Learning objectives
First Dublin descriptor: knowledge and understanding
At the end of the course, students must be able to recognize the clinical characteristics of the main conditions that can be found in the everyday practice of an Emergency Department, with particular focus on cardiological, respiratory and neurological emergencies. They must also have appropriate knowledge of the main algorithms of diagnosis, treatment and management associated with these emergencies. They must also know the principles of triage and organization of an Emergency Department.
Second Dublin descriptor: applied knowledge and understanding
Students must reach a sufficient capacity of applying guidelines related to the management of the main cardiological, respiratory and neurological emergencies and urgencies. In particular, they must be able to find a way among prescription of laboratory and instrumental examinations, therapeutical prescriptions and organization of healthcare at the pre-hospital and hospital level.
Third Dublin descriptor: making judgements
Students must be able to recognize the main medical and surgical emergencies and give appropriate counselling on the most appropriate management.
Fourth Dublin descriptor: communication skills
Students must prove to have acquired a sufficient level of mastery of specific medical jargon related to emergencies.
Fifth Dublin descriptor: learning skills
At the end of the course, students must prove to have acquired a method of clinical reasoning, allowing them to effectively approach even situations or clinical scenarios not met before.
Prerequisites
Knowledge of physiopathology, semeiotics and clinical methodology, basics of clinical pharmacology.
Course unit content
The "Internal Medicine" module is integrated within the course of "Urgency Medicine and First Aid" with the aim of giving medical students knowledge of the approach to the main medical emergencies in both a territorial and hospital context, with particular focus on the management of these conditions in an hospital Emergency Department. Students will have to be able to orient themselves in the differential diagnosis of the main acute symptoms, know the main diseases of interest in the context of emergency-urgency medicine, know the main life-saving manoeuvres and know the basics of therapeutics that are used in territorial and intra-hospital emergencies. They will also have to get knowledge of the main alterations of instrumental examinations and laboratory tests of interest in a context of emergency/urgency medicine. The organization of an Emergency Department and its impact on the healthcare need satisfaction of the population will be particularly focused during the course.
Full programme
1) Alarm Symptoms (coma, cardiopalm, headache, motor deficiency, diarrhea, dyspnoea, pain, bleeding, fever, back pain, vomiting, etc.).
2) Cardiovascular emergencies (arrhythmias, acute coronary syndrome, pulmonary embolism, acute pulmonary edema, pericarditis, aneurysms, critical ischemia, hypertensive crises).
3) Pulmonary emergencies (bronchospasm, pneumonia, pneumothorax, respiratory failure).
4) Emergencies of the digestive system (digestive bleeding, perforation, acute appendicitis, intestinal occlusion, acute pancreatitis, acute diverticulitis, biliary colic).
5) Neurological and psychiatric emergencies (epilepsy, TIA, stroke, intracranial hemorrhage, delirium, acute psychosis, drug and / or narcotic abuse).
6) Infective illnesses (meningitis, sepsis, endocarditis).
7) Endocrinological emergencies (diabetic ketoacidosis, hyperosmolar syndromes, Addison's disease, thyrotoxicosis).
8) Hematological emergencies (coagulopathy, acute anemia, acute leukemia, acute piastrinopenia).
9) Nephro-urologic emergencies (renal colic, acute renal failure, nephritic syndrome).
10) Acute acid-base and hydro-electrolyte balance alterations.
11) Internistic polyrauma complications (Crush syndrome, compartmental syndrome, rhabdomyolysis).
12) Shock: definition, classification, clinical and therapeutic approach.
13) Healthcare Principles (triage, overcrowding in Emergency Departments: Causes, Consequences and Remedies).
Bibliography
Casagranda-Ghiselli. Medicina d'Emergenza-Urgenza. Ed Idelson-Gnocchi 2017
Teaching material published on the Elly Medicina site, which is accessible to all the course students
Teaching methods
Frontal lessons with a strong interactive component, possibly organized as seminars also with the partecipation of clinicians and Emergency Medicine residents. These seminars will be structured as collegial discussion of simulated clinical cases, in which students will be interactively involved.
Due to the COVID-19 pandemic, in compliance with Italian law and local regulations, lessons will be delivered with 30% of students in classroom and 70% connected with online streaming. In case of emergency clinical situations due to the COVID-19 pandemic, part of the lessons may be delivered in pre-recorded online streaming.
Assessment methods and criteria
Oral examination. Students will be asked to discuss the clinical approach to a simulated clinical case, a disease or an acute symptom in the context of territorial emergency services or hospital Emergency Department. They will also be asked to outline general principles of therapeutics in the proposed clinical case or disease.
