Download Clinical/Didactic Objectives Form

Critical Care Cognitive Objectives
Take this document to each clinical shift and bring to class. The items listed herein should serve
to stimulate conversation with other medical professionals during the clinical encounters and
peers in class. Students will complete this form utilizing a combination of techniques, including,
but not limited to: interview with patients, family, medical providers, professional articles,
books, or other reliable sources.
Student Name: __________________________________
Class: FM17 CCP
Labor and Delivery
Verbalize physiologic changes during pregnancy (cardiovascular, respiratory, gastrointestinal, renal, and
endocrine).
Describe the assessment of an obstetrical patient.
Describe the management of the pregnant patient who is in cardiac arrest.
Demonstrate understanding of fetal monitoring and how to assess tracings.
Demonstrate the understanding of several methods of fetal monitoring that you may use during transport of a
pregnant patient.
Identify complications of pregnancy, including spontaneous abortion and causes of bleeding.
a. Preeclampsia
b. Eclampsia
c. HELLP Syndrome
Demonstrate appropriate use of medications used in treating medical conditions that can exist during
pregnancy.
Recognize fetal malpresentations of delivery and perform appropriate management of situation.
Identify and manage shoulder dystocia.
Manage multiple-birth deliveries and considerations during transport.
Manage potential postpartum complications and identify considerations during transport.
Neonatal Intensive Care Unit
Verbalize physiological and anatomical differences of the neonate.
Recognize, evaluate and manage patients with the signs and symptoms that present commonly in the NICU:
a. Cardiomyopathy
b. Congenital heart disease
c. Congestive heart failure
d. Dysrhythmias
e. Pericarditis
f.
g.
h.
i.
j.
Genetic and endocrine disorders
GI/Nutrition: complications of umbilical catheterization, gastroesophageal reflux, hepatitis,
hyperbilirubinemia, meconium plug, necrotizing enterocolitis, and nutritional management of high risk
neonates or those with special needs (Cleft lip/palate, other facial anomalies, etc.)
Neurologic disorders: Central apnea, CNS malformations, drug withdrawal, hydrocephalus,
intraventricular hemorrhage, seizures, spina bifida
Pulmonary disorders: atelectasis, bronchopulmonary dysplasia, meconium aspiration, persistent
pulmonary hypertension of the newborn, pneumonia, pneumothorax, respiratory distress syndrome
Surgery: pre and post considerations
Demonstrate use of ventilators during neonatal transport
Demonstrate how to determine the proper size equipment and adjuncts necessary to treat the neonate
Explain the risks associated with critical care transport, including factors unique to air transport of a neonate
Pediatric Intensive Care Unit
Understand the differences of the pediatric patient during assessment of clinical presentation.
Describe anatomical and physiological differences of the pediatric patient that will impact treatment.
Describe the management (treatment, pharmacological, equipment, systems support) of the septic child.
Describe sedation considerations for the pediatric patient.
Understand the unique challenges for transport of the pediatric patient (size, family, equipment, etc.).
Describe resuscitation of pediatric patients in various scenarios.
Adult Care Units
Respiratory
Define ventilation
Compare inspiration and expiration as to the direction of air movement, use of energy, and muscles involved
Define the terms related to ventilation (i.e., surfactant, compliance, airway resistance, work of breathing, tidal
volume, anatomic dead space, alveolar ventilations)
Identify adventitious sounds that are characterized as continuous and discontinuous
Relate clinical conditions that produce crackles, wheezes and rhonchi
Formulate a management plan for transporting the patient in respiratory failure
Interpret acid-base balance and arterial blood gases
Understand the physiology of ventilation and respiration and identify common pathological events that affect
the pulmonary system
Know pharmacological preparations that are used for management of respiratory diseases and conditions
Know abnormal assessment findings associated with pulmonary diseases and conditions
Understand the indications, contraindications, complications, equipment and techniques for the following:
a. Tracheobronchial suctioning for the intubated patient
b. Alternative methods of endotracheal intubation
c. Needle/Surgical Cricothyrotomy
d. Tube thoracostomy
e. Thoracic drainage system
f. End-tidal CO2 monitoring
g. Mechanical Transport ventilators with flow-control and PEEP attachments
Adult Care Units
Cardiovascular:
Describe the initial approach to managing the manifestations of chest pain as related to cardiovascular disease
Describe the physiology of cardiovascular disease
Differentiate between normal and abnormal ECGs using multi-lead ECGs
Understand indications, contraindications, equipment, techniques and maintenance of various methods of
hemodynamic monitoring
Utilize assessment data obtained from hemodynamic monitoring in the formulation of a clinical impression and
management plan for the cardiovascular compromised patient
Understand diagnostic resources such as laboratory tests, ultrasound, ECHO, etc.
Adult Care Units
Neurological:
Understand the differences in the neurological assessment between a brain injured or spinal cord injured
patient
Know the management of non-traumatic neurological emergencies
Describe the major components of a neurological exam and describe the findings of a normal and abnormal
exam
Identify transport considerations for the patient with neurological injury
Describe the pathophysiology of ICP including knowing how to describe an ICP waveform
Understand the terms and implications of compliance, herniation, CPP as related to the brain
Identify signs and symptoms of increasing ICP and strategies for decreasing ICP during critical care transport
Describe the advantages, disadvantages, and transport considerations for the following ICP monitoring devices:
a. Intraventricular catheter
b. Epidural catheter
c. Subdural/subarachnoid monitoring devices
d. Fiber optic transducer tipped probe
Adult Care Units
GI/GU, and Renal:
Discuss the characteristics and manifestations of blood in the gastrointestinal tract
Differentiate the signs and symptoms of acute and chronic GI, GU and renal diseases
Know the commonly accepted methods of managing GI, GU, and renal patients
Know the pharmacological management of the GI, GU and renal patient
Know different renal dialysis techniques; along with complications and management techniques associated with
each method
Recognize lab values related to GI, GU and renal pathophysiology
Discuss the discontinuation of dialysis in the event of acute complications
Understand differential diagnosis and management priorities of GI, GU and renal disease
Adult Care Units
Burns:
Understand burn assessment criteria and how to score the burn in terms of total body percentage
Understand hemodynamic assessment criteria associated with burn related injuries and their effect on body
system functions in include potential complications
Understand management of burn injuries to include wound, airway and pain management
Describe burn wound treatment protocols and products based on the latest criteria established for burn
management
Understand the considerations for treatment and management for the various types of burn related injuries
(Chemical, Heat/Fire, Radiation)
Adult Care Units
Endocrine:
Explain the A&P of the endocrine system including associated hormones
Differentiate between normal and abnormal findings in the endocrine assessment
Describe the etiology, pathophysiology, presenting systems and management of endocrine system disorders
Identify the indications, contraindications and maintenance of insulin drip therapy, insulin pumps and
Vasopressin
Adult Care Units
Shock and MODS:
Differentiate the major types of shock according to causes and pathophysiologic alterations
Identify patients at risk to develop each of the major types of shock
Describe the body's responses to shock, including early and late
Summarize the clinical findings of shock
List the abnormal laboratory findings in shock
Describe the hemodynamic findings in:
a. Hypovolemic
b. Cardiogenic
c. Neurogenic
d. Anaphylactic
e. Septic shock
List complications of shock
Differentiate definitive and supportive measures for the patient with shock
Explain fluid administration in shock
State the cardiovascular effects of stimulation of alpha, beta1, beta2, and dopaminergic receptors
Summarize the actions, indications, dosages and adverse effects of the following in treating shock:
a. Dopamine
b. Dobutamine
c. Epinephrine
d. Milrinone
e. Norepinephrine
f. Phenylephrine
g. Vasopressin