KNOWLEDGE AND UNDERSTANDING
To define the characteristics identifying a critical ill patient. Understand the characteristics of the care settings (semi-intensive and intensive) that manage the critical patient.
To know the main sensitive nursing outcomes in the critical illness.
To know and understand strategies for preventing serious adverse events and avoidable mortality.
To know and understand the essential concepts of physiology and pathophysiology associated with critical illness and the related clinical-care implications.
To understand the universal approach algorithm for the critical patient (ABCDE) and understand its rational basis.
To know how to identify peri-arrest situations related to airway, respiratory function and cardio-circulatory function failure, and to know how to relate to major clinical frameworks.
To know and understand the rational basis of the main life-support interventions.
To know the routes of administration for emergency drugs and understand the rationale for the choices.
To recognize the cardiac arrest and to manage cardiopulmonary resuscitation.
APPLYING KNOWLEDGE AND UNDERSTANDING
To implement a systematic approach to the patient in critical conditions that will enable the rapid identification of life-threatening situations.
To identify, by describing the rational basis, the appropriate stabilization and vital support interventions to be activated in the context of a multi-professional approach and depending on the level of competence achieved.
To project according to the methodology of the nursing process specific plans of care starting from the identified problems.
To project standardized and individual monitoring plans (clinical, laboratory, functional, instrumental, non invasive and invasive).
MAKING JUDGMENTS
To identify critical life situations (current or potential) through a correct and complete diagnostic reasoning based on the assessment data (clinical, instrumental and laboratory) and on the knowledge of pathology, pathophysiology and clinical nursing.
To acquire and interpret monitoring data (clinical, laboratory, functional, instrumental) according to a rational physiopathology and decision making.
To establish care priorities, justifying the criteria for the choices, in situations involving a patient with multiple critical clinical situations.
To establish care priorities, justifying the criteria for the choices, in situations involving more than one critical patient simultaneously.
COMMUNICATIVE SKILLS
To know and use a proper and appropriate technical-professional terminology to describe the health highlighted problems, the identified objectives and the actions taken.
LEARNING SKILLS
To prepare the Profit Exam by programming and managing the study individually, based on the content of the lessons, the delivered teaching text, and the sources suggested for further study.

In-depth knowledge of the anatomy and physiology of respiratory and cardiovascular systems.
Basic knowledge of renal physiology.
Knowledge and normal values of the main laboratory tests: hemoglobin, hematocrit, leucocytes, serum sodium, potassium, glucose, creatinine, urea nitrogen.

Definition of critically ill patient and Critical Area.
Preventing serious adverse events and avoidable mortality.
Essential pathopathology associated with critical care.
Universal approach to critically ill patient: ABCDE method.
Peri-arrest situation: airway, respiratory and blood circulation failure.
Cardiac arrest.
Immediate support of vital functions.
Clinical, laboratory, functional, instrumental (non-invasive and invasive) monitoring.
Acquisition and interpretation of data according to a rational physiopathology and decision making.

There are no books to buy mandatory. The following books may be useful for personal deepening:
- Chiaranda M. Urgenze ed emergenze. 2011. Edizioni Piccin
- Ciraolo R, De Blasio E. Emodinamica chiavi in mano. 2° Ed. Antonio Delfino. 2016.
- European Resuscitation Council. Advanced Life support. 2011. IRC Edizioni, Bologna
- Kette F, Schiraldi F. Emogasanalisi, fluidi ed elettroliti. 2008. IRC Edizioni, Bologna
- Nardi G, De Blasio E, Ciraolo R. Linee guida per un Centro di Rianimazione .vent’anni dopo. 2019. Editore Delfino
- Romano E. Il malato critico. 2000. ed. UTET-Torino
- Schiraldi F, Guiotto G. Equilibrio acido-base, ossigeno, fluidi & elettroliti. 2012. ed. McGraw Hill

The critically ill patients and the care settings where they are managed (semi-intensive and intensive).
The main nursing sensitive outcomes in the critical patient: major adverse events, mortality, failure-to-rescue.
Strategies for preventing major adverse events and avoidable mortality. The "track and trigger" quick response systems: the afferent arm (threshold systems, scoring systems); the efferent arm (emergency medical team, ramp-up systems, critical care outreach).
The essential concepts of physiology (respiratory system, cardiovascular system, renal excretory system) and pathophysiology (oxygenation and oxygen transport, alterations in oxygen supply and consumption, oxidative metabolism, alteration of carbon dioxide elimination, alterations of acid-base balance, lung failure and pump failure, shock and compensation mechanisms) associated with critical illness and the resulting nursing implications.
The universal approach to critical illness (ABCDE) and its rational basis (quick identification and treatment of situations based on life-threatening risk priority).
Clinical and functional monitoring: respiratory and alveolar ventilation, blood pressure and derived data, perfusion, consciousness, diuresis, fluid balance.
Instrumental monitoring: pulse oximetry, capnometry, central venous pressure, electrocardiogram.
Laboratory monitoring: blood gas analysis.
Peri-arrest situations related to obstructive airway and respiratory failure (detection and interpretation of clinical signs and vital parameters) and correlation with main pathologic pictures (respiratory arrest, hypoxemic, hypercapnic, and hypoxemic-hypercapnic diseases).
Peri-arrest situations related to cardiovascular function failure (detection and interpretation of clinical signs and vital parameters) and correlation with main pathologic pictures (hypoperfusion and cardiovascular triad).
The main interventions to support vital functions: airway patency, oxygen therapy, ventilation support, fluid expansion, cardioversion, heart pacing, pharmacological therapy (basic elements).
The routes of administration for emergency drugs and the rationale for the choice.
Cardiac arrest and cardiopulmonary resuscitation (the chain of survival, basic and advanced life support, ACR-related ECG rhythms, defibrillation, post-ACR management and prevention of anoxic damage).

Lectures with broad interaction between students and teacher.
Discussion of clinical cases.

The teacher will provide a written overview of the main topics of the program (on Moodle platform). For the purposes of the final evaluation it is essential to integrate these contents with what learned and discussed during the lessons.

The final examination will be held in a joint session in the presence of the full commission of the integrated course.
The assessment for the module “nursing in the critical ill patient” will take place through the oral discussion of a clinical case proposed by the lecturer. To pass the exam, the student will have to demonstrate how to use the correct approach methodology according to the situation described, to be able to perform a comprehensive clinical examination and interpret the clinical, laboratory and electrocardiographic data, to be able to perform a complete diagnostic reasoning to identify the problem and classify the level of criticality, and to identify the correct interventions to be planned.
The student must also demonstrate the have appropriate knowledge about the etiopathogenesys of health problems highlighted in the proposed clinical case.
The evaluation (pass: 18/30) will be assigned based on the following criteria:
Insufficient: Little or no knowledge and understanding of the topics; limited capacity for analysis and synthesis, frequent generalizations of the required contents; inability to use technical language.
18-20: Just enough knowledge and understanding of topics, with obvious imperfections; just sufficient capacity for analysis, synthesis and independent judgement; poor ability to use technical language.
21-23: Sufficient knowledge and understanding of topics; sufficient capacity for analysis and synthesis with the ability to logically and coherently argue the required contents; sufficient ability to use technical language.
24-26: Fair knowledge and understanding of the topics; fair capacity for analysis and synthesis with the ability to rigorously argue the required contents; fair ability to use technical language.
27-29: Good knowledge and understanding of required content; good capacity for analysis and synthesis with the ability to rigorously argue the required contents; good ability to use technical language.
30-30 cum laude: Excellent level of knowledge and understanding of the requested contents with an excellent capacity for analysis and synthesis with the ability to argue the requested contents in a rigorous, innovative and original way; excellent ability to use technical language.

This course explores topics closely related to one or more goals of the United Nations 2030 Agenda for Sustainable Development (SDGs)