Veidlapa Nr. M-3 (8)

Study Course Description

Anesthesiology, Reanimatology

Main Study Course Information

Course Code

RMS_037

Branch of Science

Anatomy; Clinical medicine

ECTS

3.00

Target Audience

Medicine

LQF

Level 8

Study Course Implementer

Course Supervisor

Ģirts Šalms

Residency Speciality

Speciality

Maxillofacial Surgeon

Supervisor of Medical Speciality

Ģirts Šalms

Contacts

About Study Course

Objective

Prepare doctors - oral and maxillofacial surgeons to perform emergency medical measures. acquire kardiopulmārās resuscitation algorithms, airway permeability provided with a face mask, endotracheal intubation, and laryngeal mask. In theory, an insight into the main principles of general anesthesia and its various treatments. To learn the patient selection and preparation of the principles of general anesthesia, the specific characteristics of face and jaw surgery, as well as the tactics of the early postoperative stage. Gain practical skills to work in the operating room with the patient under general anesthesia. In theory, to learn the most commonly used types of sedation and know how to use them in work with patients. Introduce students to the etiology of obstructive sleep apnea, clinical signs, and symptoms, cardiometabolic comorbidities, and diagnostic and treatment methods.

Learning Outcomes

Knowledge

1.Knows the cardiopulmonary resuscitation (CPR) algorithm. Knows the techniques of adequate ventilation. Knows the features of general anesthesia in face and jaw surgery. Knows the principles of patient selection and assessment before operations under general anesthesia in oral and maxillofacial surgery. Knows how to assess the patient's general condition during surgery and in the postoperative period. Knows the most commonly used analgesia methods in the postoperative period. Knows the most common possible complications after orthognathic and major oral and maxillofacial operations. Knows advantages and disadvantages in relation to general anesthesia.

Skills

1.Can perform basic cardiopulmonary intensive care with extended cardiopulmonary resuscitation elements. Can perform airway permeability providing manually, with a face mask, tracheal intubation, laryngeal mask, and Combitube method. Apply the patient's physical condition control methods (hemodynamics, ventilation). Can perform data interpretation of vital signs monitoring. Can apply the common sedation methods.

Competences

1.Uses knowledge to assess the general condition of patients, and select and prepare them for surgery under general anesthesia. Is able correctly to select the type of anesthesia or sedation. Recognize difficult tracheal intubation. Is able to evaluate and interpret the patient's respiratory and hemodynamic data. Follow hemodynamic variations in the perioperative period. Argumentative management of acute postoperative pain. Is able to choose adequate sedation technique for appropriate situation.

Assessment

Individual work

Title	% from total grade	Grade
1. Individual work	-	-
Read literature on emergency care, sedation, and general anesthesia, as well as study the guidelines of professional societies of dentists and surgeons for the use of sedation in dentistry, and oral and maxillofacial surgery.

Examination

Title	% from total grade	Grade
1. Examination	-	-
In the form of a discussion, demonstrating understanding of the issues discussed in the seminars.
2. Examination	-	-
Theoretical knowledge and practical skills are assessed.

Study Course Theme Plan

FULL-TIME

Part 1

Seminar

Modality	Location
On site	Auditorium

Topics

Basic cardiopulmonary resuscitation algorithm with elements of extended cardiopulmonary resuscitation. Ensuring airway potency (manually, tracheal intubation, laryngeal mask, Combitube method). Assessment of the patient's physical condition in preparation for operations under general anesthesia. General anesthesia in maxillofacial surgery. Possible complications in the perioperative period. Sedation as an alternative to general anesthesia. Most common techniques.

Description

Annotation: Resuscitation techniques and basic principles, specifics of general anesthesia in oral and maxillofacial surgery. Topics covered during the class: The basic algorithm of cardiopulmonary resuscitation. Advanced cardiopulmonary resuscitation algorithm. Techniques for maintaining adequate breathing and oxygenation in patients under sedation and general anesthesia (GA). Assessment of the patient before operations under general anesthesia. Physical condition, general health, laboratory tests, risk assessment of surgery under GA. Specificity of general anesthesia for patients during oral and maxillofacial surgery. The most common complications after orthognathic surgery and major operations in oral and maxillofacial surgery. Literature: Compulsory reading. 1. Nolan, J. P., I. Maconochie, J. Soar, T. M. Olasveengen, et all. (2020). "Executive Summary 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations." Resuscitation 156: A1-A22 2. Olasveengen, T. M., F. Semeraro, G. Ristagno, et all.(2021). "European Resuscitation Council Guidelines 2021: Basic Life Support." Resuscitation 161: 98-114 3. Collange, O., A. Bildstein, J. Samin, R. Schaeffer, et all. (2010). "Prevalence of medical emergencies in dental practice." Resuscitation 81(7): 915-916. 4. Liu, C.-T., C.-Y. Lai, et all. (2020). "A Population-Based Retrospective Analysis of Post-In-Hospital Cardiac Arrest Survival after Modification of the Chain of Survival." The Journal of Emergency Medicine 59(2): 246-253. 5. "Practice Guidelines For Intravenous Conscious Sedation In Dentistry (Second Edition, 2017)". 2018. Anesthesia Progress 65 (4): e1-e18. doi:10.2344/anpr-65-04-15w. 6. Weaver, Joel M. “The History of the Specialty of Dental Anesthesiology.” Anesthesia Progress, vol. 66, no. 2, 2019, pp. 61–68. 7. Professional society`s guidelines: - Merchant, R. M., A. A. Topjian, A. R. Panchal, et all. (2020). "Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Circulation 142(16_suppl_2): S337-s357 - Olasveengen, T. M., F. Semeraro, G. Ristagno, et all.(2021). "European Resuscitation Council Guidelines 2021: Basic Life Support." Resuscitation 161: 98-114 - Panchal Ashish, R., A. Bartos Jason, G. Cabañas José, et all. (2020). "Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Circulation 142(16_suppl_2): S366-S468 - Merchant RM, Topjian AA, Panchal AR, et al. Part 1: executive summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency

Seminar

Modality	Location
On site	Auditorium

Topics

Obstructive sleep apnea, etiology, clinical signs and symptoms, cardiometabolic comorbidities, diagnostic and treatment methods.

Description

Annotation: Sleep apnea as a serious medical and social problem. Topics covered during the class: Pathogenetic relationship of sleep apnea with maxillofacial skeleton development. The most common etiological factors causing obstructive sleep apnea (OSA) (characteristics of the facial skeleton, genetic factors, changes in the soft tissue of the upper airways, and the role of obesity in the pathogenesis of OSA). The most characteristic symptoms of sleep apnea, clinical risk factors. The most common co-morbidities associated with sleep-disordered breathing (cardiovascular diseases, cognitive and metabolic disorders). Different diagnostic techniques of OSA. Main treatment techniques for sleep apnea (surgical treatment, oral appliances, and positive pressure therapy). Literature: Compulsory reading. 1. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 2017;13(3):479e504. 2. Susheel P. Patil, MD, PhD, Indu A. Ayappa, PhD, et all. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep MedicineVolume 15, Issue 02 (https://doi.org/10.5664/jcsm.7640) 3. Danny J. Eckert and Atul Malhotra. Pathophysiology of Adult Obstructive Sleep Apnea. Proc Am Thorac Soc. 2008 Feb 15; 5(2): 144–153. doi: 10.1513/pats.200707-114MG Recommended reading. 1. Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 2019;7(8):687e98. https://doi.org/10.1016/S2213-2600(19) 30198-5. 2. Bruyneel M. Telemedicine in the diagnosis and treatment of sleep apnoea. Eur Respir Rev 2019;28:180093. https://doi.org/10.1183/16000617.0093-2018. 3. Spicuzza L, Caruso D, Di Maria G. Obstructive sleep apnoea syndrome and its management. Therapeutic Advances in Chronic Disease. 2015;6(5):273-285. DOI:10.1177/2040622315590318 4. Sistla SK, Paramasivan VK, Agrawal V. Anatomic and Pathophysiologic Considerations in Surgical Treatment of Obstructive Sleep Apnea. Sleep Med Clin. 2019 Mar;14(1):21-31. doi: 10.1016/j.jsmc.2018.11.003. PMID: 30709530 5. Slowik JM, Collen JF. Obstructive Sleep Apnea. StatPearls. Treasure Island (FL)2019. 6. Deckers K, Schievink SHJ, et al. Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. PLoS One. 2017;12(9):e0184244.

Total ECTS (Creditpoints):

3.00

Number of Residency Seminars:

Length (weeks):

Final Examination:

Residency exam (Theory and practice)

Bibliography

Required Reading

Nolan, J. P., I. Maconochie, J. Soar, T. M. Olasveengen, et all. (2020). "Executive Summary 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations." Resuscitation 156: A1-A22; Elsevier Public Health Emergency Collection

Olasveengen, T. M., F. Semeraro, G. Ristagno, et all. (2021). "European Resuscitation Council Guidelines 2021: Basic Life Support." Resuscitation 161: 98-114

Collange, O., A. Bildstein, J. Samin, R. Schaeffer, et all. (2010). "Prevalence of medical emergencies in dental practice." Resuscitation 81(7): 915-916

Liu, C.-T., C.-Y. Lai, et all. (2020). "A Population-Based Retrospective Analysis of Post-In-Hospital Cardiac Arrest Survival after Modification of the Chain of Survival." The Journal of Emergency Medicine 59(2): 246-253.

"Practice Guidelines For Intravenous Conscious Sedation In Dentistry (Second Edition, 2017)". 2018. Anesthesia Progress 65 (4): e1-e18. doi:10.2344/anpr-65-04-15w.

Weaver, Joel M. “The History of the Specialty of Dental Anesthesiology.” Anesthesia Progress, vol. 66, no. 2, 2019, pp. 61–68

Profesionālo asociāciju vadlīnijas: - Merchant, R. M., A. A. Topjian, A. R. Panchal, et all. (2020). "Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Circulation 142(16_suppl_2): S337-s357 /https://pubmed.ncbi.nlm.nih.gov/33081530/

Kapur VK, Auckley DH, Chowdhuri S, et.all. (2017). Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med;13(3):479e504.

Susheel P. Patil, MD, PhD, Indu A. Ayappa, PhD, et all. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep MedicineVolume 15, Issue 02

10.

Danny J. Eckert and Atul Malhotra. Pathophysiology of Adult Obstructive Sleep Apnea. Proc Am Thorac Soc. 2008 Feb 15; 5(2): 144–153. doi: 10.1513/pats.200707-114MG

11.

Olasveengen, T. M., F. Semeraro, G. Ristagno, et all. (2021). "European Resuscitation Council Guidelines 2021: Basic Life Support." Resuscitation 161: 98-114

Additional Reading

Abelsson, A. and L. Lundberg (2018). "Cardiopulmonary resuscitation quality during CPR practice versus during a simulated life-saving event." International journal of occupational safety and ergonomics : JOSE 24(4): 652-655.

Ali, D. M., B. Hisam, N. Shaukat, N. Baig, et all. (2021). "Cardiopulmonary resuscitation (CPR) training strategies in the times of COVID-19: a systematic literature review comparing different training methodologies." Scandinavian journal of trauma, resuscitation and emergency medicine 29(1): 53.

Viljoen, Andre, et all. (2011) “Analysis of Oxygen Saturations Recorded during Dental Intravenous Sedations: A Retrospective Quality Assurance of 3500 Cases.” Anesthesia Progress, vol. 58, no. 3, pp. 113–120

Yusufoğlu, K., M. Erdoğan, İ. Tayfur, M. A. Afacan and Ş. Çolak (2018). "CPR-related thoracic injuries: comparison of CPR guidelines between 2010 and 2015." Turk J Med Sci 48(1): 24-27

Inverso, Gino, et all. (2016). “Complications of Moderate Sedation versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction.” Journal of Oral and Maxillofacial Surgery, vol.74, no. 3, pp.474–47.

Benjafield AV, Ayas NT, Eastwood PR, et all. (2019). Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med;7(8):687e98. https://doi.org/10.1016/S2213-2600(19) 30198-5.

Bruyneel M. (2019). Telemedicine in the diagnosis and treatment of sleep apnoea. Eur Respir Rev;28:180093. https://doi.org/10.1183/16000617.0093-2018.

Spicuzza L, Caruso D, Di Maria G. (2015). Obstructive sleep apnoea syndrome and its management. Therapeutic Advances in Chronic Disease. ;6(5):273-285. DOI:10.1177/2040622315590318

Sistla SK, Paramasivan VK, Agrawal V. (2019). Anatomic and Pathophysiologic Considerations in Surgical Treatment of Obstructive Sleep Apnea. Sleep Med Clin. Mar;14(1):21-31

10.

Slowik JM, Collen JF. (2019). Obstructive Sleep Apnea. StatPearls. Treasure Island (FL).

11.

Deckers K, Schievink SHJ, et all. (2017 ). Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. PLoS One.;12(9):e0184244.