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Medical CCRN : Critical Care Register Nurse Exam

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CCRN exam Format | CCRN Course Contents | CCRN Course Outline | CCRN exam Syllabus | CCRN exam Objectives


A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the exam is measured against a predetermined standard.
The passing point/cut score for the exam is established using a panel of subject matter experts, an exam development committee (EDC), who carefully reviews each exam question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each exam question.
Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the exam is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (17%)
1. Acute coronary syndrome:
a. NSTEMI
b. STEMI
c. Unstable angina
2. Acute peripheral vascular insufficiency:
a. Arterial/venous occlusion
b. Carotid artery stenosis
c. Endarterectomy
d. Fem-Pop bypass
3. Acute pulmonary edema
4. Aortic aneurysm
5. Aortic dissection
6. Aortic rupture
7. Cardiac surgery:
a. CABG
b. Valve replacement or repair
8. Cardiac tamponade
9. Cardiac trauma
10. Cardiac/vascular catheterization
11. Cardiogenic shock
12. Cardiomyopathies:
a. Dilated
b. Hypertrophic
c. Idiopathic
d. Restrictive
13. Dysrhythmias
14. Heart failure
15. Hypertensive crisis
16. Myocardial conduction system abnormalities
(e.g., prolonged QT interval, Wolff-ParkinsonWhite)
17. Papillary muscle rupture
18. Structural heart defects (acquired and congenital, including valvular disease)
19. TAVR

B. Respiratory (15%)
1. Acute pulmonary embolus
2. ARDS
3. Acute respiratory failure
4. Acute respiratory infection (e.g., pneumonia)
5. Aspiration
6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema)
7. Failure to wean from mechanical ventilation
8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions)
9. Pulmonary fibrosis
10. Pulmonary hypertension
11. Status asthmaticus
12. Thoracic surgery
13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation)
14. Transfusion-related acute lung injury (TRALI)

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetes mellitus, types 1 and 2
d. Diabetic ketoacidosis (DKA)
e. Hyperglycemia
f. Hyperosmolar hyperglycemic state (HHS)
g. Hyperthyroidism
h. Hypoglycemia (acute)
i. Hypothyroidism
j. SIADH
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC, HIT)
c. Immune deficiencies
d. Leukopenia
e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion)
f. Thrombocytopenia
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Acute abdominal trauma
c. Acute GI hemorrhage
d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions)
e. GI surgeries (e.g., Whipple, esophagectomy, resections)
f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced)
g. Malnutrition and malabsorption
h. Pancreatitis
4. Renal and Genitourinary
a. Acute genitourinary trauma
b. Acute kidney injury (AKI)
c. Chronic kidney disease (CKD)
d. Infections (e.g., kidney, urosepsis)
e. Life-threatening electrolyte imbalances
5. Integumentary
a. Cellulitis
b. IV infiltration
c. Necrotizing fasciitis
d. Pressure injury
e. Wounds:
i. infectious
ii. surgical
iii. trauma
D. Musculoskeletal/Neurological/

Psychosocial (14%)
1. Musculoskeletal
a. Compartment syndrome
b. Fractures (e.g., femur, pelvic)
c. Functional issues (e.g., immobility, falls, gait disorders)
d. Osteomyelitis
e. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Brain death
c. Delirium (e.g., hyperactive, hypoactive, mixed)
d. Dementia
e. Encephalopathy
f. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
iii. subarachnoid (traumatic or aneurysmal)
g. Increased intracranial pressure (e.g., hydrocephalus)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barr, myasthenia)
j. Neurosurgery (e.g., craniotomy, Burr holes)
k. Seizure disorders
l. Space-occupying lesions (e.g., brain tumors)
m. Stroke:
i. hemorrhagic
ii. ischemic (embolic)
iii. TIA
n. Traumatic brain injury (TBI): epidural, subdural, concussion
3. Behavioral and Psychosocial
a. Abuse/neglect
b. Aggression
c. Agitation
d. Anxiety
e. Suicidal ideation and/or behaviors
f. Depression
g. Medical non-adherence
h. PTSD
i. Risk-taking behavior
j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence)
E. Multisystem (14%)
1. Acid-base imbalance
2. Bariatric complications
3. Comorbidity in patients with transplant history
4. End-of-life care
5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
6. Hypotension
7. Infectious diseases:
a. Influenza (e.g., pandemic or epidemic)
b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE)
8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism)
9. Multiple organ dysfunction syndrome (MODS)
10. Multisystem trauma
11. Pain: acute, chronic
12. Post-intensive care syndrome (PICS)
13. Sepsis
14. Septic shock
15. Shock states:
a. Distributive (e.g., anaphylactic, neurogenic)
b. Hypovolemic
16. Sleep disruption (including sensory overload)
17. Thermoregulation
18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose)
19. Toxin/drug exposure (including allergies)

II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o physical assessment findings
o psychosocial assessment findings
Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
Recognize indications for, and manage patients requiring:
o capnography (EtCO2)
o central venous access
o medication reversal agents
o palliative care
o SvO2 monitoring
Manage patients receiving:
o complementary/alternative medicine and/or nonpharmacologic interventions
o medications (e.g., safe administration, monitoring, polypharmacy)
Monitor patients and follow protocols for pre- and postoperative care
Assess pain
Evaluate patients response to interventions
Identify and monitor normal and abnormal diagnostic test results
Manage fluid and electrolyte balance
Manage monitor alarms based on protocols and changes in patient condition Cardiovascular
Apply leads for cardiac monitoring
Identify, interpret and monitor cardiac rhythms
Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardiac catheterization
o cardioversion central venous pressure monitoring
o defibrillation
o IABP
o invasive hemodynamic monitoring
o pacing: epicardial, transcutaneous, transvenous
o pericardiocentesis
o QT interval monitoring
o ST segment monitoring
Manage patients requiring:
o endovascular stenting
o PCI Respiratory
Interpret blood gas results
Recognize indications for, and manage patients requiring:
o modes of mechanical ventilation
o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)
o oxygen therapy delivery devices
o prevention of complications related to mechanical ventilation (ventilator bundle)
o prone positioning
o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 )
o thoracentesis
o tracheostomy Hematology and Immunology
Manage patients receiving transfusion of blood products
Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion)
o related to blood conservation Neurological
Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain)
Use a swallow evaluation tool to assess dysphagia
Manage patients requiring:
o neuroendovascular interventions (e.g., coiling, thrombectomy)
o neurosurgical procedures (e.g., pre-, intra-, post-procedure)
o spinal immobilization Integumentary
Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal
Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement)
Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
Recognize indications for, and manage patients requiring:
o abdominal pressure monitoring
o GI drains
o enteral and parenteral nutrition Renal and Genitourinary
Identify nephrotoxic agents
Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound)
Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis)
Musculoskeletal
Manage patients requiring progressive mobility
Recognize indications for, and manage patients requiring, compartment syndrome monitoring
Multisystem
Manage continuous temperature monitoring
Provide end-of-life and palliative care
Recognize risk factors and manage malignant hyperthermia
Recognize indications for, and manage patients undergoing:
o continuous sedation
o intermittent sedation
o neuromuscular blockade agents
o procedural sedation - minimal
o procedural sedation - moderate
o targeted temperature management (previously known as therapeutic hypothermia)
Behavioral and Psychosocial
Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)
Use behavioral assessment tools (e.g., delirium, alcohol withdrawal, cognitive impairment)
Recognize indications for, and manage patients requiring:
o behavioral therapeutic interventions
o medication management for agitation
o physical restraints

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (14%)
1. Cardiac infection and inflammatory diseases
2. Cardiac malformations
3. Cardiac surgery
4. Cardiogenic shock
5. Cardiomyopathies
6. Cardiovascular catheterization
7. Dysrhythmias
8. Heart failure
9. Hypertensive crisis
10. Myocardial conduction system defects
11. Obstructive shock
12. Vascular occlusion
B. Respiratory (18%)
1. Acute pulmonary edema
2. Acute pulmonary embolus
3. Acute respiratory distress syndrome (ARDS)
4. Acute respiratory failure
5. Acute respiratory infection
6. Air-leak syndromes
7. Apnea of prematurity
8. Aspiration
9. Chronic pulmonary conditions
10. Congenital airway malformations
11. Failure to wean from mechanical ventilation
12. Pulmonary hypertension
13. Status asthmaticus
14. Thoracic and airway trauma
15. Thoracic surgery

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetic ketoacidosis (DKA)
d. Diabetes mellitus, types 1 and 2
e. Hyperglycemia
f. Hypoglycemia
g. Inborn errors of metabolism
h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Myelosuppression (e.g., thrombocytopenia, neutropenia)
e. Oncologic complications
f. Sickle cell crisis
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Abdominal trauma
c. Bowel infarction, obstruction and perforation
d. Gastroesophageal reflux
e. GI hemorrhage
f. GI surgery
g. Liver disease and failure
h. Malnutrition and malabsorption
i. Necrotizing enterocolitis (NEC)
j. Peritonitis
4. Renal and Genitourinary
a. AKI
b. Chronic kidney disease (CKD)
c. Hemolytic uremic syndrome (HUS)
d. Kidney transplant
e. Life-threatening electrolyte imbalances
f. Renal and genitourinary infections
g. Renal and genitourinary surgery
5. Integumentary
a. IV infiltration
b. Pressure injury
c. Skin failure (e.g., hypoperfusion)
d. Wounds

D. Musculoskeletal/Neurological/Psychosocial (15%)
1. Musculoskeletal
a. Compartment syndrome
b. Musculoskeletal surgery
c. Musculoskeletal trauma
d. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Agitation
c. Brain death
d. Congenital neurological abnormalities
e. Delirium
f. Encephalopathy
g. Head trauma
h. Hydrocephalus
i. Intracranial hemorrhage
j. Neurogenic shock
k. Neurologic infectious disease
l. Neuromuscular disorders
m. Neurosurgery
n. Pain: acute, chronic
o. Seizure disorders
p. Space-occupying lesions
q. Spinal fusion
r. Stroke
s. Traumatic brain injury (TBI)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Post-traumatic stress disorder (PTSD)
c. Post-intensive care syndrome (PICS)
d. Self-harm
e. Suicidal ideation and behavior

E. Multisystem (13%)
1. Acid-base imbalance
2. Anaphylactic shock
3. Death and dying
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypovolemic shock
6. Post-transplant complications
7. Sepsis
8. Submersion injuries (i.e. near drowning)
9. Hyperthermia and hypothermia
10. Toxin and drug exposure

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
Manage patients receiving:
o continuous sedation
o extracorporeal membrane oxygenation (ECMO)
o nonpharmacologic interventions
o pharmacologic interventions
o intra-procedural and post-procedural care
o post-operative care
o vascular access
Conduct physical assessment of critically ill or injured patients
Conduct psychosocial assessment of critically ill or injured patients
Evaluate diagnostic test results and laboratory values
Manage patients during intrahospital transport
Manage patients undergoing procedural sedation
Manage patients with temperature monitoring and regulation devices
Provide family-centered care Cardiovascular
Manage patients requiring:
o arterial catheterization (e.g., arterial line)
o cardiac catheterization
o cardioversion
o CVP monitoring
o defibrillation
o epicardial pacing
o near-infrared spectroscopy (NIRS)
o umbilical catheterization (e.g., UVC, UAC)
Manage patients with:
cardiac dysrhythmias
hemodynamic instability Respiratory
Manage patients requiring:
o artificial airways (e.g., endotracheal tubes, tracheotomy)
o assistance with airway clearance chest tubes
o high-frequency oscillatory ventilation (HFOV)
o mechanical ventilation
o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula)
o prone positioning
o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2)
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
Manage patients receiving:
o plasmapheresis, exchange transfusion or leukocyte depletion
o transfusion
Neurological
Conduct pain assessment of critically ill or injured patients
Manage patients with seizure activity
Provide end-of-life and palliative care
Manage patients requiring:
o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids)
o spinal immobilization Integumentary
Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment)
Gastrointestinal
Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
Manage patients receiving:
o enteral and parenteral nutrition
o GI drains
o intra-abdominal pressure monitoring Renal and Genitourinary
Manage patients requiring:
o electrolyte replacement
o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis)
Multisystem
Manage patients requiring progressive mobility
Behavioral and Psychosocial
Conduct behavioral assessment of critically ill or injured patients (e.g., delirium, withdrawal)
Manage patients requiring behavioral and mental health interventions
Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (5%)
1. Acute pulmonary edema
2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus)
3. Dysrhythmias
4. Heart failure
5. Hypovolemic shock
6. Structural heart defects (acquired and congenital, including valvular disease)

B. Respiratory (21%)
1. Acute respiratory distress syndrome (ARDS)
2. Acute respiratory failure
3. Acute respiratory infection (e.g., pneumonia)
4. Air-leak syndromes
5. Apnea of prematurity
6. Aspiration
7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia)
8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis)
9. Failure to wean from mechanical ventilation
10. Meconium aspiration syndrome
11. Persistent pulmonary hypertension of the newborn (PPHN)
12. Pulmonary hemorrhage
13. Pulmonary hypertension
14. Respiratory distress (RDS)
15. Thoracic surgery
16. Transient tachypnea of the newborn

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%)
1. Endocrine
a. Adrenal insufficiency
b. Hyperbilirubinemia
c. Hyperglycemia
d. Hypoglycemia
e. Inborn errors of metabolism
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Leukopenia
e. Polycythemia
f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis
g. Thrombocytopenia
3. Gastrointestinal
a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions)
b. Feeding intolerance
c. Gastroesophageal reflux
d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias)
e. GI surgeries
f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices)
g. Malnutrition and malabsorption
h. Necrotizing enterocolitis (NEC)
i. Pyloric stenosis
4. Renal and Genitourinary
a. Acute kidney injury (AKI)
b. Chronic kidney disease
c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy)
d. Genitourinary surgery
e. Infections
f. Life-threatening electrolyte imbalances
5. Integumentary
a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags)
b. IV infiltration
c. Pressure injury/ulcer (e.g., device, incontinence, immobility)
d. Wounds:
i. non-surgical
ii. surgical

D. Musculoskeletal/Neurological/Psychosocial (13%)
1. Musculoskeletal
a. Congenital or acquired musculoskeletal conditions
b. Osteopenia
2. Neurological
a. Agitation
b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele)
c. Encephalopathy
d. Head trauma (e.g., forceps and/or vacuum injury)
e. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
f. Hydrocephalus
g. Ischemic insult (e.g., stroke, periventricular leukomalacia)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., spinal muscular atrophy)
j. Neurosurgery
k. Pain (acute, chronic)
l. Seizure disorders
m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment)
n. Stress (e.g., noise, overstimulation, sleep disturbances)
o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Families in crisis (e.g., stress, grief, lack of coping)

E. Multisystem (14%)
1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations)
2. Developmental delays
3. Failure to thrive
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypotension
6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms)
7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental
abruption, placenta previa) 8. Low birth weight/prematurity
9. Sepsis
10. Terminal conditions (e.g., end-of-life, palliative care)
11. Thermoregulation
12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic).

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
Assess pain considering patients gestational age
Follow protocol for newborn car seat testing, hearing and congenital heart disease screening
Follow protocol for feeding and supplementation
Identify and monitor normal and abnormal diagnostic test results
Implement interventions to keep neonates safe (e.g., transponder use, safe sleep)
Manage monitor alarms based on protocol and change in patient condition
Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions
Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy)
Monitor patients and follow protocols for pre- and postoperative care
Recognize indications for, and manage patients requiring, central venous access
Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o family psychosocial assessment findings
o physical assessment findings
Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
Cardiovascular
Apply leads for cardiac monitoring
Identify, interpret and monitor cardiac rhythms
Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
Recognize early signs of decreased cardiac output
Recognize normal fetal circulation and transition to extra-uterine life
Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardioversion
o invasive hemodynamic monitoring Respiratory
Interpret blood gas results
Manage medications and monitor patients requiring rapid sequence intubation (RSI)
Recognize indications for, and manage patients with, tracheostomy
Recognize indications for, and manage patients requiring:
o assisted ventilation
o bronchoscopy
o chest tubes
o endotracheal tubes
o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula)
o oxygen therapy delivery device
o prone positioning (lateral rotation therapy)
o rescue airways (e.g., laryngeal mask airway [LMA])
o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
Manage patients receiving transfusion of blood products
Monitor and manage patients with bleeding disorders
Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., exchange transfusion)
o related to blood conservation
Neurological
Manage patients with congenital neurological abnormalities



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Medical Critical learning

training discovered from clinical schooling in the instances of COVID-19 | CCRN Study Guide and Cheatsheet

credit: Unsplash

this article changed into exclusively written for the ecu Sting via Ms. Massiel Méndez Jorge, a last-yr medical pupil, physiology trainer, and analysis assistant on the Universidad Autónoma de Santo Domingo (usa), Dominican Republic. She is affiliated with the overseas Federation of clinical students Associations (IFMSA), cordial accomplice of The Sting. The opinions expressed during this piece belong strictly to the writers and don't necessarily reflect IFMSA’s view on the topic, nor the eu Sting’s one.

In a time of drastic exchange, it is the inexperienced persons who inherit the long run. —Eric Hoffer

the first wave of the pandemic brought us to a in no way-viewed-earlier than opposed scenario that Tested their ability to have a look at specific situations, study from them, plan techniques and present options. when you consider that their public institution has constrained elements, the COVID-19 pandemic forced us to promptly put in force resourceful, most economical measures to facilitate the start of route content in a first-time virtual structure. As a scientific scholar and laboratory assistant in physiology and biophysics classes in Domnican Republic, I felt encouraged to share this compilation of changes, training and obstacles confronted right through this transition to digital education.

The DR is a core-revenue country in the Caribbean, and has an estimated 21% of the inhabitants dwelling beneath the national poverty line, in keeping with the realm bank [1]. Inconsistent electricity coverage resulted in connectivity-linked challenges, net servers with confined bandwidth, and constrained broadband internet access in rural communities. financial obstacles constantly hindered the skill to  buy acceptable electronic devices.

These described obstacles highlighted the want for the implementation of inventive measures. They divided main curriculum subject matters into smaller modules than usual, gave asynchronous (pre-recorded) presentations of main experiments, and offered information to college students using Whatsapp messaging companies. These diversifications provided college students enough time to evaluate concepts on a versatile agenda and supplied rapid communique pathways, whereas minimizing their fatigue and anxiety and narrowing socioeconomic gaps to studying.

right through synchronous (true-time) sessions, they randomly asked participants about route content to be able to motivate their energetic participation. Making direct random questions through identify throughout the complete-size of the webinars helped us to make sure that students are actively engaged.

on account that physiology laboratory periods covered chiefly experiments and case discussions, they used a physiology simulation software to demonstrate experimental options and raise critical considering on the virtual platform. They additionally supplied the college students a detailed checklist of the competences that necessary to be achieved by using the end of every unit and encoureged its building by means of experiments to do at home.

One overview of virtual gaining knowledge of concluded that educators may still focal point on active learning, (rather than passive) strategies [2]. As many health professional educators know, retaining category engagement all over lockdown restrictions was difficult. by means of incorporating dynamic activities, corresponding to crossword puzzles, polls, riddles, and other analogy games, students bolstered their consider of key direction concepts.

The COVID-19 fitness crisis took place whereas many Dominican clinical colleges had been seeking international accreditation. As future steps, considering the fact that these tutorial credentials require an audit of all administrative and instructing tactics, there's a necessity to standardize all the included methods and record evidence of how virtual courses are now being organized and assessed. 

Our concepts offer perception to educators in low- and core-revenue countries who searching for novel didactic approaches to boost virtual gaining knowledge of throughout and after this international pandemic. for the reason that digital platforms will inevitably kind part of global medical education, positive ingenious elements are critical to ensure that future medical doctors are academically well-organized to supply exquisite health features in their scientific and neighborhood apply.

References

  • World financial institution, World construction symptoms. Poverty headcount ratio at country wide poverty [Data file]. 2019. [cited 24 Oct 2014]. available from: https://information.worldbank.org/country/dominican-republic
  • Brady AN, Pradhan D. getting to know without borderlines: asynchronous and distance learning within the age of COVID-19 and beyond. ATS student. 2020;1:233–242.
  • concerning the writer

    Massiel Méndez Jorge is a last-year scientific student, physiology instructor, and research assistant at the Universidad Autónoma de Santo Domingo (u.s.a.), Dominican Republic. She has a eager interest in epidemiology, public health and ​​clinical research, which motivates her to voluntarily serve at the research institute of Dr. Hugo Mendoza Pediatric medical institution. Massiel is additionally an active member of the Standing Committee of analysis Exchanges (score) of the Organización Dominicana de Estudiantes de Medicina (ODEM) and volunteers on the Laboratorio de Investigación en Sustancias Naturales (LABISNAT), a native research laboratory.  She is also a passionate crafts and cats lover.




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