When everything falters! Treatment of seriously ill patients at Intensive Care Unit, 3 credits

All higher education credits from semester 1-6.

The general aim is that the student should obtain a broad and advanced knowledge and a basic security in how the initial treatment takes place of acute ill patients paired with advanced knowledge within pathophysiology and pharmacology. The knowledge is tiered according to the SOLO taxonomy (S1-S4) and the skills according to Miller's pyramid (M1-M4) *. Knowledge and understanding The student should: - Be able to understand abnormal physical structure and function symptom and pathophysiology and basic principles of investigation and treatment of diseases at a multi-disciplinary intensive care unit (S3). - Be familiar with ethical principles of care of patients at an intensive care unit and for handling of patient in the final stage of life (S2). - Be familiar with the brain death concept and principles of organ donation (S2). - Know to how a mobile intensive care team (the MIG-team) works outside the intensive care unit (S2). Skills The student should: - be able to identify acute diagnose, process and treat patients with failing organ systems. respiration, circulation, neurology and renal and hepatic function and patients in shock (M3). - be able to connect pathophysiology and pharmacology to clinical conditions (M3). - be able to process and interpret the results of medical history and common invesigations, and set diagnosis and discuss differential diagnoses for intensive care-demanding patients (M3). - be able to discuss clinical decisions and action plans for intensive care-demanding patients (M2). - be able to analyse, determine and base ethical decisions (M3). Attitude The student should: - be able to build further on the knowledge and attitudes concerning the fundamental value, basic ethical principles, own values and attitudes that have been acquired earlier under the studies of the health care (M3) . - be able to show a critical and scholarly attitude (M3). - be able to identify, discuss and explain ethical problems of own and others' action within the intensive care, and in the final stage of life (M3).

The course consists of advanced study around intensive care including pathophysiology and pharmacology. The course is an advanced course after the course clinical medicine specialisation surgery. On completion of the course, the student is expected to have a broader and advanced knowledge for the future work as physicians respect treatment, diagnostics and treatment of seriously ill patients at a multi-disciplinary intensive care unit. Basic scientific knowledge will be integrated in the different parts of the course. Professional skills are integrated, above all, in the placement clinical duty. Ethical issues and attitudes are discussed. The teaching is focused on evidence-based medicine where each part in the course should include instruction, in which this is taken into account. During the course be informed about ongoing research project within the intensive care Integrating assignments: • Respiration: Respiratory failure • Circulation: Circulation failure • Mental: Unconsciousness/coma

The course consists of lectures, case-based and student-activating seminars, rounds, demonstrations, practical exercises. School located placement will take place at intensive care units at Karolinska Universitets-sjukhusets intensive care units in both Huddinge and Solna, where also participation in 24-hour duty takes place. The course is completed with an examination.

Compulsory parts: Roll-calls, all seminars, demonstrations, proficiency training and all school located teaching including 24-hour duty is compulsory. Examination: At the end of the course, an examination through oral discussion cases is arranged.

Limitations in the right to get credit for the course in a degree The course may not be included in a degree at the same time as an advanced course completed inside or outside the country, the contents of which fully or in essential parts corresponds to the current course contents. The course connects to and enhances core knowledge, mainly in the stages of the Study Programme in Medicine B. Examination The examiner may with immediate effect interrupt a student's clinical rotation (VFU), or the equivalent, if the student demonstrates such serious deficiencies in knowledge, skills or attitudes that patient safety or patient confidence in healthcare is at risk. When clinical rotation is interrupted according to this, it implies that the student fails in the current part, and that one clinical rotation opportunity is used up. In such cases, an individual action plan should be set up for required activities and examinations, before the student is given a possibility for a new clinical rotation in the course. Eligibility A student failing due to shortcoming in knowledge skills or attitudes, thus jeopardizing patient security and/or trust in medical care, could be assigned for a new clinical rotation only after having completed the individual plan. * The knowledge is tiered according to the SOLO taxonomy: S1) simple (e.g. know, identify), S2) compound (e.g. account for, describe), S3) related (e.g. analyse, relate), and S4) extended (e.g. theorise, analyse). The skills are structured according to Miller's pyramid: M1) know, M2) know how to carry out M3) be able to demonstrate, and M4) be able to carry out in a professional manner.