AIRWAY MANAGEMENT, VENTILATION AND RESUSCITATION IN CRITICAL CARE

SHE Level 3
SCQF Credit Points 20.00
ECTS Credit Points 10.00
Module Code M3B922063
Module Leader Owen Williams
School School of Health and Life Sciences
Subject Scottish Ambulance Service
Trimesters
  • A (September start)
  • B (January start)
  • C (May start)

Pre-Requisite Knowledge

Paramedic registered with the Health Professions Council

Summary of Content

The Critical Care Paramedic (CCP) will be required to assess and manage critically unwell patients either as part of the multidisciplinary critical care team with appropriate direct and indirect supervision or autonomously with identified patients. This module explores how airway and ventilatory compromise impacts on the clinical outcome of the unwell patient. The full range of methods of assisting in airway management care from basic manoeuvres to drug assisted airway maintenance and failed intubation will be evaluated. The CCP will also be required to recognise and differentiate respiratory failure, including physiology, pathophysiology, changes to compliance, why this may have occurred and airway obstruction; therefore this module will cover the appropriate oxygenation and ventilation techniques that can be employed in these situations. The peri-arrest and post-arrest critically unwell patients will also be discussed. These periods are seen when the patient's condition is most unstable and active management is required to prevent progression or regression into a full cardio-respiratory arrest. This will include the use and interpretation of relevant investigations such as arterial blood gas analysis while also recognising when patients need intervention, such as external cardiac pacing or pharmacology.

Syllabus

-360b7 Anatomy and physiology of the respiratory system and pathophysiology underlying emergency airway management and pre-hospital anaesthesia in relation to maintaining homeostasis of critically unwell patient. -360b7 Pharmacology of induction and paralysing agents relating to emergency airway management and pre-hospital anaesthesia. b7 Theory of emergency anaesthesia and practical team member role in application of procedure. b7 Difficult and failed airway management according to appropriate protocols, including surgical airways b7 Recognition, assessment and stabilisation of the critically ill patient with disordered physiology b7 Assessment and management of the patient during peri and post cardiac arrest resuscitation b7 Cardiopulmonary resuscitation including interventions as necessary; defibrillation, cardioversion and cardiac pacing (transthoracic) b7 Familiarisation of advanced techniques required within critical care including endotracheal suction, and chest drainage, under supervision as required. b7 All types of monitoring associated with transfer and retrieval of a critical care patient

Learning Outcomes

On successful completion of the module the student should be able to:1. Demonstrate knowledge and understanding of the principles of, and factors affecting, gas exchange and transport and control of breathing in both health and disease; respiratory failure and the pathophysiological changes affecting the respiratory system, such as mismatching of alveolar ventilation to perfusion, increase in shunt fraction, alveolar-capillary block syndrome.2. Demonstrate an understanding of the pathophysiological processes underlying the difficult airway, with regard to emergency pre-hospital anaesthesia. Specifically in relation to the maintenance of homeostasis.3. Describe the pharmacological actions of induction, sedative, and paralysing agents used in contemporary pre-hospital anaesthetic practice by reference to pharmacodynamics, pharmacokinetics and pharmacotherapeutic effects.4. Demonstrate comprehensive knowledge and understanding of effective airway assessment and management in a range of clinical presentations of the critically unwell patient.5. Demonstrate knowledge and skills in delivering manual and mechanical ventilation strategies in the critical care setting.6. Diagnose cardiac arrest and administer cardiopulmonary resuscitation to advanced life support provider level to include the management of common arrhythmias.7. Recognise, assess and manage peri-arrest patients to minimise deterioration.8. Manage the post resuscitation period including airway, oxygenation, ventilation, circulation, temperature and arrhythmias.9. Triage and prioritise critically unwell patients and seek senior medical support as appropriate.

Teaching / Learning Strategy

This module will predominantly be taught 'face to face' either within the university or within practice placement, with both areas offering a safe environment for the student to practice their new enhanced skills. The theoretical elements will employ varied teaching and learning strategies to be inclusive of student needs. This will be detailed within the module handbook and will clearly articulate stage by stage the learning activities designed to assist students with undertaking and negotiating this module. The teaching and learning strategies will include lectures and tutorials, including pre recorded lectures available via the internet and podcasts. The virtual learning environment, GCU learn, will also be utilised, allowing tutors and students to access the core learning platform. This will enable tutors to place relevant reading materials, announcements orcourse materials in an area easily accessibale to students even if they aren't physically on campus. This is ideal for our student, due to student location. Students will be encouraged to engage with the key concepts, which will then be developed through directed reading, literature searching and student initiated reading. Using both the practical and theoretical teaching and learning strategies the student should develop and practice skills accordingly, allowing for the development of a specialised paramedic.

Indicative Reading

Advanced Life Support Group (ALSG) (2012) Advanced Paediatric Life Support. Oxford: John Wiley Benger, J. Nolan, J & Clancy, M (ed) ( 2008) Emergency Airway Management. Cambridge: Cambridge University Press Ellis, D & Hooper,M. ( 2010) Cases in Pre-hospital and Retrieval Medicine. Australia: Elsevier Griffiths, A. Lowes, T. and Henning, J. ( 2010) Pre-Hospital Anesthesia Handbook. London: Springer Hung,O. & Murphy,M. (ed) (2011) Management of the Difficult and Failed Airway 2 nd Ed. New York: McCraw Hill Nolan,J. Lockley,S.A. & Pitcher, D. ( 2011) Advanced Life Support. London: ALSG Pillay,Y. (2010) Paramedic Rapid Sequence Intubation: A Framework for Decision Making. London: Lambert Popat,M. (ed) (2009) Difficult Airway Management (Oxford Anaesthesia Library) Oxford: Oxford University Press Resuscitation Council (UK) (2010) Resuscitation Guidelines. London: Resuscitation Council Walls,R. & Murphy, M. (2012) Manual of Emergency Airway Management. Netherlands: Wolter Kluwer

Transferrable Skills

Work in a self directed manner, taking responsibility for own learning and personal development. Develop communication and IT skills to underpin effective learning. Communicate effectively in both written and oral forms with fellow students and the teaching team. Work effectively with others. Underpin professional development by integration of theory and practice.

Module Structure

Activity Total Hours
Assessment (PT) 20.00
Practice Placement 100.00
Workbooks 35.00
Lectures (PT) 30.00
Clinical Skills Labs 15.00

Assessment Methods

Component Duration Weighting Threshold Description
Exam (School) 2.00 60.00 40% Clinical Decision Case Study (Exam) - 2 hours
Coursework 1 n/a 0.00 n/a Practice Placement Portfolio
Exam (School) n/a 0.00 n/a OSCE
Exam (School) 1.00 40.00 40% Pathophysiology and pharmacology