The EMS Academics
Module 1: Introduction & Basics
Good clinical practice
Work ethics and legal issues in Emergency medicine
Soft skills: Effective communication, Breaking bad news, Conflict resolution and Teamwork
Hospital policies and codes
Continual quality improvement (CQI) tools
Community medicine: Biostatistics basics
Documentation and Electronic medical records
Anatomy: Bones, Muscle groups, Main nerves of extremities, Brain and Spinal cord
Physiology: Cardiac output, Lung volumes and Endocrine system
Microorganisms: Bacteria, Viruses, Parasites and Fungi
Module 1: Exam Link
Module 2: Primary Assessment & ACLS
Primary survey; ABCD approach & Vitals: HR, RR, BP, Temp, GRBS, SPO2 and Pain score
Airway management: Airway adjuncts and RSI
Crash cart drugs and high-risk medicines
BLS and ACLS
Head to Toe Examination
Module 2: Exam Link
Module 3: ANS & Pharmacology
Autonomic nervous system: Anatomy and physiology review
Immunology: Immune cells, Malignancy and Allergic reactions & Anaphylaxis
Pharmacology: Analgesics, Sedatives, Procedural sedation, OTC medicines, Penicillins and RSI drugs review
Module 3: Exam Link
Module 4: Trauma & Disaster Management
Trauma management (ITLS/ATLS)
Orthopaedics : Fracture healing, Dislocations, Colles fracture, Neck of the femur (NOF) fracture and Nerve block
Nexus criteria and Ottawa Knee rule
Wound management
Burns
Disaster management (BDLS)
Module 4: Exam Link
Module 5: Paediatrics
Paediatrics: Milestones in life, Immunisation, Intussusception, Incessant cry, Fever and Febrile seizure
PALS
Neonatal resuscitation (NALS)
Module 5: Exam Link
Module 6: Hemodynamics
Fluids and Electrolytes
Blood resuscitation
Hemodynamics: Arterial BP, Vasopressors and Inotropes
Approach to Shock
Sepsis
Module 6: Exam Link
Module 7: Procedures & Equipments
ED Procedures: Vascular access, IO access, Central line, Intramuscular sites, Ryles tube, Bladder catheterisation, Suturing, I&D, ICD, LP and Paracentesis
ED equipments: BIPAP, Ventilator, Defibrillator, Infusion pump and Cardiac monitor
Intubation review
Module 7: Exam Link
Module 8: Infections & Investigations Analysis
Toxicology: Paracetamol poisoning, Opiates poisoning and Snakebite
Infections
Investigations: Electrolytes, CBC, ESR, CRP, CUA, RFT, LFT, CXR, ECG and ABG
Imaging: CXR, CT head
Module 8: Exam Link
Module 9: Renal & Neurosciences
Neuroscience: Brain arteries (ACA, MCA and PCA), CVA (thrombotic and hemorrhagic), IC bleeds (EDH, SDH and SAH)
Eye Emergencies - Corneal FB, Retro-orbital hematoma, Acute angle closure glaucoma, and Anisocoria
Canadian CT head rule
Headache and seizure
Renal system: Kidney anatomy, Renal calculi, UTI, AKI, dialysis and CKD
Endocrine emergencies: DKA, Adrenal crisis and Thyrotoxicosis
Module 9: Exam Link
Module 10: Cardiopulmonary System
Pulmonology: Dyspnoea, Asthma, COPD, Pneumothorax, Pleural effusion and Pneumonia
Cardiology: Syncope, ACS, Sudden cardiac death, Pulmonary embolism (Wells criteria) and Cardiac arrhythmia review (ACLS)
Module 10: Exam Link
Module 11: Abdomen & Psychiatry
Abdominal pain
OBG: Ectopic pregnancy, Abruptio placenta, Eclampsia, Amniotic fluid embolism PPH and Resuscitation in pregnancy
Gastro: Hepatitis, Biliary colic and Pancreatitis (modified Glasgow criteria)
Psychiatry: Anxiety, Depression, mania, Delirium and psychotropic drugs review
Bioterrorism and Radiation injuries
Module 11: Exam Link
Module 12: Review
Module 12: Exam Link
Academic transcript diagrams
"The Anatomical Planes in the Human Body"
"Bag Valve Mask Resuscitator"
"Intravenous Line system and Cannula Components"
"Peripheral Vein Anatomy"
"The Heart: Chambers, Vessels, and Blood Flow"
"The Internal Jugular and Superior Vena Cava Veins"
"The Femoral Triangle"
"Direct laryngoscopy"
"The Structure of a Long Bones"
"Conduction System of the Heart and ECG Waves"
Simulation Scenarios
Here's a general outline of the process:
Pre-briefing; 5 minutes (Explain the goals, expectations and logistics)
Scenario; 20 minutes A realistic case scenario that aligns with the learning objectives.
Debriefing and feedback; 10 minutes (review the learning objective and constructive feedback)
Repeat and reinforce; Additional simulation to address specific aspects that require improvements.
Evaluation and continuous improvement; Assess performance, and use feedback data for future scenarios.
Trauma Resuscitation
Respiratory distress
Sepsis Management
Stroke Management
Pediatric respiratotry failure
Team communication and Crisis resource management
Obstetric emergency
Code green
Neonatal resuscitation
Cardiac arrest
Scenario - 1; Trauma
A 35-year-old male is brought to the ED after a motor vehicle accident. The patient is unconscious with a Glasgow Coma Scale (GCS) score of 10. His vital signs include a blood pressure of 90/60 mmHg, heart rate of 120 bpm, respiratory rate of 28 breaths per minute, and oxygen saturation of 88% on room air. Physical examination reveals multiple injuries, including a femur fracture, a tension pneumothorax on the right side, and abdominal tenderness.
Learning objectives;
Primary assessment (ABCD, Vitals and Critical actions)
Airway checking, C-collar application, spine board application,
Oxygen with FM
Tension pneumothorax release followed by ICD
IV fluid resuscitation
Identification of Class 4 hemorrhagic shock (due to right femur shaft fracture and scalp laceration) and initiate massive blood transfusion (1:1:1) O negative
Call for help for eFAST (positive), and start Tranexamic acid 1 gm.
ECG and ABG (airway adjuncts)
Pelvis X-ray and Chest X-ray
Pain medication (look for allergies)
Scenario - 2; Respiratory distress
A 55-year-old male presents with sudden onset dyspnea, tachypnea, and accessory muscle use. Auscultation reveals decreased breath sounds on the right side and wheezing in all lung fields.
Scenario - 3; Sepsis
AA 70-year-old female with a urinary tract infection develops a fever, hypotension, tachycardia, and altered mental status.
Scenario - 4; Stroke
AA 65-year-old male presents with sudden-onset right-sided weakness, facial droop, and slurred speech.
Scenario - 5; Paediatric respiratory failure
A A 3-year-old child presents with severe respiratory distress, nasal flaring, and increased work of breathing.
Scenario - 6; Conflict Resolution
During a busy night shift in the emergency department, a conflict arises between two nurses, Amy and John. Both nurses are experienced professionals but have different communication styles and approaches to patient care. They are assigned to work together on a critical case, and tensions escalate due to their conflicting opinions on the patient's treatment plan.
Scenario - 7; Obstetric emergency
AA pregnant patient presents with sudden-onset vaginal bleeding, abdominal pain, and signs of hypovolemic shock
Scenario - 8; Disaster management
The TL received a call at 8.30 pm that a boat capsized at Tanur around one hour back, expecting ~40 victims.
Learning points
The preparation you do as a TL (Logistics and internal manpower)
Inform EP and HOD (Facilitate Crisis committee (HOD, CMS, and Administrator) meeting)
Facilitate ICS
Activate Code green
Surge capacity (capability)
Reverse triaging
Ask about the triage principle difference - Entry point triage Vs SALT (deploy EMS in coordination with the incident commander of the district, collector office).
Pre-briefing;
Address unexpected challenges (hazardous material exposure & Just-in-time training)
Cardiac arrest case in between - do nothing (resource management).
Debriefing.
Address specifically the communication issues (over-crowding).
Scenario - 9; Neonatal resuscitation
AA full-term newborn is born with poor muscle tone, apnea, and inadequate respiratory effort.
Scenario - 10; Cardiac arrest
APresentation: A 60-year-old patient collapses suddenly, becomes unresponsive, and has no palpable pulse.
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