Introduction to Subject Anaesthesiology & Resuscitation

INTRODUCTION TO SUBJECT ANAESTHESIOLOGY & RESUSCITATION

MUDr. Jozef Firment, PhD.

Head of the Department

MUDr. Antigona Studená, CSc.

Assistant Professor, Senior Lecturer

DIFFERENTIAL MEDICAL CARE IN SLOVAK REPUBLIC

1. Intensive (Critical) Care (ICU, CCU, ITU, ARO, OAIM)

2. Intermediary care unit

3. Standard – ordinary care

4. Long duration and rehabilitation care

5. Nursing care

6. Hospices

COMPONENT PARTS OF ANAESTHESIOLOGY & INTENSIVE CARE

1. Anaesthesiology

2. Intensive (Critical) Care Medicine

3. (Pre-hospital) emergency care, acute medicine, life-treating situations

4. Algaesiology

TYPES OF ANAESTHESIA

•General

•Regional

AVAILABILITY OF ANAESTHESIA

•Diagnostic procedures

•Therapeutic (surgical) procedures

HISTORY

•3500 BC – Genesis, mouth-to-mouth ventilation

•Antiquity – opium, alcohol, mandragora

•800 AD – mandragora, opium, hemp

•1516 – curare

•1562 – regional compress n. roots

•1646 – regional anaesthesia by cold

•1657 – IV opium in dog

•1844 – nitrous oxide (“laughing gas”)

•1846 – ether – “gentleman this is no humbug!”

•1846 – ether in Europe

•1847 – chloroform anaesthesia

•1848 – the first death under chloroform

•1885 – cocaine epidurally

•1898 – subarachnoidal anaesthesia

•1960 – modern CPR

prim. MUDr. Anton Lučanský CSc.

*28.2.1929 Plechotice

†20.9.1997 Prešov

•1953 graduation in LF UPJŠ

•ass. physics LF UPJŠ

•1955 Prešov, Surgery

•1957 certified in Surgery

•1960 certified in A+R

•6.10.1966 founded 1st ward ICU in Slovakia in Prešov

•1967 first CSc. degree in A+R in Czechoslovakia

•1971 county expert in A+R

•1991 2nd Postgrad Clinic

prof. Wiliam Ganz MD. PhD. F.A.C.C.

*7.1.1919 Košice

- 1937 Košice, school-leaving exam gymnasium

- 1947 Praha UK graduation MD.

- 1947 – 1951 internist Bulovka

-1966 U.C.L.A.

-1970 introduced to clin. praxis with Swan S-G catheter

-1970 ass. professor

-1972 professor

SUBJECT: ANAESTHESIOLOGY & RESUSCITATION

•Lectures within Surgery up to 1990

•Independent subject A+R since 1990

•I. KAR established 17.5.1996

•28 anaesthesiologists

•54 nurses

CURRICULUM A+IM

•2 hours/ week lectures (14 x)

•2 hours/ week practices / study group (14 x)

•Credit test, Practical exam CPR

•Credit

•Exam

THESIS OF LECTURES

•Introduction to A+IM. History. Organisation

•Cardio-pulmo-cerebral resuscitation.

•General patient preparation to anaesthesia. Patients’ preparation for anaesthesia with the most frequent co-existing diseases.

•General anaesthesia.

•Regional anaesthesia.

•Anaesthesia in special surgery.

•Monitoring in anaesthesiology & ICU

•Acute poisoning.

•Misbalance of water and electrolytes.

• Infusion therapy.

•Artificial nutrition. Enteral and parenteral.

•Respiratory failure.

•Unconsciousness, transplant program.

•Shock. Multi-organ failure. Basal algorithms in emergency medicine.

INFLUENCE OF LOS BEFORE ADMISSION TO ICU TO MORTALITY

•Anaesthesiology working place, ICU.

•Airway equipment. Endotracheal intubation

•CPCR training with fanthom

•Pre-anaesthetic assessment and premedication. Drugs in anaesthetic praxis.

•Spinal anaesthesia. Epidural anaesthesia. Peripheral neural blocks

•Anaesthetic apparatus. Monitoring equipment.

•ABB problems. Oxygen therapy.

•Water balance. Infusion therapy, fluids.

•Artificial nutrition. Farmacotherapy in ICU.

•Artificial ventilation and equipment.

•Central vein canullation. Invasive BP measurement. Shock treatment.

•CNS injuries. Neuro-surgical pts. GCS.

•Intoxication, elimination methods, antidotes.

STUDY LITERATURE FOR ANAESTHESIOLOGY & INTENSIVE CARE

•Adams A. P., Cashman J. N. :

Anaesthesia, Analgesia and Intensive care (1991)

•Campbell D., Spence A. A. :

Anaesthetics, Resuscitation and Intensive Care (1997)

•King M. H. :

Primary Anaesthesia (1994)

•Rushman G. B., Davies N. J. H., Cashman J. N.: Lee‘s Synopsis of Anaesthesia (1999)

•Skinner D., Vincent R. :

Cardiopulmonary resuscitation (1993)

•Aitkenhead A. R., Smith G. :

Textbook of Anaesthesia (1996)

•Oh T. E. :

Intensive Care Manual (1997)

•Hinds C. J., Watson:

Intensive Care (1997)

ŠTUDIJNÁ LITERATÚRA

•Bohuš O.: Anestéziológia a resuscitológia a intenzívna starostlivosť (1987, 1992)

•Bohuš O.: Anestéziologické komplikácie

•Larsen R.: Anestezie (1998)

•Firment J., Studená A.: Vybrané kapitoly (1998)

•Ševčík P. a kol.: Intenzivní medicína (2000, 3)

•Firment J., Studená A.: Anestéziológia a intenzívna medicína (2001, 2004)