Emergency Medicine and Surgery

Learning Objectives:

•  Recognise administrative, legal, and ethical issues involving the critically ill
• patient (NOT EXAMINED)
• Describe triage systems and detail a suitable initial patient assessment
• Describe emergency vascular access techniques including jugular and intra-osseous routes
• Discuss the principles of pain management, stabilization and monitoring
• Identify health and safety concerns and precautions, including managing situations involving potential zoonoses and nosocomial infections in the ntensive care unit
• Discuss infectious diseases and preventative healthcare

Key learning objectives:

• Recognize, assess and treat shock
• Appreciate the indications for the different types of fluid therapy with their advantages and disadvantages, and explain the need for electrolyte supplementation
• Compare techniques for venous access: sites, catheter placement, preparations and complications including advanced and intraosseous techniques
• Outline acid-base balance and the approach to disturbances
• Explain the need to monitor for complications during treatment and the importance of recording central venous pressure
• Recognize and assess acute malnutrition
• Discuss how to provide enteral, total parenteral and partial parenteral nutrition

Learning Objectives

• Describe sampling techniques, sample processing, sample storage, and data recording
• Interpret microscopic features when examining blood smears, urinary sediment, and basic cytology, and be able to diagnose common acute and chronic conditions seen in general practice
• Assess haemostasis
• Interpret clinical laboratory medicine information including hematology, biochemistry, electrolytes, and arterial and blood gas analyses
• Identify when transfusion should be considered, and recognize that there are no ‘magic’ numbers
• Select appropriate blood products and protocols to minimize adverse outcomes
• Manage common conditions leading to hematological abnormalities that require transfusion

Learning Objectives

• Detail the approach to patient stabilisation prior to anaesthesia
• Select appropriate parenteral and inhalational anaesthetic regimes and recognise their relative advantages and disadvantages
• Differentiate sedation and anaesthesia
• Identify anaesthetic equipment and monitoring techniques, highlighting their advantages and disadvantages
• Justify the selection of NSAIDs, opioids, local anaesthetic and topical treatment options for the emergency patient
• Explain the pharmacokinetics, potential interactions and adverse effects of commonly used therapeutic agents, including anti-microbials and antiparasiticides in addition to anaesthetics and anti-inflammatories, in the emergency patient
• Decide about the use of other drugs including neuromuscular blocking agents and sedatives in the emergency patient

Learning Objectives

• Describe how to perform a neurological examination
• Select appropriate diagnostic tests, including radiography and CSF analysis, and apply them to individual cases
• Manage common neurological emergencies including head trauma, traumatic brain injury, meningoencephaltis of unknown origin (MUO) and seizures

Learning Objectives

• Triage poisoned patients, recalling the general principles of intoxication
• List common toxicities, including insecticides, molluscicides, rodenticides, herbicides, household preparations, and plants, and recognize their clinical signs
• Diagnose, manage and assess the prognosis of patients presenting with common poisonings

Learning Objectives

• Apply diagnostic techniques including laboratory investigations and imaging to these cases
• Investigate and manage common renal and urinary tract emergencies, namely urethral obstruction, ureteral obstruction and management of nonsurgical acute kidney injury 
• Recognise the principles of renal, ureteral, bladder and urethral surgery
• Recall the steps to correctly perform a cystocentesis
• Identify the limitations, principles of placement and maintenance of urinary catheters
• Recall the normal reproductive physiology
• Identify the physiological aspects involved in the conversion from foetal to neonatal circulation
• Diagnose and establish a management plan for common reproductive and paediatric emergencies, namely C-section, mastitis, pyometra and prostatitis
• Diagnose and establish a management plan for common paediatric emergencies, including hypothermia, hypoglycaemia, failure in passive immunity and malnutrition 

Learning Objectives

• Understand the cardiovascular assessment and management of patients presented with cardiovascular emergencies
• Utilise and interpret a range of diagnostic techniques including ECGs, radiographs, echocardiographs and laboratory data
• Diagnose and manage acute canine congestive heart failure, feline cardiomyopathy and aortic thromboembolism
• Recognise and manage pericardial disease and understand how to perform pericardiocentesis
• Identify and manage cardiac arrhythmias
• Consider the predisposing factors likely to result in cardiac arrest, how this changes the approach to CPCR and determining prognosis following CPCR
• Understand the various components of CPCR (DABC) and their various importance

Key learning objectives:

• Detail the common metabolic conditions requiring urgent or emergency therapy
• Be familiar with the impact of metabolic disturbances on the patient’s major body systems
• Devise an approach to the diagnosis and management of common diseases including hypoadrenocorticism, DKA, thyroid storm and metabolic diseases related to hypoglycaemia 
• Understand key diagnostic tests and their application
• Appreciate the complications encountered during therapy, their prevention and management

Learning Objectives

• Understand the general approach to dyspnoea
• Triage and create a management plan for patients in respiratory distress
• Utilise and interpret a range of diagnostic techniques for respiratory patients including auscultation, radiography, endoscopy, and arterial blood gas analysis to localize the underlying cause
• Appreciate the methods of oxygen delivery and be able to monitor the efficacy of treatment
• Review the problems associated with oxygen delivery
• Explain the techniques available for drainage of the pleural cavity

Learning Objectives

• Stabilize a patient before surgery, plan surgery, and manage complications
• Appreciate the indications for immediate surgical intervention
• Understand surgical asepsis, theatre protocol, and the rational use of anti-microbials in surgical patients
• Approach the acute management of hemostasis, abdominal and respiratory trauma
• Approach external soft tissue wounds, myocardial injury, and musculoskeletal trauma
• Define damage-controlled resuscitation and identify the cases where it applies 

Learning Objectives

• Interpret the practical findings of a physical examination
• Formulate a diagnostic approach to common presentations of emergency conditions
• Manage common emergency conditions
• Approach the anesthesia and analgesia of these species in emergency situations.

Learning Objectives

• Describe how to perform a systematic ophthalmological examination, recognizing its importance to properly access an emergency patient
• Recognize normal features and variants when performing an ophthalmological examination, considering possible ophthalmological emergencies
• Formulate a diagnostic approach to common presentations including red eye, ocular pain, ocular discharge, blindness, proptosis, and retinal detachment
• Describe medical and surgical management of common ocular conditions including corneal ulceration, uveitis, and glaucoma
• Recognise ocular manifestations of systemic disease
• Select ocular medications and compare therapeutic agents

Learning Objectives

• Describe the approach to the ‘acute abdomen’
• Recognize common emergency conditions affecting the esophagus, stomach, small intestine, large intestine, liver, and pancreas
• Formulate a diagnostic plan, including the use of imaging modalities, and describe effective monitoring strategies for common emergency conditions affecting the esophagus, stomach, small intestine, large intestine, liver, and pancreas
• Select appropriate surgical interventions for gastrointestinal emergencies
• Assess acute malnutrition
• Recognize the procedures to provide enteral, total parenteral, and partial parenteral nutrition
• Create a diagnostic and management plan to approach the refeeding syndrome

Learning Objectives 

• Tracheotomy and chest drain placement
• Emergency abdominal surgery including the approach to the acute abdomen and peritonitis, enterotomy and enterectomy
• Gastric dilatation/ volvulus and gastropexies
• Urinary obstruction including urethrotomy in the dog and perineal urethrostomy in the cat

Learning Objectives

• Tracheotomy and chest drain placement
• Emergency abdominal surgery including the approach to the acute abdomen and peritonitis, enterotomy and enterectomy
• Gastric dilatation/ volvulus and gastropexies
• Urinary obstruction including urethrotomy in the dog and perineal urethrostomy in the cat

Learning Objectives

• CPCR
• Feeding tubes placement
• Arterial blood collection
• Central venous catheter placement
• Nasal cannula placement
• Venous cut down
• Tracheotomy and chest drain placement