Undergraduate teaching, training and examination of urgent bedside management
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A presentation by Jonas Åkeson at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine. All available content from SSAI2017: https://scanfoam.org/ssai2017/ Delivered in collaboration between scanFOAM, SSAI & SFAI.
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Undergraduate teaching, training and examination of urgent bedside management
- 1. | 1 Undergraduate teaching, training, and examination of urgent bedside management Jonas Åkeson, MD, PhD, EDAIC, ETP Professor/Sr Consultant Anaesthesiology and Intensive Care Medicine Lund University Skåne University Hospital Malmö Sweden PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 2. | 2 No conflict of interest Jonas Åkeson, MD, PhD, EDAIC, ETP Professor/Sr Consultant Anaesthesiology and Intensive Care Medicine Lund University Skåne University Hospital Malmö Sweden PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 3. | 3 Few studies have reported systematic undergraduate teaching of clinical patient safety issues Nie et al. BMC Med Ed 2011;11:33 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 4. | 4 Within a decade, Sweden will most probably have a compulsory six-year program of undergraduate teaching and training, leading to medical licensure. Medical schools should prepare to meet this challenge. PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 5. | 5 Traditional teaching PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se clinical signs clinical signs clinical signs clinical signs clinical signsdiagnose diagnose diagnose diagnose diagnose
- 6. | 6 Teaching preparing for licensure PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se diagnose diagnose diagnose diagnose diagnose clinical signs clinical signs clinical signs clinical signs clinical signs
- 7. | 7 Clinical Medicine 5 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 8. | 8 Clinical Medicine 5 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 9. | 9 knowledge and clinical practice from previous semesters Clinical Medicine 5 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 10. | 10 knowledge and clinical practice from previous semesters Clinical Medicine 5 emergency medicine PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 11. | 11 knowledge and clinical practice from previous semesters Clinical Medicine 5 anaesthesiology and intensive care medicine emergency medicine PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 12. | 12 Clinical Medicine 5 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 13. | 13 Clinical Medicine 5 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 14. | 14 Clinical Medicine 5 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 15. | 15 simulations case seminars PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 16. | 16 structured evaluation pain problems ABCD problems trauma simulations case seminars PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 17. | 17 structured evaluation pain problems ABCD problems trauma structured work simulations case seminars PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 18. | 18 simulations case seminars structured evaluation pain problems ABCD problems trauma structured work urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 19. | 19 structured evaluation pain problems ABCD problems trauma structured work simulations case seminars urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 20. | 20 clinical practice structured evaluation pain problems ABCD problems trauma structured work simulations case seminars urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 21. | 21 clinical practice structured evaluation pain problems ABCD problems trauma structured work simulations case seminars urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se emergency department ambulance out-off-office-hour anaesthesia intensive care unit
- 22. | 22 clinical practice structured evaluation pain problems ABCD problems trauma structured work structured work simulations case seminars urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se emergency department ambulance out-off-office-hour anaesthesia intensive care unit
- 23. | 23 clinical practice structured evaluation pain problems ABCD problems trauma structured work structured work differential diagnostic thinking simulations case seminars urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se emergency department ambulance out-off-office-hour anaesthesia intensive care unit
- 24. | 24 clinical practice structured evaluation pain problems ABCD problems trauma structured work structured work simulations case seminars examinations differential diagnostic thinking urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se emergency department ambulance out-off-office-hour anaesthesia intensive care unit
- 25. | 25 clinical practice structured evaluation pain problems ABCD problems trauma structured work structured work simulations case seminars examinations differential diagnostic thinking urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se emergency department ambulance out-off-office-hour anaesthesia intensive care unit diagnostic test diagnostic test
- 26. | 26 clinical practice structured evaluation pain problems ABCD problems trauma structured work structured work simulations case seminars examinations differential diagnostic thinking urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se emergency department ambulance out-off-office-hour anaesthesia intensive care unit
- 27. | 27 structured work structured work differential diagnostic thinking urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 28. | 28 structured work structured work clinical reports differential diagnostic thinking urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 29. | 29 structured work structured work MCQ test clinical reports urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se differential diagnostic thinking
- 30. | 30 structured work structured work MCQ test simulation tests clinical reports differential diagnostic thinking urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 31. | 31 urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 32. | 32 ANAESTHESIOLOGY & INTENSIVE CARE MEDICINE urgent bedside management PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 33. | 33 ANAESTHESIOLOGY & INTENSIVE CARE MEDICINE PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 34. | 34 CNS FUNCTION CIRCULATIONRESPIRATION ANAESTHESIOLOGY & INTENSIVE CARE MEDICINE PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 35. | 35 CNS FUNCTION CIRCULATIONRESPIRATION TEAMWORK ETHICS ANAESTHESIOLOGY & INTENSIVE CARE MEDICINE PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 36. | 36 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 37. | 37 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 38. | 38 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 39. | 39 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 40. | 40 non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 41. | 41 pneumothorax non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 42. | 42 bleeding pneumothorax non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 43. | 43 bleeding pneumothorax cardiac tamponade non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 44. | 44 bleeding septicaemia pneumothorax cardiac tamponade non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 45. | 45 bleeding septicaemia pneumothorax cardiac tamponade hyperkalaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 46. | 46 bleeding septicaemia pneumothorax cardiac tamponade seizures hyperkalaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 47. | 47 bleeding septicaemia pneumothorax cardiac tamponade seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 48. | 48 bleeding septicaemia pneumothorax cardiac tamponadeanaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 49. | 49 bleeding septicaemia pneumothorax cardiac tamponade hypoventilation anaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 50. | 50 bleeding septicaemia pulmonary embolism pneumothorax cardiac tamponade hypoventilation anaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 51. | 51 bleeding septicaemia pulmonary embolism pneumothorax drowning cardiac tamponade hypoventilation anaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 52. | 52 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation anaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 53. | 53 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 anaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 54. | 54 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage anaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 55. | 55 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 56. | 56 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 seizures hyperkalaemia hypoglycaemia non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 57. | 57 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 seizures hyperkalaemia hypoglycaemia adrenaline non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 58. | 58 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 seizures hyperkalaemia hypoglycaemia adrenaline O2/drainage/CPR non-patent airway PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 59. | 59 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 seizures hyperkalaemia hypoglycaemia adrenaline O2/drainage/CPR non-patent airway compression/fluid/blood/CPR PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 60. | 60 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 seizures hyperkalaemia culture/antibiotic/drainage hypoglycaemia adrenaline O2/drainage/CPR non-patent airway compression/fluid/blood/CPR PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 61. | 61 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 calcium/ion exchanger/glucose-insulin seizures hyperkalaemia culture/antibiotic/drainage hypoglycaemia adrenaline O2/drainage/CPR non-patent airway compression/fluid/blood/CPR PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 62. | 62 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 O2/heparin calcium/ion exchanger/glucose-insulin seizures hyperkalaemia culture/antibiotic/drainage hypoglycaemia adrenaline O2/drainage/CPR non-patent airway compression/fluid/blood/CPR PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 63. | 63 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 gastric emptying/lavage/carbon/antidote/O2 O2/heparin calcium/ion exchanger/glucose-insulin seizures hyperkalaemia culture/antibiotic/drainage hypoglycaemia adrenaline O2/drainage/CPR non-patent airway compression/fluid/blood/CPR PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 64. | 64 bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation diazepam/O2/ventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 gastric emptying/lavage/carbon/antidote/O2 O2/heparin calcium/ion exchanger/glucose-insulin seizures hyperkalaemia culture/antibiotic/drainage hypoglycaemia adrenaline O2/drainage/CPR non-patent airway compression/fluid/blood/CPR PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se
- 65. | 65 PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se bleeding septicaemia pulmonary embolism pneumothorax drowning intoxication cardiac tamponade hypoventilation glucose/glucagone diazepam/O2/ventilation ventilation/O2 pleural puncture/drainage CPR/ventilation/O2 anaphylaxis inspection/jawthrust/Heimlich/O2 gastric emptying/lavage/carbon/antidote/O2 O2/heparin calcium/ion exchanger/glucose-insulin seizures hyperkalaemia culture/antibiotic/drainage hypoglycaemia adrenaline O2/drainage/CPR non-patent airway compression/fluid/blood/CPR
- 66. | 66 We consider proposed major components of this compulsory course to help medical students prepare for medical licensure – regardless of whether clinical internship will be maintained or not in the future. PREPARING MEDICAL STUDENTS FOR RAPID BEDSIDE ACTION jonas.akeson@med.lu.se