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 2013年10月19日(土)

救急集中治療医学講座も開講10周年を迎えました。10月19日(土)に祝賀会を開催しました。

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CURRICULUM FOR SPECIALIZED MEDICAL TRAINING

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Curriculum for specialized medical training
Emergency and Critical care unit is an indispensable part of acute-phase treatment. As it is a central unit, we all have to be able to take care of any kind of acute patient. The presence of emergency and critical care specialists, and other full-time physicians, enhances the quality of acute phase treatment. We are especially distinguished by our practicing of Closed-Policy with a core portfolio of specialists and full-time physicians. Thanks to the presence of experts and full-time specialists in emergency and critical care units, the death rate of patients is reduced by 30-50 percent. Since we have introduced Closed-Policy in the emergency and critical unit, the medical treatment records have shown a drastic improvement to a level that would be considered excellent at any other medical facility. Thus, for becoming a skillful doctor with a good prognostic sense, training in a medical facility with full time specialists and physicians is essential. I have a faith that training here will lead to the acquisition of the medical skills that are required in acute phase treatments.

Aim

Want to become qualified critical care doctor[1], and an emergency doctor [2]
To become a skillful doctor who knows how to go about prognosis and improve things for a patient, and not merely be qualified on paper.

Features

You will study the basic required skills and knowledge needed to become a qualified emergency and critical care specialist. The most important and difficult to learn skill is the correct reasoning for making diagnoses and deciding on treatment. You will be in-charge of about three critical patients at the emergency and critical care unit of Tokushima University Hospital; you will take your time to decide treatment strategies, and in this process you will learn the reasoning skills needed for making appropriate diagnoses and deciding on treatments.

Morning meeting: 08:30 AM Daily
Evening meeting: 04:30PM Daily
Routine check-up: Sunday only on 09.00AM onward (check-up by a professor on Monday and Thursday)
Case study meeting: Every Thursday on 05:30PM

Emergency and critical care unit at Tokushima University Hospital is not an emergency medical care center. For that reason, there are not many opportunities to see many emergency patients for diagnosis and treatment.
In order to improve our training results, we have collaborated with Kochi Japan Red Cross Hospital Emergency Unit, and Kurashiki Central Hospital General Medical Unit, which takes in a great number of emergency patients, and has many specialists working full-time.

Training in-charge

Masaji Nishimura (Japanese Society of Anesthesiologists Board Certified Anesthesiologist, Fellow of Japanese Society of Anesthesiologists, Fellow of the Japanese Society of Intensive Care Medicine, Fellow of the Japanese Association for Acute Medicine)

Advisor system

Advisor

Masaji Nishimura (Japanese Society of Anesthesiologists Board Certified Anesthesiologist, Fellow of Japanese Society of Anesthesiologists, Fellow of the Japanese Society of Intensive Care Medicine, Fellow of the Japanese Association for Acute Medicine)

Hideaki Imanaka (Japanese Society of Anesthesiologists Board Certified Anesthesiologist, Fellow of the Japanese Society of Intensive Care Medicine)

Jun Oto (Japanese Society of Anesthesiologists Board Certified Anesthesiologist, Fellow of Japanese Society of Anesthesiologists, Fellow of the Japanese Society of Intensive Care Medicine, Fellow of the Japanese Association for Acute Medicine)

Emiko Nakataki ( Qualified physician)

Rie Ono (anesthesia specialist)

One advisor on one trainee, this way our medical treatment to a patient is a joint work.

Disease based training goals

Study of priorities of tests and treatment based on physical examination of the patients, through diagnosis and medical treatment of tertiary emergency disease, patients of impaired consciousness, in-house emergency patients, and post operative patients. Study to gain required knowledge and techniques for the treatment of a critical patient.

Study of know-how and techniques of mechanical ventilation and cardiovascular therapy, as well as the indication and treatment of blood purification methods, through the medical treatment of a critical patient.

In case of a critical patient, learning how to provide highly specialized diagnoses and treatment through stabilizing respiration and blood circulation, then administering the diagnosis and medical treatment.

Through post operative treatment of a patient, learning the point of postoperative processes and postoperative management.

Study of highly specialized primary treatment for an emergency patient.

Study of diagnosis and primary treatment as well as details of treatment for a stroke patient.

Study of diagnosis and primary treatment as well as details of treatment for a patient of acute respiratory failure.

Study of diagnosis and primary treatment as well as details of treatment for a patient of acute heart failure.

Study of diagnosis and primary treatment as well as details of treatment for a patient of septic shock.

We have introduced standardized education programs as well in order to foster acquisition of the know-how that is rarely touched upon medical case studies.

Clinical track record

There were 363 patients in the critical care and emergency unit, 1236 patients in the intermediate care unit, and 389 patients in the stroke care unit in 2008. There were 416 patients in the critical care and emergency unit, 1422 patients in the intermediate care unit, and 368 patients in the stroke care unit in 2009. Admitted patients mainly are post-operative from the departments of cardiovascular surgery, thoracic surgery, obstetrics, urology, and orthopedics surgery, and severe co-morbid patients from cardiology, respiratory medicine, gastroenterology, and hematology. Other than that, we also admit and provide treatment to in-house emergency patients, and tertiary emergency patients (burn, medicine poisoning, and cardiopulmonary resuscitation).

Training schedule

A five year track record as a medical association member is a must to become a specialized doctor of critical care medicine. A three-year track record as a medical association member is a must to join emergency medicine. Generally, one becomes a member of the medical association after completing one’s medical studies and training. First, one aims to be a qualified emergency care specialist, and then work toward becoming a qualified critical care specialist. In five years time one goes through training at three places mentioned below, which leads to becoming a qualified doctor for both emergency and critical care. In principle, one must train at least two locations. One year training is given at Tokushima University Hospital emergency and critical care unit. Training at one place lasts a minimum of one year. Learning intubation is also an essential skill for the treatment of emergency and critical care patients. In five years time, one learns intubation in one’s duties at the anesthesia department, which is from six month to one year at Tokushima University Hospital.

Tokushima University Hospital, emergency and critical care unit

Studying primarily critical care medical science

Kochi Red-Cross Hospital, Emergency Unit

Studying diagnosis and primary treatment for many emergency patients

Kurashiki Central Hospital General Medical Unit

Studying diagnosis and primary treatment for an emergency patient

[1] Qualifications to earn certification for critical care specialization
One must have five years of clinical experience after earning becoming a physician. Also, one must possess sound knowledge and experience concerning critical care treatment.

[2] Qualifications to earn certification for emergency care specialization
A medical license from Japan
Must have been a member of the same medical association for more than three years continuously
Must have more than five years clinical experience
Must have more than three years clinical experience as an emergency care doctor, from a medical institute or its equivalent institution

About clinical experience after graduation

Overview

The study of emergency and critical care is an area of direct study of critical patients and their treatment. It is a way to learn dynamic knowledge, as medical students and post studies trainees are exposed directly to the treatment. Medical students and trainees work together with an advisor doctor to administer treatment to a critical patient. In this way they work to deepen their knowledge as well as teach required know-how of medical science.

General Goals

1.Diagnosis of a critical care patient, and administering tests and treatment. Also, learning required skills for critical care treatment.

2. A patient is sent to their department after primary diagnosis of an emergency care disease, which requires a high level of specialization and frequent attention. A high level is pursued by asking for feedback from the respective departments.

3. We have introduced standardized education programs as well in order to learn the know-how which is rarely touched upon in medical case studies.

1 Critical care treatment for a severe patient.
acute respiratory failure, acute heart failure, shock, infection, cerebro-vascular disease.
2 Primary and critical care of a tertiary disease.
Cardiopulmonary arrest, acute poisoning, burn, environmental insult, external injury
3 Complete body control of preoperative period.
Post-surgery control, evaluation of a patient before surgery.
4 Emergency care treatment related Off-Job Training
Basic life support and advanced cardiac life support(BLS,ACLS)
Triage training of disaster treatment etc.

Seminar

Short seminars are conducted twice a week to enhance pathological understanding, from basic to specialized one. (60 minutes each)

Disease discussion meet

A discussion meet is called once a week regarding admitted patients and their diseases. Also, in order to deepen knowledge learned, a journal club is conducted once in a week.

Attaining goals

After understanding the state of the disease of a critical patient, a proper medical treatment is administered. The techniques required for that are to be acquired.

1 Learning knowledge pertaining to airway management, mask-to-face ventilation, and intubation technique.
2 Learning the application of mechanical ventilation.
3 Learning the knowledge and techniques required for intravenous catheter insertion and arterial puncture.
4 Understanding and applying cardiovascular agents. Learning the methods of circulation assistance.
5 Understanding and learning to apply acute blood purification methods, and the making and application of blood cleansing circuits.
6 Application of lumbar, thoracic cavity, abdominal puncture.
7 Learning to administer proper treatment after blood gas sampling and its analysis.
8 Learning to administer burn treatment.

Training period: Three months.

Tokushima University, Emergency and Critical Care Unit (Training at Emergency and Critical Care Unit, Seminar on its working system)

Write to us for any query regarding the same to:

〒770-8503
Tokushima University Hospital,
Emergency and Critical Care Medicine
3-18-15 Kuramoto-cho, Tokushima City,
Tokushima Prefecture
Japan.

E-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.
Tel:088-633-9347 Fax:088-633-9339



 

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〒770-8503 徳島県徳島市蔵本町2丁目50-1 東棟4F


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