Form № H – 3.04

SHEE “Ternopil State Medical University I.Ya.Gorbachevskogo MoH Ukraine”

(full name of Higher Education)

Department of military field and ambulatory surgery

“APPROVED”

first Vice-Rector

Dr. med. n., prof. Shulgai A.G.

“__29__” ___ August___2014_ Year

 

WORKING Program of academic discipline

Military field surgery

(code and name of discipline)

 

training direction          1201–  Medicine

                                                               (code and name of the training direction)

 

Speciality:                     7.110105 “Medical-prophylaxys business”

                                           (code and name of the specialty)

 

Faculty                      medical

                                                      (name of Institute, faculty, department)

 

2014 – 2015 academic year

 

The work program of Military field surgery

(name of discipline)

 

            In the direction of 1201–  Medicine, Speciality 7.110105 “Medical-prophylaxys business”

 

 

developers:

Head of the Department of military field and ambulatory surgery, Dr. med. Mr. Professor Gerasymchuk P.O.

PhD, Assistant, Department of military field and ambulatory surgery Fira D.B.

               (indicate the authors, their positions, degrees and academic titles)

 

 

Work program approved at a meeting of the department of military field and ambulatory surgery

Protocol of “_27_” ___ August____2014_ year № _1_

 

Head of the Department of military field and ambulatory surgery

______________________ (Gerasymchuk P.O.)

                                                          (signature)              (name and initials)

 

Ó __________, 2014

Ó __________, 2015

 

1.    DESCRIPTION OF THE DISCIPLINE

 

 

Note.

The ratio of class hours for independent and individual work is (%):

for full-time education – 66,6 : 33,4

2. The purpose and objectives of the discipline

 

Objective: The purpose of military surgery are preparing medical wide profile, which is able to provide medical care in emergency situations and in terms of military action. Students must master the basics of providing medical care in a combat surgical pathology wartime and emergencies, acquire knowledge and learn the discipline and to work a practical skills and some medical manipulation.

Objectives:

• create a communication, moral and deontological medical specialist skills and principles of professional subordination of military surgery;

• learn the basic position of the organization and provision of surgical care during medical evacuation;

• to study and learn the basic themes of the course of military surgery;

• explore ways and types of medical injuries sorting;

• learn the tricks and techniques of medical care in modern combat trauma and emergency situations.

A study of the discipline the student must know:

– General Principles of surgical care to the wounded in wartime conditions;

– Problems and scope of care during medical evacuation in wartime;

– Methods and types of assistance to victims during medical evacuation;

– Clinic, diagnosis and treatment of modern gunshot , mechanical and mine-explosive injuries, wound infections, traumatic shock, bleeding;

Be able to

– To collect the anamnesis of the victim;

– To assess the function of the basic vital body systems (cardiovascular, respiratory, nervous system);

– To determine the amount, nature and priority of assistance to victims, a medical and evacuation – transport sorting;

– Assess the nature of gunshot wound and diagnose penetrating wound cavities of the body of the victim;

– Diagnose mechanical and gunshot lesions of the musculoskeletal system;

– Set the type and nature of bleeding;

– To carry out a temporary stop the bleeding;

– To carry out debridement;

– To carry out transport immobilization;

– To evacuate the injured from the battlefield;

– Be able to diagnose basic purulent-septic complications of modern gunshot, mechanical and mine-explosive damage;

3. The program of the discipline

MODULE 1. Organization and general issues of military surgery. Modern combat gunshot injury, and treatment of complications during medical evacuation.

Content module 1. Common questions of military surgery. Modern combat gunshot injury, their treatment during medical evacuation.

Specific objectives:

– Define the role of discipline in the overall system of training doctors of modern combat injury;

– Carry out basic types of medical injuries sorting;

– Classify modern gunshot injury, their diagnosis, treatment during medical evacuation;

– To determine the structure of the morphological changes of tissues in the wound channel with gunshot wounds;

– Provide first aid, pre-doctor and first medical aid in gunshot wounds;

– Conduct primary surgical treatment of modern gunshot wounds;

– Classify type of bleeding and the severity of hemorrhage;

– Apply methods of temporary stop bleeding;

Lesson 1 

1. Organization and content of surgical care in wartime. Organization of surgical care in the Army during medical evacuation.

2. Objective assessment of the severity of surgical trauma of combat. Assessment of the wounded. Primary and secondary survey. Evaluation of the main functions of vital organs and systems.

3. Principles of Medical sort affected in conditions of peace and wartime. The concept of the medical sort of victims. Definitions and urgency of surgical medical care to victims.

Lesson 2

1. Gunshot wound. Characteristics of modern gunshot ammunition. Wound ballistics. Modern types of firearms. The possible structure of sanitary losses. Damaging factors in human tissue gunshot wound. Wound ballistics.

2. Gunshot wound. Modern gunshot wound and wound disease. Features of structural and functional changes in tissues, depending on the type of weapon. Peculiarities of the phases of wound healing with gunshot wounds. Current views on the wound disease, periods.

3. Principles of treatment of gunshot wounds. Intensive care to the wounded. Medical aid to the wounded, prevention of wound infection. Primary surgical treatment of wounds, their features and differences from gunshot wounds. Features and Differences primary surgical treatment for large mechanical damage. Types of primary surgical treatment by volume and deadlines. Indications, contraindications, and no indications for primary surgical treatment of wounds. Methods for stitching wounds. Error executing primary surgical treatment of wounds. Terminal states. Intensive therapy and pulmonary heart resuscitation. Indications and technique of mechanical ventilation and indirect heart massage. Testing techniques cardiopulmonary resuscitation on the phantom.

Lesson 3

1. Bleeding and blood loss. Definition and types of bleeding. Reaction to acute blood loss. Determination of blood loss. Independent mechanism to stop bleeding.

 

2. Methods of temporary and the final stopping bleeding. Methods temporary stop bleeding (finger pressing, pressing bandage, twist, tourniquet).

Final methods stopping bleeding: mechanical, physical, biological. Vascular suture. Transplantation, aloplastic.

 

3.    Notion of hemorrhagic shock. Pathogenesis, clinical manifestations, diagnosis and treatment of hemorrhagic shock.

 

Content module 2. Mechanical and gunshot lesions of the musculoskeletal system. Infectious complications of combat wounds and injuries, their prevention and treatment.

Specific objectives:

– Classify modern mechanical and mine-explosive destruction, their diagnosis, treatment during medical evacuation;

– Provide first aid, pre-doctor and first medical aid in mechanical lesions and in mine-blast injury;

– To carry out transport immobilization depending on the nature of the lesion;

– Master the methods of removal and evacuation of the wounded from the battlefield;

– Be able to diagnose the development of specific and non-specific infections in wounds and injuries;

– Organize activities on prevention and treatment of specific and non-specific infections in wounded during medical evacuation.

Lesson 4

1.    Military lesions the musculoskeletal system (fractures, dislocations, gunshot damage). General concepts of traumatic shock and crush syndrome. Fractures, dislocations: classification, clinical features, diagnosis, general treatment principles. Features of modern gunshot fractures. The definition of traumatic shock. Modern understanding of the etiology and pathogenesis of traumatic shock. Clinical manifestations of shock in various locales wounds. Combined treatment of shock. Content antishock measures in terms of military action and extreme situations. Early prevention of shock. Long crush syndrome, etiology and pathogenesis. Classification. Phases of development. Clinic. Modern methods of treatment in military action and natural disasters.

2. Transportation immobilization, types and methods of removal of the wounded from the battlefield. Transport immobilization improvised and standard means depending on the type and location of the place of injury. Methods and means of evacuation of the wounded from the battlefield.

3. Mine-explosive injury. Features lesions of the human body with mine-blast injury. Principles of medical care in mine-blast injury. Defeat mine-explosive devices explosives.

 

Lesson 5

1. Infectious complications of combat wounds and injuries. Infected wounds. The course of wound healing in purulent wounds. Surgical treatment of purulent wounds, types of secondary sutures. Treatment of purulent wounds depending on the phase of wound healing. Types of drainage of purulent wounds.

2. Specific wound infection (tetanus). Etiology, pathogenesis, clinical manifestations, diagnosis, principles of treatment of tetanus.

3. Anaerobic сlostridial and nonclostridial infection in a combat injury. Terms of anaerobic infection in the wound. Principles of diagnosis and treatment.

 

4. The structure of the discipline

 

5. Topics of lectures

The lecture course is not provided

6. Themes of seminars

 

7. Themes practical classes – not provided

8. Themes laboratory classes – not provided

9. Individual work

 

10. Individual lessons

Not provided

11. Training Methods

According to sources of knowledge such methods of learning: verbal – the story, explanation, lecture, briefing; demonstrable – demonstration, illustration, practical – practical work tasks.

By the nature of the logic of knowledge, the following methods:

analytical, synthetic, analytical and synthetic, inductive, deductive.

By the level of mental activity independent methods are used:

problematic, partly-search, research.

 

12. Methods of control

Forms of control and evaluation of discipline

In assessing students’ knowledge preferred standardized methods of control: test (oral, written, computer), structured written work, structured control skills.

Evaluation is defined as the discipline assessment for the module in which the structured academic discipline.

Estimation for the module is defined as total current learning activities and assessment of final module control and expressed as a 200-point system.

Forms of control

Current control is carried out at each lab, according to the specific objectives of the theme. In all practical exercises used objective monitoring of theoretical training and learning practical skills.

 Forms of monitoring :

Theoretical knowledge – test tasks , computer testing , individual survey , interview , written work .

Practical skills – independent performance of individual tasks and the ability to draw conclusions , the ability to independently perform certain operations , writing schemes and algorithms . Final control is based on theoretical knowledge and practical skills.

Final control module assimilation occurs on completion of study unit relevant content modules through testing and is considered enrolled if the student scored at least 50 points.

Forms of final control:

Theoretical knowledge – the system issues a written and computer-based testing.

Practical skills – delivery of practical skills according to Matriculation.

 13. Distribution points that students receive

Maximum number of points is assigned to students in mastering each module (test credit) – 200, including for current educational activity – 120 points, according to the results of the final control unit – 80 points.

Assessment of current educational activity:

Student for each stage of practical training (practical part, seminar discussion, writing control) exhibited score to 12 – point scale. Then displays the arithmetic mean of the three ratings, which is set in a magazine.

On the practical side for each stage of the mark is as follows:

1. At the beginning of the practical part , students must admit to carrying out practical work ( they need to know during the practical part of the lesson , etc.). During this stage the student can gain a maximum of 2 points.

2 . The implementation of practical work is careful teacher , after it evaluates the result. Maximum for this type of work a student can get 4 points.

3 . Protection practice. At this stage, the student can receive a maximum of 6 points.

At the end of the practical part of the teacher displays the arithmetic mean of each assessment of the lessons and exposes it to each student.

 

DISTRIBUTION POINTS THAT STUDENTS ASSIGNS

 

 

 Minimum grade point average, with whom the student be allowed to take final control module – 4 points.

The maximum amount that a student can score in the study module is 120 points.

Modular final control:

 Modular final control study carried out on completion of the module. By the final control students who have completed all kinds of works , provided the curriculum , and to learn the module to get the score not less than the minimum .

Form of final control should be standardized and include control of theoretical and practical training . Specific forms of control on the basics of economic theory are defined in the work program .

Maximum score is 80 final control .

The final module control is considered enrolled if the student scored at least 50 points.

 

Rating discipline:

Based on general surgery exhibiting those students who set off all the modules in the discipline.

Number of points that the student gains on discipline, is defined as the arithmetic mean of the number of points of discipline modules and final mastering control module number 1.

Objectivity of evaluation of learning activities students should be verified by statistical methods (correlation coefficient between the current progress and the results of the final module control).

 

Conversion total number of points on hirurgiiu rating scale ECTS and a 4-point (Traditional)

The number of points in the discipline, which have been calculated students converted into ECTS scale as follows:

 

 

The percentage of students is determined on a sample of students in this course within the relevant specialty.

The number of points in the discipline, which have been calculated students converted to a 4-point scale as follows:

 

 

Based on the discipline of FX and F (« 2») exhibit student who is not credited at least one module in the discipline .

 

Score FX (” 2″) to the students who score a minimum number of points for current educational activity , but do not pass the final control module . They are entitled toresit the final module control , not more than 2 – times during the winter holidays and for two (more) weeks after the end of the spring semester on a schedule approved by the Rector.

 

Students who were rated F at the end of the study subjects ( not completed a training program of at least one module , or not typed for current educational activity modulo minimum number of points ) must undergo refresher training on an individual curriculum.

 

Scale of assessment: national and ECTS

 

14. Methodological support

1. Training materials for seminars

2. Preparation materials for the lectures.

3. Presentation of lectures.

4. Methodical instructions for seminars.

5. Variants of tasks for independent and individual work of students.

6. Tests for the final test module control.

7. Tests for daily monitoring.

8. Variants of theoretical questions for self-study.

 

15. Recommended literature

Basic

1. Військова хірургія з хірургією надзвичайних ситуацій /за ред. проф. В.Я.Білого/ // Тернопіль, “Укрмедкнига”, 2004.- 185 с.

2. Посібник до практичних занять з військово-польової хірургії / за ред. проф. О.Є. Лоскутова / // Тернопіль, “Укрмедкнига”, 2003.- 218 с.

3. Указания по военно-полевой хирургии /под. ред. А.Н. Бельских/ // Москва, 2013.- 474 с.

4. Военно-полевая хирургия. Руководство к практическим занятиям /под. ред. М.В.Лысенко/ // Москва, 2010.- 276 с.

5. Указания по военно-полевой хирургии / под. ред. В.Н. Балина / // Москва, 2000.- 416 с.

6. Военно-полевая хирургия / под. ред. Е.К.Гуманенко // Москва, 2008.- 817 с.

7. В.Ф. Трубников, В.А. Лихачев Военно-полевая хирургия // Харьков, 1990.- 299 с.

8.Юнко М.А., Яцкевич Я.Е. Хірургія військової травми. //Практикум для студентів медвузів України.- Львів, 2005-166 с.

 

Additional

1.Бадюк М.І., Левченко Ф.М., Токарчук В.П., Солярик В.В. та ін. Організація медичного забезпечення військ: Підруч. для студ. вищ. мед. закл. освіти України Ш-ІV рівнів акредитації/За редакцією професора Паська В.В. – К.: “МП Леся”, 2005. -425 с.

2. Бадюк МІ., Токарчук В.П., Солярик В.В., Бадюк Л.М., Гут Т.М Військово-медична підготовка / Під ред. Бадюка МІ. – К.: “МП Леся”, 2007. -484 с.

3. Білий В.Я., Пасько В.В., Сохін О.О. Військово-медична доктрина України. //Наука і оборона, 2000 р. -№ 4. -С. 18-23.

4. Дубицький А.Ю., Семенов І.О., Чепкій Л.П. Медицина катастроф, –К.: “Здоров’я”, 1993.-234 с.

5. Инструкция по этапному лечению раненых с боевой хирургической травмой //ЦВМУ МО, Воениздат, 1981,-20 с.

6. Ерюхин ИА., Нечаев ЗА. Военно-полевая хирургия. Учебник. – С- Пб:ВМедА, 1994.-540 с.

7. Жиляев Е.Г., Чернецов А.А., Беленьский В.М. Организационные аспекты оказания хирургической помощи раненым на этапах медицинской эвакуации. /Воен-мед.журнал, 1998,№9,-с. 8-12.

8. Лисицын К.М. Военно-полевая хирургия. – М.: Медицина, 1982 —567 с.

9. Маслов В.И. Практические занятия по военно-полевой хирургии. Из-ю Саратовского университета, 1988,-216 с.

10. Медицина катастроф. Учебное пособие под ред. В.М.Рябочкина. -М., “ИНИ ЛТД”, 1996,272 с.

11.        Нечаев ЗА., Грицанов А.И., Фомин Н.Ф. Минно-взрывная травма.- С.-Пб.: Альд, 1994.-488 с.

12. Указания по военно-полевой хирургии.- М:ГВМУ МО РФ, 2000.-415с.

27.Шапошников Ю.Г., Маслов В.И. Военно-полевая хирургия. -М: “Медицина”, 1995 Г.-432 с.

13.  Петров С.В. Общая хирургия. // М.: ГЭОТАР-Медиа, 2010.- 768 с.

14.  Гостищев В.К. Общая хирургия // М.: ГЭОТАР-Медиа, 2009.- 608 с.

15.  Хірургія: Підручник з загальної хірургії / за ред. Я.С. Березницького, М.П.Захараша, В.Г. Мішалова, В.О. Шідловського.- Дніпропетровськ: РВА “Дніпро-VAL”, 2006.- 443 с.

16.  Пантьо В.І., Шимон В.М., Болдіжар О.О. Загальна хірургія // Ужгород, ІВА, 2010.- 464 с.

17.  Л.Я. Ковальчук та співав. Алгоритми спілкування студентів (лікарів) з пацієнтами (методичні рекомендації). Тернопіль, ТДМУ, «Укрмедкнига» 2009, 39 с.

 

16. Information Resources

1. Materials to prepare students for practical classes.