زمالة تخصصية في العناية المركزة
الدراسة تكون تحت مظلة المجلس العلمي للتخدير والعناية المركزة
شروط القبول
يمكن للأطباء الحاصلين على زمالة المجلس العراقي أو ما يعادلها من شهادات في فروع الطب الآتية التقديم للدراسة
يتدرب ألأطباء المقبولين في الدراسة تحت عنوان (طبيب زميل متدرب)
مدة الدراسة: سنتان
المراكز التدريبية:
مركز مدينة الطب التدريبي
مركز اربيل التعليمي
منهاج الدراسة التدريبي:
السنة الأولى:
1-الجراحة العامة: شهر واحد
2-النسائية والتوليد: شهر واحد
3-جراحة الصدر والاوعية الدموية: شهر واحد
3- يتدرب الطالب في:
السنة الثانية:
يحصل الطالب عل لقب (زمالة تخصصية)في العناية المركزة/ المجلس العراقي للاختصاصات الطبية
بعد ان يجتاز الامتحان النهائي (الكتابي والعملي) في العلوم السريرية بعد اتمامه السنة الثانية وكافة متطلبات الدراسة الاخرى وبنفس شروط النجاح وعدد المحاولات المعتمدة في المجلس العربي للاختصاصات الطبية.
المحاضرات النظرية:
ألسنة ألأولى:
Module 1: Physiology
Excitable tissues: nerve & muscle |
Respiratory physiology Part:1 |
Respiratory physiology Part:2 |
Cardiovascular physiology Part:1 |
Cardiovascular physiology Part:2 |
Renal physiology |
Neuro physiology Part:1 |
Neuro physiology Part:2 |
Physiology of the endocrine Part:1 |
Physiology of the endocrine Part:2 |
Physiological changes in pregnancy |
Fluid :physiology &replacement |
Blood transfusion Part:1 |
Blood transfusion Part:2
Module 2: Pharmacology |
General pharmacology Part:1 |
General pharmacology Part:2 |
I.V anesthetic drugs |
Inhalational anesthetic drugs |
Analgesics |
Muscle relaxants &neuro muscular junction |
Local anesthetic drugs |
Drugs affecting autonomic nervous system |
Drugs affecting cardiovascular system
Module 3: Physics & instrument |
Anesthetic breathing system |
Anesthesia machine anatomy &check list |
Vaporizer |
Ventilators |
Gas laws |
Measurement of flow &volume |
Heat & temperature |
Humidity & Humidifier |
O2 & Co2 measurement |
Blood pressure measurement (IBPM + NIBPM) |
Nerve stimulator & nerve locater |
ECG |
Gas supply [cylinder & central] & scavenging |
السنة الثانية:
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Blood transfusion |
Fluid physiology and therapy |
Coagulation disorder and management |
Clinical manifestation of ECG |
Spinal and epidural anesthesia |
Regional anesthesia |
ACLS |
Chronic pain management |
Acute pain management including Postoperative pain |
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Organization and management
Scoring system in ICU
Clinical outcome & safety assessment
Infection control in ICU
Clinical imaging
Hemodynamic monitoring in ICU
Acid base disorders. |
Electrolyte disorders.. |
Sepsis & MODs. |
Antimicrobial agents in the ICU. |
Nutrition in ICU. |
Sedation in the ICU. |
Scoring in the ICU. |
Disorders of body temperature in ICU
Artificial ventilation
Sever and multiple trauma
Burn
Respiratory failure
Renal failure in ICU
Acute hepatic failure
Traumatic brain injury
Obstetric critical care
Acute coronary syndrome
Toxicology emergency in ICU
Coma & altered consciousness
المنهاج العملي:
The training domains
Domain 1: Resuscitation and initial management of the acutely ill patient
1.1-Adopts a structured and timely approach to the recognition, assessment and stabilisation of the acutely ill patient with disordered physiology
1.2-Manages cardiopulmonary resuscitation – ALS recommended
1.3-Manages the patient post--‐resuscitation
1.4-Triages and prioritises patients appropriately, including timely admission to ICU
1.5-Assesses and provides initial management of the trauma patient
1.6-Assesses and provides initial management of the patient with burns
1.7-Describes the management of mass casualties
Domain 2: Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation.
2.1-Obtains a history and performs an accurate clinical examination
2.2-Undertakes timely and appropriate investigations
2.3-Performs electrocardiography (ECG / EKG) and interprets the results
2.4-Obtains appropriate microbiological samples and interprets results
2.5-Obtains and interprets the results from blood gas samples
2.6-Interprets imaging studies
2.7-Monitors and responds to trends in physiological variables
2.8-Integrates clinical findings with laboratory investigations to form a differential diagnosis
Domain 3: Disease Management
3.1-Manages the care of the critically ill patient with specific acute medical conditions
3.2-Identifies the implications of chronic and co--‐morbid disease in the acutely ill patient
3.3-Recognises and manages the patient with circulatory failure
3.4-Recognises and manages the patient with, or at risk of, acute renal failure
3.5-Recognises and manages the patient with, or at risk of, acute liver failure
3.6-Recognises and manages the patient with neurological impairment
3.7-Recognises and manages the patient with acute gastrointestinal failure
3.8-Recognises and manages the patient with acute lung injury syndromes (ALI / ARDS)
3.9-Recognises and manages the septic patient
3.10-Recognises and manages the patient following intoxication with drugs or environmental toxins
3.11-Recognises life--‐threatening maternal peripartum complications and manages care under supervision
Domain 4: Therapeutic interventions / Organ support in single or multiple organ failure
4.1-Prescribes drugs and therapies safely
4.2-Manages antimicrobial drug therapy
4.3-Administers blood and blood products safely
4.4-Uses fluids and vasoactive / inotropic drugs to support the circulation
4.5-Describes the use of mechanical assist devices to support the circulation
4.6-Initiates, manages, and weans patients from invasive and non--‐invasive ventilator support
4.7-Initiates, manages, and weans patients from renal replacement therapy
4.8-Recognises and manages electrolyte, glucose and acid--‐base disturbances
4.9-Co--‐ordinates and provides nutritional assessment and support
Domain 5: Practical procedures
Respiratory System
5.1-Administers oxygen using a variety of administration devices
5.2-Performs emergency airway management
5.3-Performs difficult and failed airway management according to local protocols
5.4-Performs endotracheal suction
5.5-Performs fibreoptic bronchoscopy and BAL in the intubated patient
5.6-Performs percutaneous tracheostomy
5.7-Performs chest drain insertion
Cardiovascular System
5.8-Performs arterial catheterisation
5.9-Describes ultrasound techniques for vascular localisation
5.10-Performs central venous catheterisation
5.11-Performs defibrillation and cardioversion
5.12-Performs transthoracic cardiac pacing, describes transvenous
5.13-Describes how to perform pericardiocentesis
5.14-Demonstrates a method for measuring cardiac output and derived haemodynamic
Variables
Central Nervous System
5.15-Performs lumbar puncture (intradural / ‘spinal’) under supervision
5.16-Manages the administration of analgesia via an epidural catheter
Gastrointestinal System
5.17-Performs abdominal paracentesis
5.18-Describes Sengstaken tube (or equivalent) placement
5.19-Performs nasogastric tube placement
Genitourinary System
5.20-Performs urinary catheterisation
Domain 6: Perioperative care
6.1-Manages the pre--‐ and post--‐operative care of the high risk surgical patient
6.2-Manages the care of the patient following cardiac surgery under supervision
6.3-Manages the care of the patient following craniotomy under supervision
6.4-Manages the care of the patient following solid organ transplant under supervision
Domain 7: Comfort and recovery
7.1-Identifies and attempts to minimize the physical and psychosocial consequences of
critical illness for patients and families
7.2-Manages the assessment, prevention and treatment of pain and delirium
7.3-Manages sedation and neuromuscular blockade
7.4-Communicates the continuing care requirements, including rehabilitation, of patients at ICU discharge to health care professionals, patients and relatives
7.5-Manages the safe and timely discharge of patients from the ICU
Domain 8: End of life care
8.1-Manages the process of withholding or withdrawing treatment with the multidisciplinary team
8.2-Discusses end of life care with patients and their families / surrogates
8.3-Manages palliative care of the critically ill patient
8.4-Performs brain--‐stem death testing
8.5-Manages the physiological support of the organ donor
8.6-Manages donation following cardiac death
Domain 9: Paediatric care
9.1 Describes the recognition of the acutely ill child and initial management of paediatric emergencies ..
9.2 Describes the national legislation and guidelines relating to child protection and their relevance to critical care .
Domain 10: Transport
10.1 Undertakes the transport of the mechanically ventilated critically ill patient outside the ICU
Domain 11: Patient safety and health systems management
11.1 Leads a daily multidisciplinary ward round
11.2 Complies with local infection control measures
11.3 Identifies environmental hazards and promotes safety for patients and staff
11.4 Identifies and minimises risk of critical incidents and adverse events, including complications of critical illness
11.5 Organises a case conference
11.6 Critically appraises and applies guidelines, protocols and care bundles
11.7 Describes commonly used scoring systems for assessment of severity of illness, case mix and workload
11.8 Demonstrates an understanding of the managerial and administrative responsibilities of the ICM specialist
Domain 12: Professionalism
Communication
12.1 Communicates effectively with patients and relatives
12.2 Communicates effectively with members of the health care team
12.3 Maintains accurate and legible records / documentation
Professional relationships with patients and relatives
12.4 Involves patients (or their surrogates if applicable) in decisions about care and treatment
12.5 Demonstrates respect of cultural and religious beliefs and an awareness of their impact on decision making
12.6 Respects privacy, dignity, confidentiality and legal constraints on the use of patient data
Professional relationships with members of the healthcare team
12.7 Collaborates and consults; promotes team-working
12.8 Ensures continuity of care through effective hand-over of clinical information
12.9 Supports clinical staff outside the ICU to enable the delivery of effective care
12.10 Appropriately supervises, and delegates to others, the delivery of patient care
Self governance
12.11 Takes responsibility for safe patient care
12.12 Formulates clinical decisions with respect for ethical and legal principles
12.13 Seeks learning opportunities and integrates new knowledge into clinical practice
12.14 Participates in multidisciplinary teaching
12.15 Participates in research or audit under supervision