral, parenteral.
Tumors: generalities, classification, mode of diffusion, stages.
Transplantation: generalities; notions about organ transplants: skin, kidney, liver, pancreas, heart, lungs, multiorgan.

SPECIAL PART
Pathology of the esophagus and esophagus-gastric junction.
Diaphragmatic diseases.
Pathology of the stomach and duodenum.
Pathology of the small and large intestine.
Proctological pathology.
Hernias of the abdominal wall.
Laparocele.
Pathology of the liver and biliary duct.
Pathology of the pancreas.
Pathology of the spleen.
Arguments of emergency surgery.
Arguments of endocrine surgery.
Arguments of chest surgery.
Arguments of vascular surgery.
Syndromes of surgical interest.

Recommended Bibliography

ANESTHESIOLOGY AND EMERGENCY TREATMENT
- G. Manani e Coll. "Anestesia Odontostomatologica" Il Ed. ldelson-Gnocchi 2003
- European Resuscitation Council. Guidelines for Cardiopulmonary Resuscitation 2015. Resuscitation 2015;95:1-311
- S.F. Malamed. Manuale di anestesia locale. Quinta edizione, 2006. Elsevier-Masson

GENERAL SURGERY
Davide F. D’Amico: “CHIRURGIA GENERALE – Fisiopatologia Clinica e Terapia” Ed. Piccin, Padova, 2006

INTERNSHIP
Material provided by the course teachers (slides, lecture notes)

Teaching Methods

Lectures; discussion of clinical cases; simulation and hands on (BLS); clinic internship

Evaluation methods

Verification of learning:

Integrated assessment with all the teachers of the Integrated Course
Learning assessment will be carried through an exam consisting of an oral test on the program’s topics to verify whether the student has achieved the expected goals, assessing his / her ability to present, with adequate completeness, the different topics discussed during the exam.

Contacts/More Information

Attendance at the courses according to the calendar scheduled at the beginning of the academic year, with required attendance of not less than 70% of the courses, attendance signatures will be issued at the end of the course. Making up lessons for students who have at least 50% of attendances in class will be agreed with the teachers on an individual basis.
ANESTHESIOLOGY - Teacher: Prof. Salvatore M. Maggiore (Director of the School of Specialization in Anesthesia, Resuscitation, Intensive Care and Pain Therapy; salvatore.maggiore@unich.it)

Tutors and experts on the subject:
- Dr. Vittorio Lalli (Pain Service, ASL2 Chieti)
- Dr. Giovanni Iovino (Anesthesia and Intensive Care, ASL2 Chieti)
- Dr. Sara Sabbatini (Anesthesia and Intensive Care, ASL2 Chieti)
- Dr. Luigi Ferrante (Anesthesia and Intensive Care, ASL2 Chieti)

Università degli Studi
"G. d'Annunzio"

Chieti - Pescara

Aree