DHANALAKSHMI SRINIVASAN UNIVERSITY

SAMAYAPURAM – 621112

SYLLABUS FOR BACHELOR OF SCIENCE IN CRITICAL CARE TECHNOLOGY

HEALTH FOR ALL

1
 CRITICAL CARE TECHNOLOGY

I YEAR

S.NO NAME OF THE SUBJECTS TOTAL HOURS ALLOTTED

ANATOMY +APPLIED ANATOMY +
1. BIOCHEMISTRY (ANATOMY 75% + 105 HOURS
BIOCHEMISTRY 25%)
PHYSIOLOGY + BASIC PHYSICS (PHYSIOLOGY
2. 90 HOURS
75% + PHYSICS 25%)
COMPUTERS + ENGLISH (COMPUTER 50% +
3. 60 HOURS
ENGLISH 50%)
4. CLINICAL 1000 HOURS

II YEAR

S.NO. NAME OF THE SUBJECTS TOTAL HOURS ALLOTTED

ANATOMY + APPLIED ANATOMY &
1. PHYSIOLOGY 90 HOURS
2. CLINICAL MICROBIOLOGY 30 HOURS
ICU MONITORING I (BASIC)
& BIOMEDICAL ENGINEERING
3. 90 HOURS
(ICU MONITORING 75% +
BIOMEDICAL ENGINEERING 25%)
PATHOLOGY, PATHOPHYSIOLOGY &
PHARMACOLOGY (PATHOLOGY 50% +
4. 90 HOURS
PHARMACOLOGY 50%)

6. CLINICAL 1000 HOURS

2
 III YEAR SUBJECT

S.NO NAME OF THE SUBJECTS TOTAL HOURSALLOTTED

ICU MONITORING II +MAINTENANCE OF
1. EQUIPMENT (ICU MONITORING 75% + 100 HOURS

MAINTENANCE 25%)
2 ICU THERAPY 100 HOURS
ICU ADMINISTRATION +LOGISTICS +
3. STATISTICS+MEDICAL ETHICS 100 HOURS

4. CLINICAL 1000 HOURS

3
YEAR - I
ENGLISH

COURSE DESCRIPTION
The course is designed to enable students to enhance ability to comprehend
spoken and written English (and use English) required for effective
communication in their professional work. Students will practicetheir skills in
verbal ad written English during clinical and classroom experience.

OBJECTIVES
At the end of the course, the student will develop

1. Ability to speak and write grammatically correct English.

2. Effective skill in reading and understanding the English language.
3. Skill in reporting and documenting

COURSE CONTENT

1. COMMUNICATION

• Role
• Definition
• Communication
• Classification of communication
• Purpose
• Major difficulties
• Barriers
• Characteristics – The seven Cs
• Communication at the work place
• Human needs and communication “Mind mapping”
• Information communication

2. COMPREHENSION PASSAGE
• Reading purposefully
• Understanding what is read
• Drawing conclusion
• Finding and analysis

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 3. EXPLAINING

• How to explain clearly

• Defining and giving reasons
• Explaining differences
• Explaining procedures
• Giving directions

4. WRITING BUSINESS LETTERS

• How to construct correctly

• Formal language
• Address
• Salutation
• Body and Conclusion

5. REPORT WRITING

• Reporting an accident
• Reporting what happened at a session
• Reporting what happened at a meeting

PRACTICUM

• The clinical experience in the wards and bed side nursing will provide
opportunity for students to fulfill the objectives of learninglanguage.
• Assignment on writing and conversation through participation in
discussion debates seminars and symposia. The students will gain
further skills in task oriented communication.

METHODS OF TEACHING

1. Lecture
2. Pair and Group work
3. Role plays
4. Oral presentations
5. Decoding & production of grammar exercise
6. Comprehension exercise
7. Writing assignments

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 8. Word puzzles & Quizzes
9. Communicative games & fluency activities

METHODS OF EVALUATION
1. Individual oral presentations
2. Group discussion
3. Answering questions from the prescribed English text.
4. Summary / Essay / Letter writing
5. Grammar exercises
6. Medical / General vocabulary exercises

WEIGHTAGE OF MARKS

Theory: Paper 3 in Year 1 combined with computer science Theory:

English-50 + Computer Science-50 (Total 100 marks)

No Practicals for English

Internal Assessment for Paper 3 in Year 1:

English-25 + Computer Science-25 (Total 50 marks)

Internal assessment For English

15 marks
Term test
10 marks
Assignment

6
Reference Books
1. Selva Rose. 1997, Career English for Nurses. Published by: OrientBlackswan
Ltd
2. Oxford advanced Leaners Dictionary, 1996
3. Quirk Randolph and Greenbaum Sidney, 1987. A University Grammar of
English, Hong Kong: Longman group (FE) Ltd/ Pearson.
4. Thomson A.J. and Maituiet A.V. 1987, A Practical English Grammar, Delhi:
Oxford University Press.
5. Gimson A.C.1989, An Introduction to pronunciation of English. Hodder
Arnold; 4th Revised edition (1 May 1989).
6. O’Connor J.D, 1986. Better English pronunciation. Cambridge: University
Press
7. By water F.V.A. 1982, Proficiency Course in English. London: 1- lodder and
Strongliton.
8. Roget S.P. 1960, Thesaurus of English Words & Phrases, London: Lowe &
Brydone Ltd. 196

7
YEAR – I

INTRODUCTION TO COMPUTERS

COURSE DESCRIPTION

This course is designed for students to develop basic understanding ofuses of

computer and its application in Critical Care Technology [CCT]

OBJECTIVES
At the end of the course, the student will

1. Identify & define various concepts used in computer. Identify

application of computer in CCT.
2. Describe and use the Disk Operating System.
3. Demonstrate skill in the use of MS Excel and MS Power point
4. Demonstrate use of internet and Email

COURSE CONTENT
1. INTRODUCTION TO COMPUTER
• I/O devices –memories
• RAM and ROM-- - Different kinds –Kilobytes.
• Smart phones ,Tablets
• Basic commands – MD,CD,DIR,TYPE and COPY CON Commands
• Networking – LAN,WAN,MAN (only basic ideas)

2. TYPING TEXT IN MS WORD

• Manipulating text
• Formatting text - using different font sizes, bold, italics
• Bullets and numbering
• Pictures, file insertion
• Aligning the text and justify
• Choosing paper size - Adjusting margins
• Header and footer, Inserting page No s in a document
• Printing a file with options
• Using spell check and grammar
• Find and replace

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 • Mail merge
•
Inserting tables in a document.
3. CREATING TABLE IN MS EXCEL
• Cell editing-Using formulas and functions
• Manipulating data with excel
• Using sort function to sort numbers and alphabets
• Drawing graphs and charts using data in Excel- Auto
formatting – Inserting data from other worksheets.

4. PREPARING NEW SLIDES USING MS- POWER POINT

• Inserting slides – Slide transition and animation – Using
templates
• Different text and font sizes –Slides with sounds – Inserting
clips arts, pictures, tables and graphs- Presenting using
wizards.

5. INTRODUCTION TO INTERNET
 Using search engine – Google search – Exploring the next
using Internet Explorer and Navigator and Download of files
and images
 E-mail ID creation –Sending messages- Attaching
files – Introduction to “C” language –Different variables,
declaration usage – writing small programs - using functions
and sub-functions.
PRACTICAL
• Typing a text and aligning the text with different format using MS –
Word
• Inserting a table with proper alignment and using MS-Word
• Create mail merge document using MS-Word to prepare
greetings for 10 friends
• Preparing a Slide show with transition, animation and sound
effect using MS-Power point
• Customizing the slide show and inserting pictures and tables inthe
slides using MS-Power Point
• Creating a worksheet using MS-Excel with data and use of functions
• Using MS-Excel prepare a worksheet with text, date time and data
• Preparing a chart and pie diagrams using MS-Excel
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 • Using Internet for searching, uploading files, downloading filesand
creating e-mail ID
•Using C language writing programs using functions
•Using Hospital IT services
METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Lab visit
4. Practical work record

METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
Candidate should create new table, enter sample data and apply basicexcel
calculation forumula.
4. Oral Presentations
WEIGHTAGE OF MARKS
 Candidate should create a new document Type the matter align & format.
Theory: Paper 3 in Year 1 combined with computer science Theory:

Computer Science-50 + English-50 (Total 100 marks)

Practicals in Computers – 50 marks

Internal Assessment for Paper 3 in Year 1:

Computer Science-25 + English-25 (Total 50 marks)

Internal assessment For Computers

Term test 15 marks
Assignment 10 marks

Reference Books

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 1. Fundamentals of computers- V. Rajaraman-2004
2. Absolute beginners guide to computer basics-Michael Miller. Que
Publisher, September 1, 2009.
3. Networking concepts and technology – by Deepak Kalkadia,
Francesco DiMambro, Prentice hall publisher, May 25, 2007
4. Operation system concepts (8th edition) by Abraham Silberschatz,
Peter Baer Galvin, Greg Gangne, Wiley Publisher, Feb 13, 2009.
5. Microsoft office 2013 for Dummies – by Wallace Wang, July 31, 2013.
YEAR - I

ANATOMY

COURSE DESCRIPTION

The course is designed to assist students to acquire knowledge of the normal

structure of human body and its functions. To ensure that the students
understand the alteration in anatomical structure and functionin disease in
the practice of critical care technology

OBJECTIVES

At the end of the course, the student will be able to

1. Describe and identify the the anatomical terms, organization of

human body and structure of cell, tissue, membranes and glands.
2. Describe the structure and functions of bones and joints.
3. Describe the structure and functions of systems in body.

COURSE CONTENT

Block I: Introduction to human anatomy

Unit 1: Basic Anatomical Terminology, planes, body positions, relations

Unit 2: Human Cell Structure

Unit 3: Tissue – definition, types, characteristics,
classification, location, functions & formation
Unit 4: Membranes and glands – classification and structure
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Block II: Musculoskeletal system
Unit 1: Upper Limb: Clavicle, Scapula, Humerus, Radius, Ulna, Hand

Unit 2: Muscles, blood supply, nerve supply of upper limb & lower limb

Unit 3: Lower Limb: Femur, pelvis, Sacrum, Tibia, Fibula, and

Vertebral column
Unit 4: Muscles, blood supply, nerve supply of upper limb and lower limb.

Block III: Respiratory System

Unit 1: Thoracic cage anatomy
Section 1: Thoracic cage, ribs, sternum, thoracic vertebrae Section 2:
Diaphragm, intercostal muscles, muscles of the backSection 3: Pleura
Section 4: Blood supply, nerve supply, lymphatics
Unit 2: Upper respiratory anatomy
Section 1: Nose, nasopharynx, Oral cavity, oropharynx
Section 2: Pharynx, larynx
Section 3: Blood and nerve supply of Nose/Larynx
Unit 3: Lower respiratory anatomy
Section 1: Trachea to bronchial tree
Section 2: Lungs with broncho-pulmonary segments and
surface anatomy
Section 3: Bronchial circulation, nerve supply

Block IV: Cardiovascular System

Unit 1: Heart and valves, pericardium, endocardium, myocardium,
surface anatomy
Unit 2: Major vessels of circulatory system: Aorta, Pulmonary
vessels, IV and major branches
Unit 3: Coronary circulation

Block V: Central Nervous System

Unit 1: Organization of the CNS
Section 1: Central nervous system: Brain and spinal cord
Section 2: Peripheral nervous system
Section 3: Autonomic nervous system
• Sympathetic system,
• Parasympathetic system
• CSF – Synthesis, circulation
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 Unit 2: Cerebral circulation
• Circle of Willis
• Blood supply of the spinal cord/CSF
Unit 3: Pain pathway
Block VI: Excretory System
Unit 1: Kidney, ureter, bladder
Unit 2: Blood supply and innervation

Block VII: Abdomen

Unit 1: Liver, pancreas, small & large Intestine liverUnit
2: Adrenals
Block VIII : Endocrine Glands

PRACTICALS IN ANATOMY
I. Osteology
II. Surface anatomy

III. Radiology
METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Lab visit
4. Practical work record
METHODS OF EVALUATION

1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

WEIGHTAGE OF MARKS

Theory: Paper 1 in Year 1 combined with biochemistry

Theory: Anatomy - 75 marks + Biochemistry - 25 marks (Total 100 marks)

Practicals

Anatomy – 35 marks + Biochemistry – 15 marks (Total 50 marks)

13
Internal Assessment for Paper 1 in Year 1:

Anatomy – 35 marks + Biochemistry – 15 marks (Total 50 marks)

Internal assessment For Anatomy

Term test 20 marks
Assignment 15 marks

Reference Books
1. Cohen, Memmler: Structure & Function of Human Body, Lippincott
Williams & Wilkins; Tenth edition (2012)
2. Waugh: Ross & Wilson Anatomy & Physiology in health and illness
Penguin Books Ltd (2010)
3. Tortora: Anatomy & Physiology, John Wiley & Sons (2012)
4. Chaurasia: Human Anatomy CBS Publishers (2012)
5. Standring: Gray’s Anatomy Penguin Books Ltd (2008)

14
 YEAR – I

BIOCHEMISTRY

COURSE
DESCRIPTION

The course is designed to assist students to acquire the knowledge ofthe

normal biochemical functioning of human body and alterations.

OBJECTIVES

At the end of the course, the student will be able to

1. Identify the basic principles of biochemistry.

2. Synthesize the knowledge of these principles in various situations.

COURSE CONTENT

Block 1: Carbohydrates
Unit 1: Glucose & Glycogen metabolism

Block 2: Proteins
Unit 1: Classification of Proteins and functions

Block 3: Lipids
Unit 1: Classification of Lipids and functions

Block 4: Enzymes
Unit 1: Definition, Nomenclature, and Classification

Unit 2: Factors affecting enzymes activity

Unit 3: Active site, Co-enzyme, enzymes inhibition, units of
enzymes, iso enzymes, Enzyme pattern in disease

Block 5: Vitamins & Minerals

Unit 1: Fats soluble vitamins (A, D, E, K)
Unit 2: Water soluble vitamins (B complex vitamin)
Unit 3: Principle elements (Calcium, Phosphorus, Magnesium,Sodium,
Potassium)
Unit 4: Trace elements:
 Calorific value of foods
 Basal metabolic rate(BMR)

15
  Respiratory quotient (RQ)
 Specific dynamicaction (SDA)
 Balanced diet
Unit 5: Nutrition Marasmus, Kwashiorkor
Section 1: Assessment of nutrition requirements & Basic
nutritional plan
Section 2: Normal requirements of calories, proteins, fluid,
electrolytes
Section 3: Fluid balance and electrolytes
Block 6: Acids Base balance
Unit 1: Definition, PH values, Henderson – Hasselbach equation, Buffers

Unit 2: Indicators, Normality, Molarity, and Molality

PRACTICALS
• Benedict’s test
• Heat coagulation tests
• Normal values of Biochemical parameters
METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Lab visit
4. Practical work record
METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

16
WEIGHTAGE OF MARKS
Theory: Paper 1 in Year 1 combined with anatomy

Theory: Anatomy - 75 marks + Biochemistry - 25 marks (Total 100 marks)

Practicals

Anatomy – 35 marks + Biochemistry – 15 marks (Total 50 marks)

Internal Assessment for Paper 1 in Year 1:

Anatomy – 35 marks + Biochemistry – 15 marks (Total 50 marks)

Internal assessment for Biochemistry
Term test
Assignment
10 marks
5 markseference Books
1. U. Sathyanarayana: Essentials of biochemistry. Books & Allied
Publications(2013)
2. Ambika Shanmugam: Fundamentals of Biochemistry. Lippincott India
(2013)
3. A. C. Deb: Fundamentals of Biochemistry (2001)
4. Murray: Harper’s biochemistry. Mac-Graw Hill (2012)
5. Ferrier: Lipincott’s Biochemistry. LWW(2013)

17
 YEAR - I

PHYSIOLOGY & BASIC PHYSICS

COURSE DESCRIPTION
The course is designed to assist students to acquire the knowledge of the
normal physiology of various human body systems and understand the
alternation in physiology in disease and practice of critical care technology

OBJECTIVES
At the end of the course, the student will be able to:

1. Describe the physiology of cell, tissues, membranes and glands.

2. Describe the physiology of blood and functions of heart.
3. Demonstrate blood cell count, coagulation, grouping, Hb; BP and
Pulse monitoring
4. Describe the physiology and mechanism of respiration.
5. Demonstrate spirometry
6. Describe the physiology of Excretory system

COURSE CONTENT

Block 1: The Cell

Unit 1: Cell structure and functions of the various organelles,
Endocytosis and exocytosis
Unit 2: Acid base balance and disturbances of acid base balances
(alkalosis, acidosis)

Block 2: Cardiovascular system

Unit 1: Physiology of heart
Unit 2: Heart sounds, auscultatory areas
Unit 3: Cardiac cycle, cardiac output and factors affecting cardiac output,
stroke volume, contractility, preload, after load
Unit 4: O2 delivery, uptake to tissues
Unit 5: Cardiac conduction system, Regulation of rate, basic
arrhythmias
Unit 6: Arterial pressure, Blood pressure, Hypertension, hypotension
Section 1: Blood pressure
• Maintenance of normal BP and factors affecting it
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 • Systolic, diastolic, pulse pressure, mean arterial
• pressure
Unit 7: Electrocardiogram
Section 1: Principles of ECG, Normal ECG/Abnormal ECGCommon
cardiac Problems – MI, -VPC, Ischmia - VT, VF
Block 3: Blood
Unit 1: Homeostasis
Unit 2: Composition of blood, functions of blood and plasma
proteins, classification of protein.
Unit 3: Pathological and Physiological variation of the RBC, WBC’s,
platelets
Unit 4: Functions of haemoglobin
Unit 5: Erythrocyte sedimentation rate
Unit 6: Detailed description about WBC, TC, DC & functionsUnit
7: Platelets: Formation, normal level and functions Unit 8:
Blood group and Rh factor
Block 4: Respiratory system
Unit 1: Physiology of breathing
Section 1: Regulation of breathing
Section 2: Respiratory movements
Section 3: Mechanics of breathing, muscle action
• Pressure, volume
• Resistance, compliance
Section 4: Definition and normal values of lung volumes andlung
capacities, Lung volumes & capacity
Unit 2: Gas exchange & transport - oxygen, CO2
Section 1: Diffusion, Gas exchange, mechanism of diffusion
Section 2: O2 transport & abnormalities, Factors affecting O2
transport
Section 3: CO2 transport & abnormalities
Unit 3: Work of breathing, pulmonary function testsUnit
4: Acid base balance, ABG

Block 5: Central Nervous system

Unit 1: Function of CSF, Intracranial pressure
Unit 2: Metabolic requirements of the brain, Cerebral autoregulation
19
 Unit 3: Consciousness
Unit 4: Basic function of the eyes: light reflex, movementsUnit
5: Cough and gag reflex

Block 6: Digestive system

Unit 1: Physiological and anatomy of the GIT
Unit 2: Food digestion in the mouth, stomach and intestineUnit 3:
Absorption of foods
Unit 4: Role of bile in the digestion

Block 7: Excretory system

Unit 1: Normal urinary output, Micturition
Unit 2: Renal function tests, Renal disorders

Block 8: Endocrine system

Unit 1: Function of pituitary
}
Unit 2: Thyroid
} Hormones
Unit 3: Parathyroid
}
Unit 4: Adrenal /Pancreatic

Block 9: Reproductive system

20
 Unit 1: Formation of semen & spermatogenesis
Unit 2: Brief account of menstrual cycle

PRACTICALS
• Microscope
• Pulse oximetry Tracing , E7Co2 -Tracing
• Blood group
• Measurement of BP, Auscultation, Heart sounds
• Measurement of PR, HR &RR
• Examination of the eye / pupil
• Cough and gag reflex
• Examination of respiratory system

METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Lab visit
4. Practical work record

METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations
WEIGHTAGE OF MARKS

Theory: Paper 2 in Year 1 combined with basic physics

Theory: Physiology - 75 marks + Physics - 25 marks (Total 100 marks)

Practicals - Physiology – 50 marks

Internal Assessment for Paper 2 in Year 1:

Physiology – 35 marks + Physics – 15 marks (Total 50 marks)

Internal assessment for Physiology

Term test 20 marks
Assignment 15 marks
Reference Books
21
1. Cohen, Memmler: Structure & Function of Human Body, Lippincott
Williams & Wilkins; Tenth edition (2012).
2. Waugh: Ross & Wilson Anatomy & Physiology in health and illness
Penguin Books Ltd (2010).
3. Tortora: Anatomy & Physiology, John Wiley & Sons (2012).
4. Venkatesh D: Basics of Medical Physiology for Nursing, LWW (2009).
5. Hall J: Guyton Textbook of Medical Physiology. Elsevier (2012).
6. Tandon: Best & Taylor’s Physiologic Basis of Medical Practice (2011).

22
 YEAR - I

BASIC PHYSICS

COURSE DESCRIPTION
The course is designed to assist students to acquire the knowledge ofbasic
physics in the practice of critical care technology

OBJECTIVES

At the end of the course, the student will be able to

1. Describe the properties that characterize the three states of matter.

2. Describe the gas behavior in changing conditions.
3. Describe the principles that govern the fluid dynamics.
4. Describe the basics concept of pressure, volume, thermodynamicsand
humidity.

COURSE CONTENT
Block 1: Basic physics
Unit 1: States of matter
Unit 2: Changes of state
Unit 3: Gas behavior under changing conditions
Gas laws: Boyles / Charles / Gay Lussais, Daltons laws &
application
Unit 4: Fluid dynamics
Concepts of pressure, volume, flow, Temperature,
Humidity Measurements – units & devices
Introduction to Medical term describing normal & abnormal
process
Block 2: Medical Gases:
Unit 1: Characteristics of Medical gases
Unit 2: Storage of medical gases
Section 1: Cylinders, Liquid gas storage, oxygen concentrator

Unit 3: Distribution of regulation of medical gases

Section 1: Piped distribution system

23
WEIGHTAGE OF MARKS

Theory: Paper 2 in Year 1 combined with physiology

Theory: Physiology - 75 marks + Physics - 25 marks (Total 100 marks)

Practicals

No practical in physics

Internal Assessment for Paper 2 in Year 1:

Physiology – 35 marks + Physics – 15 marks (Total 50 marks)

Internal assessment for Physics

Term test 10 marks
Assignment 5 marks

PRACTICALS – NO PRACTICALS

Reference Books
1. Davis P: Basic Physics and Measurement Anesthesia.
2. Thayalan K: Bio Medical Physics for Nurses.
3. Kacmarek R. M: Egan’s Fundamentals of Respiratory Care. Elsevier(2013)

24
 YEAR II

APPLIED ANATOMY & PHYSIOLOGY

COURSE DESCRIPTION
This course is designed to assist students in developing an in depth
knowledge in the field of applied anatomy and physiology.

OBJECTIVES

At the end of the course the students will be able to acquire knowledge and
develop proficiency in the anatomical and physiological aspects of patients
with medical and surgical disorders in various health care settings.

COURSE CONTENT

Block 1: Applied Anatomy Related To Critical Care

Unit 1: Introduction to anatomy
Section 1: Anatomical terms, planes, and relations etc.
Unit 2: Respiratory system
Section 1: Anatomy of thoracic cage bones-
• Ribs, spine,
• Diaphragm, intercostal muscles,
• Blood supply and nerve supply

• Nose, nasopharynx
• Oral cavity, tongue, oropharynx
• Laryngopharynx
• Blood and nerve supply
• Lungs with bronchopulmonary segments
• Pleura
• Blood and nerve supply
Unit 3: Cardiovascular System
Section 1: Heart, Pericardium, Myocardium, endocardium, valves
Section 2: Major vessels of circulatory system –
• Aorta
• IVC
• Pulmonary vessels and all major
branches Section 3: Coronary circulation
25
Unit 4: Central Nervous System
Section 1: Basic organization of the nervous system
• Central –Brain, Spinal cord
• Peripheral
• Autonomic nervous system
o Sympathetic nervous system
o Parasympathetic nervous
system Section 2: Cerebral circulation
• Circle of Willis
• Blood supply of spinal cord
Section 3: Pain pathway
Unit 5: Excretory System
Section 1: Kidney, Ureter, and Bladder, Blood, nerve supply
Unit 6: Abdomen
Section 1: Liver, pancreas, islet cells Section 2:
Thyroid, parathyroid, adrenals.
Block II: Applied Physiology
Unit 1: Respiratory System
Section 1: Homeostasis
Section 2: Physiology of Breathing
 Regulation of respiration
 Respiratory movements
 Chest wall mechanics- pressure, volumes,
resistance, compliance
 Lung volume and capacities
 Work of breathing
 Oxygen transport
 Carbon di oxide transport
 Factors affecting oxygen transport
 Mechanism of hypoxia
 V/Q mismatch.
 Indications For Artificial Airways
 Relieving airway obstruction
 Secretion removal

26
  Protecting the airway
 Positive pressure
 Ventilation
 Selecting &Establishing An Artificial Airway
 Nasal airways
 Pharyngeal airways
 Tracheal airways
 Airway Clearance Techniques
 Airway suctioning
 Bronchoscopy
 Airway Maintenance
 Securing the airway & confirming placement
 Providing adequate humidification
 Minimizing nosocomial infections
 Providing cuff care
 Facilitating clearance of secretion
 Trouble shooting airway emergencies
 Extubation
 Indication
 Procedure
 Post extubation – care and complication
Section 6: Oxygen Therapy
 Sources of Oxygen for therapy
 Storage of Oxygen
 Oxygen delivery system
 Hazards of Oxygen
Section 7: Chest X-Ray
 Normal Chest X-Ray
• Normal anatomy
• Basic physics of X –ray and assessment of
film quality
• Cardiac configuration
• Lung fields and airway

27
 • Optimum position of –Endotracheal tubes,
Nasogastric tubes, Central lines
 Abnormal Chest X-Ray
 Trauma
 PneumothoraxHemothorax
 Lung contusion
 Pulmonary edema

 ARDS

 Pneumonia

 Broncho pneumonia

 Lobarpneumonia

 Aspiration pneumonia

Unit 2: Cardiovascular System

Section 1: Cardiac cycle
 Cardiac output - Factors affecting cardiac output
 Preload, afterload, stroke volume, contractility
 Cardiac conduction system - Regulation of rate,
basic arrhythmias
 Principles of ECG, Normal ECG

Section 2: O2 delivery, uptake in tissues

Section 3: Blood pressure
• Maintenance of normal BP and factors affecting it
• Systolic, diastolic, pulse pressure, mean arterial
pressure

Unit 3: Central Nervous System

Section 1: Cerebral auto regulation, cerebral oxygen
consumption, Coma
Section 2: Cerebrospinal fluid, intracranial pressureSection
3: Cranial nerves
• III, IV, VI
• IX, X, Cough reflex, gag reflex

28
 • Pupils: accommodation reflex, light reflex
Section 4: Sedation and analgesia
Section 5: Brain death
PRACTICAL:
• Clinical Evaluation
• Case Study/ Case Book
• Practical Record
• Observational/ Field Visit
• Each student should be given planned healthcare teaching by
conducting clinical teachings and case presentations.

METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Lab visit
4. Practical work record

METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

WEIGHTAGE OF MARKS
Theory: Applied Anatomy & Physiology - Paper 1 in Year 2 -Total
100 marks Practicals - Total 50 marks
Internal Assessment: 50 marks (Term tests 30 marks + 20 marks for
assignments)

Reference Books
1. Cohen, Memmler: Structure & Function of Human Body, Lippincott
Williams & Wilkins; Tenth edition (2012).
2. Waugh: Ross & Wilson Anatomy & Physiology in health and illness
Penguin Books Ltd (2010)
3. Tortora: Anatomy & Physiology, John Wiley & Sons (2012)
4. Chaurasia: Human Anatomy CBS Publishers (2012)
5. Standring: Gray’s Anatomy Penguin Books Ltd (2008)
6. Venkatesh D: Basics of Medical Physiology for Nursing, LWW (2009).
7. Hall J: Guyton Textbook of Medical Physiology. Elsevier (2012).
29
8. Tandon: Best & Taylor’s Physiologic Basis of Medical Practice (2011).

30
 YEAR - II

MICROBIOLOGY

COURSE
DESCRIPTION

31
The course is designed to assist students to acquire understanding of fundamentals
of microbiology and identification of microorganisms. It also provides
opportunities for practicing infection control measures in hospital settings

OBJECTIVES
At the end of the course, the student will be able to:

1. Identify common disease producing microorganisms

2. Explain the basic principles of microbiology and their
significance in health and disease.
3. Demonstrate skill in handling specimens
4. Explain various methods of disinfection and sterilization
5. Identify the role of the nurse in hospital infection control system
COURSE CONTENT

Block 1: Introduction to microorganisms

Unit 1: Microbiological terms
Unit 2: History of microbiology
Hypersensitivity reactions
Block 2: Major groups of microorganisms
Unit 1: Structure and classification of microbes Unit 2:
Identification methods of microorganisms

Block 3: Infection control

Unit 1: Introduction to infection, spread and transmission of infectionUnit
2: Sterilization and disinfection
Unit 3: Cleaning and sterilizing equipmentUnit
4: Disposal of waste
Unit 5: Surveillance, quality control
Unit 6: Control of organisms with antibiotics
Unit 7: Vaccines, toxoids – bacterial, viral, immunization scheduleUnit
8: Barrier nursing, universal precautions

Block 4: Specific infections

Unit 1: Nosocomial infections – VAP, CRBSI, UTI, SSI, NSI
Unit 2: Bacterial – Gram Positives & Negatives, infections caused
Unit 3: Viral – HIV, Hep B, HCV, other common viral infections
Unit 4: Fungal

32
 Unit 5: Parasitic
Unit 6: Tropical infections - Tb, malaria, leptospirosis, dengue,
rickettsia,
amoebiasis
Unit 7: Applied Microbiology : RTI, UTI, Sepsis

PRACTICALS
1. Collection and handling of clinical specimens-urine, sputum,
blood and pus.
2. Demonstration and handling of microscope
3. Staining-gram staining, Zeihl Neelsen
4. Common examination: stained smears, Fungus-Yeasts and Molds
5. Sterilization-incineration and Autoclaving
6. Each student will practice aseptic procedures in the wards and
maintain personal and Environmental hygiene.
7. Observation visit to incinerator, posting in CSSD and infection
control department
METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Lab visit
4. Practical work record
METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

33
WEIGHTAGE OF MARKS
Theory: Clinical Microbiology - Paper 2 in Year 2 -
Total 100 marks Practicals - Total 50 marks
Internal Assessment: 50 marks (Term tests 30 marks + 20 marks for
assignments)
Reference Books
1. Ananthnarayan R: Textbook of Microbiology. (2017)
2. Pommerville J. C: Fundamentals of Microbiology. Jones and Bartlett
learning (2013)
3. Apurba Sastry, Sandhya Bhat. Essentials of Microbiology

34
 YEAR – II

BIOMEDICAL ENGINEERING

COURSE DESCRIPTION
The course is designed to assist students to acquire the knowledge of
basics of electricity and electronics. It is also designed to assist students in
understanding the basics of the equipment used in the ICU.

OBJECTIVES
At the end of the course, the student will be able to:
1. Describe fundamentals of Electricity and Electronics.
2. Describe the types and uses of medical equipment

COURSE CONTENT

Block 1: Fundamentals of Electricity & electronics

Unit 1: Resistance
Unit 2: Capacitance
Unit 3: Inductance and transformers
Unit 4: Parameters of electricity – voltage, current, power
Unit 5: Difference between AC and DC current, phase, neutral,
earth, color coding
Unit 6: Ohm’s law, Kirchhoff’s law – electrical circuitsUnit
7: Classification of medical equipment
Section 1: According to type of protection: B, C, and F etc.Section 2:
According to mode of protection: Class I - III

WEIGHTAGE OF MARKS
Theory: ICU monitoring – I (basic) and Biomedical engineering

Paper 3 in Year 2 - Total 100 marks (ICU monitoring – 75 marks,

biomedical engineering – 25 marks

Practicals - None

Internal Assessment: 50 marks - Biomedical engineering – 15 + ICU

monitoring - 35

Biomedical engineering internal assessment

35
Term tests 10 marks
Assignments 5 marks

36
 YEAR - II

ICU MONITORING I

(BASIC)COURSE DESCRIPTION
This course is designed to enable students to understand the principlesof
monitoring of respiratory, cardiovascular and other systems of the patients
in ICU.

OBJECTIVES
At the end of the course the students will be able to:
1. To describe the basic principles of monitoring of respiratory
system, cardiovascular system, CNS, nutritional status, renal
function and liver function of patient in ICU
2. To identify the benefits and risks of ICU monitoring techniques.
3. To describe monitoring techniques used in ICU for a
mechanically ventilated patients.
4. To describe monitoring techniques used in ICU for patients in
shock.
5. To describe monitoring techniques used in ICU to monitor
neurological status, renal function and liver function.

COURSE CONTENT

Block 1: General monitoring

Unit 1: Temperature monitoring
Section 1: Principles of temperature monitoring
Section 2: Hypothermia and hyperthermia
Unit 2: Pulse
Unit 3: Positioning of patient
Unit 4: Monitoring for pressure sores

Block 2: Respiratory System

Unit 1: Airway monitoring- Intubation
• Securing ET tube
• Cuff pressure
Unit 2: Monitoring Gas ExchangeSection
1: Oxygenation
37
• ABG

38
 • Pulse Oximetry
• Oxygen delivery and
consumption Section 2: Ventilation
• ABG
• Capnography
Section 3: Calculations
• Oxygen consumption
• Alveolar gas equations
• Dead space
Unit 3: Monitoring muscle strength, work of breathing
Unit 4: PFT - Recognize the methods & significance of measuringthe
following lung volume and flow in the ICU.
• Tidal volume
• Vital capacity
• Peak flow rate
• Negative inspiratory pressure

Block 3: Cardiovascular System

Unit 1: ECG
Unit 2: NIBP
Unit 3: Invasive arterial blood pressure- Cardiac Input Monitoring
Unit 4: CVP monitoring
Unit 5: Zeroing, calibration, trouble shooting of pressure transducers.

Block 4: Nervous system

Unit 1: Neurological history and examination, pupils, Muscle strength
Unit 2: Glasgow Coma Scale
Unit 3: ICP Monitoring

Unit4: BIS Monitoring

Block 5: Abdomen / Renal

Unit 1: Intra-abdominal pressure monitoringUnit
2: Monitoring renal function:
• Clinical – Urine output
• Laboratory- creatinine, creatinine clearance

39
PRACTICALS
1. Assignments
2. Clinical audit to be started in 2nd year and completed by 3rd year

3. Observation of equipment handling & maintainance

METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Practical work record

METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

WEIGHTAGE OF MARKS
Theory: ICU monitoring – I (basic) and Biomedical engineering
Paper 3 in Year 2 - Total 100 marks (ICU monitoring – 75 marks,
biomedical engineering – 25 marks

Practicals – 50 marks

Internal Assessment: 50 marks

Biomedical engineering – 15
ICU monitoring - 35

ICU monitoring internal assessment

Term tests 20 marks
Assignments 15 marks

Reference Books
1. Egan’s Fundamentals of Respiratory Care – Robert L. Wikins,
James K Stoller, Craig L Scalan (Mosby)
2. The ICU Book – Paul L Marino (Lippincott, Williams & Wilkins)
3. Practical Methods for Respiratory Care – Raymond Sibberson (Mosby)
4. Respiratory Physiology – The Essentials l John B West (Williams &
Wilkins)
5. Ventilation / Blood Flow & Gas Exchange – John B West (Blackwell
40
Scientific Publications)

41
6. Techniques in Bedside haemodynamic Monitoring – Elaine
Kiess Daily & Johnspeer Schroeder (Mosby)
7. All you really need to know to interpret arterial blood gases –
Lawrence Martin (Lea & Febiger)
8. Mechanical Ventilation – Susan P Pilbeam & J M Cairo (Elsevier)
9. Critical Care Secrets: Parsons, Wiener – Kronish, Jaypee Brothers
10. Washington Manual of Critical Care

42
 YEAR II
PHARMACOLOGY

COURSE
DESCRIPTION
The course is designed to assist students to acquire understanding of
fundamentals of drugs and their mode of action. It also provides opportunities
for practicing infection control measures in hospital settings. It also helps to
assist the students to use knowledge of pharmacology in practice of critical
care technology.

OBJECTIVES
At the end of the course, the student will be able to:
1. To identify drugs used in ICU and describe their
pharmacology, administration, uses and adverse effects.
2. To describe pharmacology of vasopressors and inotropes.

COURSE CONTENT

Block 1: Introduction to pharmacology

Unit 1: Pharmacokinetics
Unit 2: Pharmacodynamics
• Drug dose calculation – Dilution, infusion rate

Unit 3: Pharmacovigilance – should be able to identify & report adverse drug reactions.

Block 2: Medical gases: O2, N2O, compressed Air

Block 3: Anaesthetic agents

Unit 1: Sedatives: barbiturates, benzodiazepines, propofol, andketamine
Unit 2: Analgesics: NSAID’s, Aspirin, opioidsUnit 3:
Neuromuscular blockers

Unit 4 : Local Anaesthetics

43
Block 4: Drugs affecting the autonomic nervous system
Unit 1: Adrenergic drugs
Section 1: Inotropic agents, chronotropic agents
Section 2: Vasopressors & Vasodilators
Section 3: Anti-hypertensive
Section 4: Bronchodilators- OHA & Insulin - Antidiabetic
Unit 2: Cholinergic drugs
Section 1: Atropine, glycopyrrolate
Section 2: Ipratropium
Block 5: Mucokinetic agents:
Unit 1: Expectorant
Unit 2: Mucolytics
Unit 3: Mucokinetics
Unit 4: Mucoregulatory agents
Unit 5: Others e.g. Bromohexine, ambroxol, saline, soda bicarbonate

Block 6: Cough suppressants Unit

1: Peripheral antitussivesUnit 2:
Central antitussives
Unit 3: Peripheral and central antitussives

Block 7: Respiratory stimulants

Unit 1: Specific e.g. Naloxone, flumazenil
Unit 2: Non-specific e.g. xanthines, nicotine, doxapram

Block 8: Antihistamines

Block 9: Steroids

Block 10: Antimicrobial drugs

Unit 1: Antibacterial, antiviral and anti-fungal agents – basic concepts
Unit 2: Antimicrobial Resistance – Basic conceptsUnit 3:
Antiseptic agents

Unit 4: Immuno suppresion

METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration

44
3. Practical work record

45
METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

WEIGHTAGE OF MARKS
Theory: Pharmacology & Pathophysiology

Paper 4 in Year 2 - Total 100 marks (Pharmacology – 50,

Pathophysiology – 50)

Practicals - None
Internal Assessment: 50 marks – Pharmacology 25, Pathophysiology - 25

Term tests 15 marks

Assignments 10 marks

Reference Books

1. Tripathi K. D: Essentials of Medical Pharmacology. JPB, (2013)

2. Smeltzer – Brunner & Siddhartha Textbook of Medical Surgical
Nursing, 2010,LWW
3. Black – Medical Surgical Nursing, 2009, Elsevier
4. Nettina – Lippincott manual of Nursing Practice, 2009. LWW
5. Lewis – medical Surgical Nursing, 2008, Elsevier

46
 YEAR II
PATHOLOGY & PATHOPHYSIOLOGY

COURSE DESCRIPTION

The course is designed o assist students to acquire the knowledge of thefundamentals of

pathology and pathophysiology in disease states.

OBJECTIVES
At the end of the course, the student will be able to describe the basic
pathology and pathophysiology of the important disease states of respiratory
system, cardiovascular system, CNS, hematology, renal and GI system in ICU
settings.

COURSE CONTENT

Block 1: General
Unit 1: Inflammation and healing
Unit 2: Tumors
Unit 3: Immune system

Block 2: Respiratory system

Unit 1: Respiratory failure
Unit 2: Acute respiratory distress syndrome
Unit 3: Pneumonia, TB
Unit 4: Opportunistic infections Unit
5: Bronchial asthma and COPD
Unit 6: Bronchiectasis and Lung abscess
Unit 7: Atelectasis, collapse
Unit 8: Pleural disease: Pneumothorax, pleural effusion
Unit 9: Occupational lung diseases - Smoke inhalation ,
Pneumoconiosis

Block 3: Cardiovascular
Unit 1: Shock: hypovolemic, cardiogenic, obstructive, septicUnit 2:
Hypertension in ICU
Unit 3: Congestive cardiac failure, acute Left ventricular failure,Right
ventricular failure

47
Unit 4: Pulmonary edema
Unit 5: Pulmonary Hypertension

48
 Unit 6: Pulmonary embolism
Unit 7: Ischemic heart disease
Block 4: CNS
Unit 1: Cerebrovascular disease (stroke)Unit 2:
Coma
Unit 3: Delirium in ICU
Unit 4: Neuromuscular disease
Section 1: Myasthenia gravis
Section 2: Critical illness polyneuropathy
Section 3: Diaphragmatic paralysis
Unit 5: Guillian Barre syndrome
Unit 6: Brain death, Persistent vegetative stateUnit
7: Trauma
Section 1: Head injury
Section 2: Unstable spine and protection

Block 5: Haematology
Unit 1: Anemia in ICU/VAP (Ventilator Associated Pnemonia)
Unit 2: Neutropenia
Unit 3: Bleeding disorders
Unit 4: Clotting disorders

Block 6: GIT, Liver, Pancreas, Renal, Endocrine

Unit 1: Upper GI bleed
Unit 2: Hepatic coma
Unit 3: Pancreatitis
Unit 4: Renal failure in ICU
Unit 5: Hypoglycemia
Unit 6: Hyperglycemia
Unit 7: Disorders Sodium, Potassium and Fluid balance.Unit
8: Stress response role of Adrenals

Block 7: Miscellaneous
Unit 1: Envenomation – snake bite, scorpion sting
Unit 2: Poisoning – general supportive care, common poisons

49
PRACTICALS – NONE

50
METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Practical work record
4. Interpretation of Lab reports
METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations
WEIGHTAGE OF MARKS

Theory: Pharmacology & Pathophysiology

Paper 4 in Year 2 - Total 100 marks (Pharmacology – 50,

Pathophysiology – 50)

Practicals - None

Internal Assessment: 50 marks – Pharmacology 25, Pathophysiology - 25

Term tests 15 marks

Assignments 10 marks

REFERENCE BOOKS
1. Smeltzer – Brunner & Suddharth Textbook of Medical Surgical
Nursing, 2010,LWW
2. Black – Medical Surgical Nursing, 2009, Elsevier
3. Nettina – Lippincott manual of Nursing Practice, 2009. LWW
4. Lewis – medical Surgical Nursing, 2008, Elsevier
5. Davidson’s Principles &Practice of Medicine, 2010, Elsevier
6. Bailey & Love Short Practice of Surgery, 2008, Hodder Arnold
7. Timby – Introductory Medical Surgical Nursing, 2009, WK
8. Das – textbook of Surgery, SD Publishers
9. Woods – Cardiac Nursing, 2010, LWW
10. Hickey – Neurologic & Neurosurgical Nursing, 2009, LWW
11. Morton – Critical Care Nursing, 2009, LWW
12. Thelan’s Critical Care Nursing, 2008, Elsevier

51
13. Spring House – Medical Surgical Nursing Made Incredibly Easy, 2008,
LWW
14. Webber – Health assessment in Nursing, 2010, WK

52
 YEAR – III

ICU MONITORING- II (ADVANCED) AND EQUIPMENT MAINTENANCE

COURSE DESCRIPTION
This course is designed to enable students to understand in detail the
principles of monitoring of respiratory, cardiovascular and other systems of
the patients in ICU. It is designed to assist students in understanding the
details of the techniques and equipment used for monitoring the patient in ICU
and their troubleshooting.

OBJECTIVES

At the end of the course the students will be able to:

1. Describe in detail the principles of basic and advanced monitoring
of respiratory system, cardiovascular system, CNS, nutritional
status, renal function and liver function of patient in ICU
2. Describe in detail monitoring techniques used in ICU for a
mechanically ventilated patients.
3. Describe principles and methods of hemodynamic monitoring.
4. Describe monitoring of brain stem function and nutritional
monitoring.
5. Describe principles of maintenance of equipment used in ICU.
6. Describe the various aspects of equipment troubleshooting.

COURSE CONTENT

Block 1: Respiratory system

Unit 1: Monitoring lung and chest wall mechanics
• Compliance
• Resistance
• Pressures
• Auto PEEP
Volumes
Unit 2: Monitoring muscle strength, work of breathing, Maximum
inspiratory and expiratory pressures
Unit 3: Monitoring patient ventilator system, Graphics monitoringUnit 4:

53
Bedside PFT

54
Block 2: Cardiovascular System
Unit 1: Assessment of Preload responsiveness static and dynamic
parameters
Unit 2: Basic Echocardiography in ICU/ Ultrasound in Critical Care
Unit 3: Defibrillator and Cardioversion
Unit 4: PICCO
Unit 5: Monitoring tissue perfusion
Unit 6: Pulmonary artery catheters
Unit 7: Temporary pacemaker

Block 3: CNS
Unit 1: Monitoring brain stem function
Unit 2: Sedation and analgesia scoring

Block 5: Nutritional monitoring

Unit 1: Functional nutritional assessment (history and physical
examination)
Unit 2: Metabolic assessment
Unit 3: Estimating nutritional requirements

Block 6: Care & maintenance if ICU equipment & Troubleshooting

(Includes quality checks and calibrations of all the equipment)
Unit 1: Mechanical Ventilators & Non-invasive ventilatorsUnit
2: Pumps: Infusion, syringe
Unit 3: Monitors: Stand-alone & multi-parameter, Cardiac Output
monitors.
Unit 4: ECG machine
Unit 5: ABG machine
Unit 6: Defibrillator
Unit 7: Ultrasound machine
Unit 8: Bronchoscope

Dialysis Machine

55
PRACTICALS
1) Log book and project completion for internal assessment
2) Should know the workings of all ICU equipment
3) Should know care and maintenance of all ICU equipment
4) Should be able to monitor ventilator parameters
5) Should be able to assess fluid responsiveness in a patient
METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Practical work record
METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

WEIGHTAGE OF MARKS

Theory: ICU monitoring – II (Advanced) and Equipment maintenance

Paper 1 in Year 3 - Total 100 marks (ICU monitoring advanced 75marks,

Equipment maintenance – 25 marks)

Practicals – 50 marks

Internal 50 marks
Assessment:

Term tests 30 marks

Assignments (log book & project) 20 marks

56
REFERENCE BOOKS
1. Egan’s Fundamentals of Respiratory Care – Robert L. Wikins,
James K Stoller,
2. The ICU Book – Paul L Marino (Lippincott, Williams & Wilkins)
3. Practical Methods for Respiratory Care – Raymond Sibberson (Mosby)
4. Respiratory Physiology – The Essentials l John B West (Williams &
Wilkins)
5. Ventilation / Blood Flow & Gas Exchange – John B West (Blackwell
Scientific Publications)
6. Techniques in Bedside haemodynamic Monitoring – Elaine
Kiess Daily & Johnspeer Schroeder (Mosby)
7. All you really need to know to interpret arterial blood gases –
Lawrence Martin (Lea & Febiger)
8. Text book of Advanced Cardiac Life Support. American Heart
Association
9. Mechanical Ventilation – Susan P Pilbeam & J M Cairo (Elsevier)
10. Critical Care Secrets: Parsons, Wiener – Kronish, Jaypee Brothers
11. Washington Manual of Critical Care

57
 YEAR - III

ICU THERAPY

COURSE DESCRIPTION
This course is designed to assist students in developing expertise and in depth
knowledge in the field of critical care technology. It will help students to
appreciate the patient as a holistic individual and developskill to function
as a specialized critical care technologist.

OBJECTIVES

At the end of the course the students will be able to:

1. Discuss in detail the concept of Mechanical Ventilation

2. Describe in detail the design features of ventilators, their types,
how they work and the various modes of ventilation
3. Describe in detail the care of patient on ventilator and
weaning from ventilator.
4. Discuss in detail the Basic and Advanced Life Support.
5. Discuss in detail the care of unconscious patient.
COURSE CONTENT
BLOCK 1: Mechanical ventilation/ventilator dependence/difficult
weaning
Unit 1: Basic Concept

 Mechanics of ventilation

 Mechanics of exhalationWork of breathing

 Distribution of ventilation

 Efficiency and effectiveness of ventilationIndications

 Mechanical VentilatorsHow ventilators work

 Operator interface Types of ventilators

Unit 2: Modes of Mechanical Ventilation
 Basic and newer modes Ventilator initiation
 Initial ventilator settings

 Adjusting ventilatory settings

58
 Oxygenation

59
  Ventilation
 Timing – Inspiratory of gas / Expiratory,
inspiratory hold Flow
 Tidal volume
 Pressure- Peak /Plateau
PEEP
 POP – OFF
 Pressure support
 Proximal airway (VS) distal
FiO2
Unit 3: Humidification
 Humidifier types
 Advantages & disadvantages
Unit 4: Non-Invasive Ventilation
 Types of NIV (CPAP, BIPAP)
 Goals of & indications of NIV
 Patient selection and exclusion criteria for NIV
Equipment used in the application of NIV
Instituting and managing NIV
 Complications of NIV
 Time & cost associated with NIV
Unit 5: Trouble shooting and alarms
Unit 6: Weaning and Extubation
 Weaning
 Definitions
 Reasons for ventilator dependence
Patient evaluation
 Preparing the patient
Methods
 Newer techniques for facilitating ventilator
discontinuance Selecting an approach
Monitoring the patient during weaning
 Chronically ventilator dependent patients & difficulty in weaning
60
 Terminal weaning
Extubation

61
  Indications
Procedure
 Post extubation care
Unit 7: Nebulization and MDI
 Inhaled drug therapyNebulization
Different types
 Advantages & disadvantagesMDI with spacer
 Characteristics of therapeutic aerosols
Hazards of aerosols therapy
 Aerosol drug delivery system
 Assessment based bronchodilator therapy
protocols Special considerations
 Controlling environmental and contamination

Unit 8: Suctioning and chestphysiotherapy

Unit 9: Incentive Spirometry

Unit 10: Inspiratory resistance exercises
Unit 11: Care of Patient on Ventilator
 Ensuring proper placement
 Cuff pressure
 Tracheo bronchial hygiene & suctioning
Humidification, chest physiotherapy
Ventilator settings
 Monitoring ventilatory parameters
Unit 12: Care of the chest tube
Drainage systems of pleural with fluidUnit
13: Extubation failure

Block 2: Airway Assistance

Unit 1: Tracheal intubation (oral, nasal) – Insertion of ICD
Unit 2: Cricothyrotomy
Unit 3: Open/percutaneous tracheostomy
Unit 4: Fiberoptic bronchoscopy
Section 1: FOB Intubation
62
 Section 1: Therapeutic BAL
Unit 5: Decanulation of tracheostomy

63
Block 3: Cardiovascular system
Unit 1: Fluid resuscitation and inotropes
Unit 2: Basic of IABP /ECMO
Unit 3: Pericardiocentesis
Block 4: Life support
Unit 1: Basic life support
• AED, Mask ventilation, Chest
compression Unit 2: Advanced cardiac life
support
• Drugs, defibrillation
Unit 3: Trauma life support
A –Airway and cervical spine stabilization
B – Breathing
C –Circulation and hemorrhage control
D –Disability

E-Exposure D Manual in linestabilizati on

Basic care of surgical wounds and fractures

Unit 4: Burns Assessment

Section 1: History and physical assessment
Section 2: Assessment of burns and fluid and electrolyte loss
Section3: Etiology classification, Pathophysiology, clinical
manifestations, Diagnosis, treatment modalities
Block 5: Renal / Abdomen
Unit 1: Basics of Renal Replacement Therapy, modes of dialysis
Unit 2: Intra-abdominal pressure, abdominal compartment syndrome

Block 6: Central Nervous system

Unit 1: Care of Unconscious Patient, Comfort Section
1: Skin integrity assessment and careSection 2:
Physiotherapy – chest & limbs Section 3:
Nutritional needs & supply
Unit 2: Pain Control, Care of epidural, Patient control led analgesia

64
Block 7: Infection Control
Unit 1: Hand hygiene
Unit 2: Universal precautions
Isolation

PRACTICAL

• Clinical rotations in selected Medical and Surgical areas

• Patient assignments for patient centered comprehensive care

• Case presentations,

• Drug study discussion

METHODS OF TEACHING
1. Lecture cum discussion

2. Demonstration
3. Practical work record
METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations
WEIGHTAGE OF
MARKS

Theory: ICU therapy

Paper 2 in Year 3 - Total 100

marks

Practicals – 50 marks

Internal Assessment: 50 marks

Term tests 30 marks

65
 Assignments 20
marks

REFERENCE BOOKS
1. Egan’s Fundamentals of Respiratory Care – Robert L. Wikins,
James K Stoller,
2. The ICU Book – Paul L Marino (Lippincott, Williams & Wilkins)
3. Practical Methods for Respiratory Care – Raymond Sibberson (Mosby)
4. Respiratory Physiology – The Essentials l John B West (Williams &
Wilkins)
5. Ventilation / Blood Flow & Gas Exchange – John B West (Blackwell
Scientific Publications)
6. Techniques in Bedside haemodynamic Monitoring – Elaine
Kiess Daily & Johnspeer Schroeder (Mosby)
7. All you really need to know to interpret arterial blood gases –
Lawrence Martin (Lea & Febiger)
8. Text book of Advanced Cardiac Life Support. American Heart
Association
9. Mechanical Ventilation – Susan P Pilbeam & J M Cairo (Elsevier)
10. Critical Care Secrets: Parsons, Wiener – Kronish, Jaypee Brothers
11. Washington Manual of Critical Care
12. Smeltzer – Brunner & Suddharth Textbook of Medical
Surgical Nursing, 2010,LWW
13. Black – Medical Surgical Nursing, 2009, Elsevier
14. Nettina – Lippincott manual of Nursing Practice, 2013. LWW
15. Lewis – medical Surgical Nursing, 2008, Elsevier
16. Davidson’s Principles &Practice of Medicine, 2010, Elsevier
17. Bailey & Love Short Practice of Surgery, 2013, Hodder Arnold
18. Timby – Introductory Medical Surgical Nursing, 2013, WK
19. Das – textbook of Surgery, SD Publishers
20. Woods – Cardiac Nursing, 2010, LWW
21. Hickey – Neurologic & Neurosurgical Nursing, 2009, LWW
22. Morton – Critical Care Nursing, 2009, LWW

66
23. Thelan’s Critical Care Nursing, 2013, Elsevier
24. Spring House – Medical Surgical Nursing Made Incredibly Easy, 2008,
LWW
25. Webber – Health assessment in Nursing, 2010, WK

67
 YEAR – III

ICU ADMINISTRATION, LOGISTICS, ETHICS, COMMUNICATIONS,

MANAGEMENT AND STATISTICS

COURSE DESCRIPTION
This course is designed to enable students to understand in the principles of
ICU administration, patient safety and transport. It is designed to assist
students in understanding the principles of medical ethics and communication.

OBJECTIVES

At the end of the course the students will be able to:

1. Describe the principles of basic ICU administration
2. Describe various aspects of medical ethics.
3. Describe the medico-legal aspects of medical records
4. Describe the principles of communication and counseling.
5. Describe all the aspects of patient safety and patient transport.
6. Understand the basic principles of management

COURSE CONTENT
Block 1: Basic administration
Unit 1: Economic issues in ICU
Unit 2: Raising purchase orders for equipmentUnit
3: Maintaining consumable stock
Unit 4: Equipment repair

Block 2: CSSD Procedures

Unit 1: Waste disposal collection of used items from user area, reception
protective clothing and disinfection safe guards.
Unit 2: Disinfection in ICU –Surfaces
• Reusable equipment and
accessories Unit 3: Wrapping & packing
Unit 4: General principles of
sterilization Section 1: Moist
heat sterilization Section 2:
68
Dry heat sterilization Section3:
Chemical sterilization

69
 • EO gas sterilization
• H2O2 gas plasma vap sterilization
Block 3: Medical ethics
Unit 1: Medical ethics –Definition – Goal – Scope
Unit 2: Code of conduct
Section 1: Introduction
Section 2: Basic principles of medical ethics
Section 3: Confidentiality
Section 4: Autonomy and Informed consent – Right of patients
Unit 3: Care of the terminally ill – Euthanasia, withdrawal, withholding
support
Unit 4: Organ transplantation
Unit 5: Medico legal aspects of medical records
Unit 6: Medico-legal case and type – Records and document related toMLC
Unit 7: Ownership of medical records –
Unit 8: Confidentiality Privilege
communication – Release of
medical information –
Unauthorized disclosure – retention of medical records –
other various aspects.
Block 4: Communication and counseling
Unit 1: Basic principles
Block 5: Basics of statistics
Unit 1: Basic concepts in measurement
Section 1: Scales of measurements
Section 2: validity, reliability, variation, measurementsystem,
conversion.
Unit 2: Basic descriptive statistics
Section 1: Central tendency, mean, mode, median. Section 2:
Dispersion range, variance, standard deviation
Unit 3: Concept of normal and abnormal
Block VI: Patient safety and transport
Unit 1: Electrical safety
Unit 2: Fire safety

70
Unit 3: Intra-hospital Patient transport
Unit 4: Inter-hospital Patient transport

71
Block VII: Principles of management
Unit 1: Basic principles of Management – functions, types,
importance, motivation etc.
Unit 2: Personnel management – staffing, orientation, disciplining,
complaints etc
Unit 3: Financial management – short and long term
METHODS OF TEACHING
1. Lecture cum discussion
2. Demonstration
3. Practical work record

METHODS OF EVALUATION
1. Written Test
2. Record Book
3. Assignments
4. Oral Presentations

WEIGHTAGE OF MARKS
Theory: ICU administration, logistics, ethics, communications,
management and statistics

Paper 3 in Year 3 - Total 100 marks

Practicals - None

Internal Assessment: 50 marks

Term tests 30 marks
Assignments 20 marks

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 SCHEME OF EXAMINATION

FIRST YEAR

Internal Theory Practical Total

Subjects assessment

Max Min Max Min Max Min Max Min

Paper 1:
Anatomy +Applied 50 25 100 50 50 25 200 100
Anatomy +
Biochemistry
(Anatomy 75% +
Biochemistry 25%)

Paper 2:
Physiology + Basic 50 25 100 50 50 25 200 100

Physics (Physiology

75% + Physics

25%)

Paper 3:
Computers + English 50 25 100 50 50 25 200 100
(Computer 50% +

English 50%)

73
 SECOND YEAR

Internal Theory Practical Total

Subjects assessment

Max Min Max Min Max Min Max Min

Paper 1:
Anatomy + Applied 50 25 100 50 50 25 200 100
Anatomy &
Physiology

Paper 2: 50 25 100 50 50 25 200 100

Clinical Microbiology

Paper 3:
ICU Monitoring I
(Basic)
& Biomedical
engineering 50 25 100 50 50 25 200 100
(ICU Monitoring 75%
+
Biomedical
engineering
25%)
Paper 4:
Pathology,

pathophysiology & 50 25 100 50 - - 150 75

Pharmacology
(Pathology 50% +

Pharmacology 50%)

74
 THIRD YEAR

Internal Theory Practical Total

Subjects assessment

Max Min Max Min Max Min Max Min

Paper 1:
ICU Monitoring II +
Maintenance of 50 25 100 50 50 25 200 100

equipment (ICU
Monitoring 75% +

Maintenance 25%)

Paper 2: 50 25 100 50 50 25 200 100

ICU Therapy

Paper 3:
ICU Administration + 50 25 100 50 - - 150 75
Logistics + Statistics
+
Medical Ethics

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POSTINGS DURING ONE YEAR INTERNSHIP

IMCU - 3 Months
PACU (Post Anaesthetic - 3Months
Care Unit)
Coronary Care Unit - 2 Months
(CCU)
RICU - 2 Months
Nephrology - 15 days
(Dialysis Unit)
NICU/PICU - 15 days
CSSD/Sterilisation - 15 days
Labs - 15 days

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 PROCEDURAL SKILLS

I Year BSc Critical Care Technology Course

OBSERVE ASSIST DO

Hand washing Hand washing

Universal Precautions Universal Universal Precautions
Precautions
Wearing clean/sterile Wearing clean/sterile
gloves gloves
Bed side manners Bedside manners
Assessment of Assessment of
Consciousnes Consciousnes
sAVPU Score sAVPU Score
Placement of pulse Placement of pulse Placement of pulse
oximeter oximeter
probe oximeter probe Probe and ECG probes
Placement of ECG leads Placement of ECG
leads
Applying NIBP cuff Applying NIBP cuff
Mask ventilation
Endotracheal intubation
Connection of patient to
ventilator
Documentation
Waste segregation and Waste segregation and
disposal
disposal

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 PROCEDURAL SKILLS
II Year BSc Critical Care Technology

Course In addition to Skills required in I Year

BSERVE/ CLASS ASSIST DO
Applying NIBP cuff Applying NIBP cuff Applying NIBP cuff
Peripheral line insertion Peripheral line
insertion
Placement of ECG leads Placement of ECG leads Placement of ECG leads
ECG recording ECG recording ECG recording
Basic ECG interpretation Basic ECG Basic ECG interpretation
interpretation
Central line insertion Central line insertion
Arterial line insertion Arterial line insertion
Setting up arterial Setting up arterial Setting up arterial
transducer transducer transducer
Bedside Pulmonary Bedside Pulmonary Bedside Pulmonary
Function Function Function
Test Test Test
Mask ventilation Mask ventilation
Endotracheal intubation
Endotracheal suctioning Endotracheal Endotracheal suctioning
suctioning
Endotracheal tube fixing Endotracheal tubefixing
Checking ETT cuff Checking ETT cuff
pressure pressure
Setting up ventilator Setting up ventilator
Placement of pulse Placement of pulse Placement of pulse
oximeter oximeter oximeter
probe probe probe
Connecting Ventilator to Connecting Ventilator
patient to patient
Humidification Humidification Humidification
Nebulization Nebulization Nebulization
Chest tube insertion Chest tube insertion
Monitoring ventilator Monitoring ventilator Monitoring ventilator
Parameters parameters parameters

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Basic ABG Basic ABG Basic ABG interpretation
interpretation interpretation

79
Extubation process Extubation process
Post extubation care Post extubation care
Chest physiotherapy Chest physiotherapy Chest physiotherapy
Incentive spirometry Incentive Spirometry Incentive Spirometry
Setting up EtCO2 Setting up EtCO2 Setting up EtCO2
Setting up Intra- Setting up Intra- Setting up Intra-
abdominal abdominal abdominal
pressure transducer pressure transducer pressure transducer
Haemodialysis Haemodialysis
canulation canulation
Pressure sore Pressure sore Pressure sore
monitoring monitoring monitoring
CXR interpretation CXR interpretation Chest X Ray interpretation
Brain death certification
Setting up O2 cylinder Setting up O2 cylinder Setting up O2 cylinder
for transport of for transport of for transport of
patient patient patient
Setting up Monitors for Setting up Monitors for Setting up Monitors for
Transport of Patient
transport of patient transport of patient

Care and maintenance Care and maintenance Care and maintenance of

of ventilator of ventilator ventilator

Care and maintenance Care and maintenance Care and maintenance of

of NIV of NIV NIV
Care and maintenance Care and maintenance Care and maintenance of
of infusion/syringe of infusion/syringe infusion/syringe pump
pump pump
Care and maintenance Care and maintenance Care and maintenance of
of monitor of monitor monitor
Defibrillator calibration Defibrillator calibration Defibrillator calibration
Setting up transducer Setting up transducer
for Intracranial for Intracranial
pressure monitoring pressure monitoring
Wrapping and packing Wrapping and packing Wrapping and packing
reusable equipment reusable equipment reusable equipment for
for sterilization for sterilization sterilization

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 PROCEDURAL SKILLS

III Year BSc Critical Care

Technology Course In addition toSkills required in I and II Year

OBSERVE ASSIST DO

Bedside Pulmonary Bedside Pulmonary Bedside Pulmonary

Function Function Function
Testing Testing Testing
Fiberoptic intubation
Connecting Ventilator to Connecting Ventilator t Connecting Ventilator
patient patient to patient
Troubleshooting Troubleshooting Troubleshooting
ventilator ventilator ventilator
Extubation process: cuff Extubation process: cuff Extubation process:
leak test leak test cuff leak test
Bronchoalveolar lavage Bronchoalveolar lavage
Tracheostomy
Defibrillation Defibrillation
Temporary pacemaker
insertion
GCS scoring GCS scoring GCS scoring
Setting up transducer Setting up transducer Setting up transducer
for for for
Intracranial pressure Intracranial pressure Intracranial pressure
monitoring monitoring monitoring

Insertion of external Insertion of external

ventricular
drain (EVD) ventricular drain (EVD)
Transport of patient out Transport of patient out Transport of patient
of ICU Of ICU out of ICU
APACHE scoring APACHE scoring

81