Diploma Course in Operation Theatre and Anaesthesia Technology ALLIED HEALTH SCIENCES. II year - Syllabus
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1 Diploma Course in Operation Theatre and Anaesthesia Technology ALLIED HEALTH SCIENCES Main Syllabus II year - Syllabus 1. Applied Anatomy and Physiology 2. Clinical Pharamacology 3. CSSD Procedures 4. Principles of Anaesthesia 5. Basic Anaesthetic techniques 6. Regional Anaesthetic techniques 1. APPLIED ANATOMY AND PHYSIOLOGY RELATED TO ANAESTHESIA I. RESPIRATORY SYSTEM A. Structure and function of the respiratory tract in relation to respiratory system Nose - Role in humidificatlon Pharynx - Obstruction in airways Larynx - Movement or vocal cords, Cord palsies. Trachea & Bronchial tree - vessels, nerve supply, respiratory tract, reflexes, bronchosparm Alveoli - Layers, Surfactants B. Respiratory Physiology Control or breathing Respiratory muscles - diaphragm,intercostals Lung volumes - dead space, vital capacity, FRC etc. Pleural cavity - intrapleural pressure, pneumothorax. 1
2 Work of breathing - airway resistance, compliance Respiratory movements under anaesthesia. Tracheal tug - signs, hiccup C. Pulmonary Gas Exchange And Acid Base Status Pulmonary circulation - Pulmonary oedema, pulmonary hypertension Pulmonary function tests. Transfer of gases - oxygen & Carbondioxide Acid base status, definitions, acidosis types, Alkalosis types, buffers in the body. D. Oxygen: properties, storage, supply, hypoxia E. Respiratory failure, type, clinical features, causes. II. CARDIOVASCULAR SYSTEM Anatomy - Chambers of the heart, major vasculature. Coronary supply, innervation. Conduction system. Cardiac output - determinants, heart rate, preload, after load. Coronary blood flow& myocardial oxygen supply ECG - arrhythmias cardiovascular response to anesthetic & surgical procedures. Hypotension - causes, errects, management. Cardio pulmonary resuscitation. Myocardial infarction, hypertension. 2
3 III. FLUIDS AND ELECTROLYTES Body Fluids - Composition Water, sodium and potassium balance I.V. Fluids - composition & administration I.V. Cannulation.\ IV. BLOOD TRANSFUSION Blood grouping, storage, administration 2. Clinical Pharmacology ANTISIALAGOGUES Atropine, Glycophyrrolate SEDATIVES I ANXIOLYTICS Diazepam, Midazolam, Phenergan, Lorazepam, Chloropromazine,Trichlophos NARCOTICS Morphine, Pethidine, Fentanyl, Pentazozine ANTIEMETICS Metaoclopramide,Ondanseteron, Dexamethasone INDUCTION AGENT Thiopentone, Diazepam, Midazolam, Ketamine, Propofol, Etomidate. MUSCLE RELAXANTS Depolarising - Suxamethonium, Non depolar:sing -Pancuronium, Vecuronium, Atracurium, rocuranium 3
4 INHALATIONAL GASES Gases - 02, N20, Air Agents - Ether-, Halothane, Isofllurane, Saevoflurane, Desflurane REVERSAL AGENTS Neostigmine, Glysopyrrolate, Atropine, Nalorphine, Naloxone, Flumazenil (Diazepam) LOCAL ANAESTHETICS Xylocaine, Preparation, Local Bupivacaine - Topical, Prilocaine-jelly, Emla - Ointment, Etidocaine. Ropivacaine EMERGENCY DRUGS Adrenaline : Mode or administration, dilution, dosage, effects, Isoprenaline Atropine, bicarbonate, calcium, ephedrine, xylocard, Ionotropes : dopamine, dobutamine, amidaron Aminophylline, hydrocortisone, antihistamlnics, potassium. Cardlovascular drugs Antihypertensives Antiarhythmics Beta - Blockers Ca - Channel blockers. Vasodilators Respiratory system Renal system 3. CSSD Procedures - nitroglycerin & sodium nitroprusside - Bronchodilators, respiratory stimulants o Bronchiolytic agents - Diuretics,furosemide,mannitol 4
5 1. Waste disposal collection of used items from user area, reception protective clothing and disinfections sage gaurds, 2. use of disinfectionts sorting and classification of equipment for cleaning purposes, sharps, blunt lighted etc. contaminated high risk baby care - delicate instruments or hot care instruments, 3. cleaning process - use of detergents. Mechanical cleaning apparatus, cleaning instruments, cleaning jars, receivers bowls etc. trays, basins and similar hand ware utensils. Cleaning of catheters and tubings, cleaning glass ware, cleaning syringes and needles. 4. Materials used for wrapping and packing assembling pack contents. Types of packs prepared. Inclusion of trays ahd galliparts in packs. Method of wrapping and making use of indications to show that a pack of container has been through a sterilization process date stamping. 5. General observations principles of sterlization. Moist heat sterlization. Dry heat sterlization. EO gas sterlization. H202 gas plasma vapo sterlization. 4. PRINCIPLES OF ANAESTHESIA 1. MEDICAL GAS SUPPLY Compressed gas cylinders Colour coding Cylinder valves; pin index. Gas piping system Recommendations for piping system Alarms & safety devices. 2. ANAESTHESIA MACHINE Hanger and yoke system Cylinder pressure gauge Pressure regulator Flow meter assembly Vapourizers - types, hazards, maintenance, filling and draining, etc. 3. BREATHING SYSTEM General considerations: humidity & heat 5
6 Common components - connectors, adaptors, reservoir bags. Capnography ; etc02 Pulse oximetry Methods of humidification. Classification of breathing system Mapleson system - a b c d e f Jackson Rees system, Bain circuit Non rebreathing valves - ambu valves The circle system Components Soda lime, indicators 4. FACE MASKS & AIRWAY LARYNGOSCOPES Types, sizes Endotracheal tubes - Types, sizes. Cuff system Fixing, removing and inflating cuff, checking tube position complications. 5. ANAESTHESIA VENTILATOR AND WORKING PRINCIPLES. 6. MONITORING ECG Sp02 Temperature IBP CVP PA Pressure LA Pressure 5. BASIC ANAESTHETIC TECHNIQUES HISTORY OF ANAESTHESIA First successful clinical demonstration: Pre - historic ( ether) era Inhalational anesthetic era Regional anesthetic era Intravenous anesthetic era Modem anesthetic era Minimum standard of anesthesia Who should give anesthesia PRE-OP PREPARATION: 6
7 Pre anesthetic assessment~ History, past history - disease / Surgery / and personal history - Smoking / alcohol General physical assessment, systemic examination CVS, RS, CNS INVESTIGATIONS Routine - Haematological - their significance - Urine - E.C.G. - Chest X - ray Special -Endcorine, hormonal assays - Echocardiography - Angiography - Liver function test - Renal function test - Others Case acceptance: ASA grading - I, II, III, IV. V PRE - ANAESTHETIC ORDERS: Patient - Informed consent - Npo - Premedication - advantages, drugs used - Special instructions - if any Machine - Checking the machine 02, N20, suction apparatus Laryngoscops, et tubes, airways - Things for IV accessibility - Other monitoring systems Drugs - Emergency drugs - Anesthetic drugs INTRAOPERATIVE MANAGEMENT ConfIrm the identification of the patient Monitoring - minimum Noninvasive & Invasive monitoring Induction - drugs used Endotracheal intubation Maintenance of anesthesia Positioning of the patient Blood / fluid & electrolyte balance Reversal from anesthesia - drugs used 7
8 Transferring the patient Recovery room set up and things needed POST OPERATIVE COMPLICATIONS & MANAGEMENT 6. Regional Anesthetic techniques. a. Local anaesthetic technique b. Nerve blocks c. Spinal Anaesthesia d.epidural anaesthesia Diploma Course in Allied Health Sciences EXAMINATION PATTERN II YEAR Diploma Course in Operation Theatre and Anaesthesia Technology Sl. No Subject Title Paper I - Applied Physiology & Pharmacology Paper II- Sterilization Procedures Paper III - Principles of Anesthesia University I A Practical Exam Max Min Max Min Max Min Viva Voce Question paper pattern: Essay Short Notes Short Answers Total 3 x 10 = 30 Marks 10 x 5 = 50 Marks 10 x 2 = 20 Marks 100 Marks 8
9 Internal Assessment: Paper I, II & III Theory Practical Log book - 20 Marks - 20 Marks - 10 Marks Practical Exam Pattern: Paper I 5 Spotters Write 3 lines about each. 1) Drugs 2) I.V Fluid 3) Transfusion Set, 4) Pulmonary Function Test 5) ECG 6) Local Anesthetic Agent. Paper II 5 Spotters Write 3 lines about each. 1) Auto Clave 2) Sterilization Procedures 3) Hot Air Oven 4) Disinfectant 5) Types of packs 6) Contaminants 7) Detergents 9
10 Paper III 5 Spotters Write 3 lines about each. Capnography ; etc02 Pulse oximetry IBP CVP O2, N2O Suction apparatus Laryngoscops Et tubes Airways Things for IV accessibility. ***** 10
11 11
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