1

Aga Khan University

School of Nursing and Midwifery
BScN Programme
Academic Year 2024
Class of 2024

Course outline

Title : Critical Care Nursing

Course #: NURS-4009-A007: Critical Care Nursing

NURS-4009C-A007: Critical Care Nursing: Clinical

VLE link site : https://vle.aku.edu/course/view.php?id=5956

Enrollment key: B24CCN

Credits : Total Credits: 7 credits

Theory Credits: 2.5 credit x 1 hour x 17 weeks = 42.5 hours
Clinical Credits: 4 credits x 3 hours x 17 weeks = 204 hours
Skills/ Labs Credits: 0.5 credits x 3 hours x 17 weeks = 25.5 hours

Placement : Year IV, Semester I

Day & Time : Theory: Week No: 1,2,7,8,9,10, 16

Day: Wednesday and Thursday
Time: Wednesday: 0900-1300 hours
Thursday: 1100-1300 and 1400-1600 hours
(8 hours/week)

Clinical: Week No: 3,4,6,11,12,13,14,15,16

Day: Tuesday, Wednesday, Thursday
Time: 10-11 Morning shift: 0800-1700 hours
( 27 hours/week)
10-11 Evening shift: 1300-2200 hours
(27 hours/week)

Skills/ Labs: Week No: 5

Day: Tuesday, Wednesday, Thursday
Time: 0830-1730 hours
(22.5 hours/week)

Refer to detailed course schedule

Course Coordinator : Ms. Zahira Amir Ali (ZAA), Instructor

Faculty : Ms. Zulekha Saleem (ZS), Senior Instructor

: Ms. Shenila Shamsuddin (SS), Instructor
: Ms. Maheen Ali (MA), Clinical Preceptor
: Ms. Kiran Hirani (KH), Clinical Preceptor
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E-mail address : zahira.amirali@aku.edu (Ext. 5251)

zulekha.saleem@aku.edu (Ext. 5486)
shenila.shamsuddin@aku.edu (Ext.)
maheen.umair@aku.edu (Ext. 5432)
kiran.hirani95@gmail.com (Ext. 5274)

Pre-requisite / Co requisite : Health Assessment II Adult Health Nursing II Pathophysiology II

Pharmacology II

Course description: It focuses on concepts of Critical Care and analyzing client’s problems to plan appropriate
care interventions with more advanced concepts. Learners are expected to apply critical care concepts, nursing
process and evidence-based practice while integrating pathophysiological, pharmacological, psychosocial,
spiritual, and cultural concepts and theories within critical and emergency setting.

Learning Outcomes:

Course learning outcomes Program learning outcome Graduate Attribute

By the end of the program, students

On completion of this course the
learner will be able to:
1. Utilize critical care nursing
process in extending safe,
competent, physical, psycho-
social, emotional, and
spiritual aspects of care to
critically ill patients.
2. Integrate pathophysiological,
pharmacological, and
transcultural knowledge in the
management of patient care in
the critical care areas.
3. Apply a variety of concepts
and theories to the care of
individuals and families,
using health assessments,
nursing process and health
education in critical care.
4. Apply professional, legal and
ethical standards of practice
in caring for patients in acute
and critical care settings.
5. Utilize the concepts &
principles of disaster
management and develop
nursing care plan related to
will be able to: By the end of the
program, students will
1. Demonstrate ethical, be able to acquire
innovative leadership skills following graduate
and build networking to attributes:
positively influence nursing
practice. 1. Ethical, global
leadership
2. Demonstrate situational and 2. Lifelong learning
life-long learning and
adaptability to confront with
health care trends and
challenges.
3. Apply professional 3. Specialist
competencies in diverse knowledge to
setting to drive change from bring change
within and outside nursing
and health care.
4. Utilize critical thinking to 4. Critical and
appraise evidence and creative thinking
facilitate creative and
contextually relevant
solutions to address
challenges.
5. Provide safe, competent, 5. Evidenced based
quality care with evidence decision making
informed decisions to
individuals, families &
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emergency conditions. communities, across primary,

6. Develop knowledge, and
clinical competencies needed
to interpret diagnostic
procedures.
7. Utilize effective oral and
written communication skills
in interpersonal and
professional interactions
(multidisciplinary team
collaborations).
secondary, and tertiary levels
of health care system.
6. Demonstrate effective verbal 6. Effective
and written communication communication
within interdisciplinary
groups and key stakeholders
including clients, families,
communities, peers, and other
professionals to improve the
health-related quality of life
of the community through
health education, advocacy,
and leadership.
7. Be considerate and adaptive 7. Socially and
to social, cultural, and environmentally
environmental challenges of aware citizens
the time and discover
reasonable solutions.

Teaching/Learning Strategies: Flipped class room, use of online virtual learning environment (VLE), hybrid
model (F2F + online), power point presentations, asynchronous and synchronous lectures, Panopto recordings,
simulation based clinical workshop, guest lectures, recorded presentations / podcasts / vodcasts, Kahoot, H5P,
online video, quizzes, mock drill of code blue, article reviews, diagnostic reviews, two way discussions, role-
plays, clinical conferences, clinical log sheet, case study discussions, skills demonstrations/return demonstrations,
group work, high fidelity simulation based education, skills boot camp, breakout rooms, and integrated case-
based double jump with performance exam.

Course Expectations (Theory)

1. Attend all lectures as per policy. More than 15% absenteeism will lead to probationary plan.
2. Participate in synchronous and asynchronous activities.
3. Pre and post reading of theory and clinical content.
4. Participates actively in classes / participation in online activity
5. Select and provide holistic care to patients in assigned setting
6. Completion of assignments, tests and examination on due dates
7. Complete the expected readings and related activities posted on Virtual Learning Environment (blended
learning) or on emails.
8. Refer to link for academic policy
https://vle.aku.edu/mod/resource/view.php?id=283245
https://vle.aku.edu/mod/resource/view.php?id=283246

Course Expectations (Simulation/ Skills/ Lab /Clinical)

1. Students are required to maintain dress code, carry their ID cards, stethoscope, and always required
stationary.
2. Clinical objectives and assignments must be completed on daily basis, and a portfolio needs to be
maintained to keep the evidence of the assignments.
3. Attendance and punctuality must be maintained throughout clinical and follow the attendance policy in
handbook.
4. Students are expected to maintain 100% attendance during clinical /Simulation / Skills.
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5. In case of emergency/sickness as approved by the course facilitator, students may miss up to four days
(cumulative) of clinical/lab/ skill experience in a semester with genuine reason and final approval of
Academic Lead is compulsory.
6. Learners are required to make up any absence on clinical areas. Students are required to make up missed
days (for approved leaves) at the end of the semester. Four days of justifiable leave in clinical area must
be made up by the learners. More than 4 days of leave in a semester may result in repeating the semester/
year or expelling from the year (if pattern of leave is persistent). A learner who is unable to attend a
clinical for any reason must notify the faculty / ward in- charge prior to the clinical. Learner who is sick
on a clinical day must be seen by a physician at their respective/ designated institutions. There is no
provision for make up for unapproved leaves and hence student will get F in clinical/lab / simulation and
will be require repeating a course whenever offered next. Student unable to make up the missed days
should consider themselves as having failed the course. Make ups will be schedule at the end of the
semester. Students are required to check for their attendance/make ups with the course coordinator.
7. Participates actively and vigilantly in bedside clinical practice
8. Students must aim to remain honest, sincere, and vigilant during group interaction and report all critical
incidents/issues to their respective faculty.
9. Any student who is unable to come on the clinical rotation due to any genuine or un genuine reason, need
to complete their missed clinical hours in the form of the make-ups at the end of the semester only. This
clinical will be supervised by clinical preceptors or joint appointees. (Refer to student handbook).
10. Active participation in post-conferences. Clinical conferences, de-briefing sessions, and any other academic
activity by the clinical or lab facilitator are part of clinical experience, students should attend regularly.
Refer to shared link for Clinical standard policy from student handbook 2019
https://vle.aku.edu/mod/resource/view.php?id=283245
https://vle.aku.edu/mod/resource/view.php?id=283246

Assessment Criteria (Theory):

The course learning (theory section) will be evaluated through four assessments. This includes (i) Clinical
portfolio, (ii) Midterm exam, (iii) Final term exam, and (iv) Double jump exam. Students must review all the
critical care nursing concepts learned through synchronous and asynchronous online modules and classes, VLE
courses, face-to-face classes, post-conferences, guest speaker sessions, simulations, skills labs, and clinical
practice. Students may wish to study in small groups or individually and should be able to strategize their learning
plans. To avoid last minute assignment submissions or exam preparations, and promote academic progress,
students are encouraged to engage themselves in ongoing learning throughout the course. Students must visit
VLE site on regular basis to receive updates and notifications regarding course plans, and assessments, and
acquire learning resources. An average length of time on VLE for each topic expected for this course is 2-3 hours,
which may differ based on individualized learning needs. Students must comply with the assessment deadlines, as
the VLE site will be locked beyond submission hours. Late submissions will not be accepted. Active class
participation is highly encouraged for comprehensive understanding- and intellectual wellbeing for maintain best
clinical practice.

Type and description of assessment Mode of Weightage Date/ Time

Assessment
Clinical Portfolio (Midterm and Final term) Online 20% Ongoing
will assess students overall performance, such submission weekly
as knowledge and practice in clinical setting on VLE submissions
during clinical
weeks

Midterm:
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14th March
2024

Final term:
21st May 2024
Midterm Exam will evaluate students’ Computer 20% 28th March
knowledge, integration, and application based exam 2024
of concepts related to critical care nursing and with physical
associated evidence-based practices. It would presence (Time will be
be evaluated through multiple choice questions communicated)
and short questions and answers.
Final Exam will evaluate students’ knowledge, Computer 30% 31st May 2024
integration and application of concepts related to based exam
critical care nursing and associated evidence- with physical (Time will be
based practices. It would be evaluated through presence communicated)
multiple choice questions and short questions
and answers.
Double Jump Exam will assess the students’ Face-to-face 30% 14th, 15th, 16th
clinical problem solving and decision-making exam May 2024
processes, predominantly nursing care processes
including assessment, outcomes, interventions, 0830-1730
and evaluation. hours
Total 100%

Title of the assignment Clinical Portfolio

Detailed description will assess students overall performance, such as knowledge and practice in
clinical setting
Due date Ongoing weekly submissions during clinical weeks
Instructions Assessment grading= 20 %, Total marks= 80

Rubric for Portfolio Assessment:

Evidence of Learning
Student Name :

Assessment Does not meet the Partially meets the Meets expectations Score
Criteria expectations (0-3) expectations (4-6) (7-10)

Content of evidence Inadequate Fairly sufficient Sufficient

Appropriateness documentation and documentation and documentation and
Sufficiency and description as description of description of
Relevant with evidence of learning learning evidence but learning evidence
learning outcomes are inappropriate and/ only few are almost all are
or do not relate to appropriate, and appropriate and
course learning related to course related to course
outcomes learning outcomes learning outcomes
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Quality of evidence Most of the evidences Few of the evidences Almost all of the
Authenticity (from presented are not from presented are from evidences presented
scientific databases) authentic database nor authentic data bases are from authentic
and recency (not are recent and few are recent data bases and are
more than 5 years recent
older) of the
evidence
Practicality of The learning shared The learning shared The learning shared
evidence from the evidence from the evidences from the evidence
Application of provided is not/ provided have limited provided have
evidence in practice hardly applicable in application in practice
significant
practice application in
practice
Presentation of The evidence The evidence The evidence
evidence presented are presented are presented are
Completeness incomplete, incomplete, but complete, organized
Organization disorganized, and organized and and accurate with
Accuracy inaccurate with errors accurate with negligible errors in
in spelling, grammar minimum errors in spelling, grammar,
and punctuation spelling grammar, and and punctuation
punctuation
Overall Assessment Comments:

Total Marks

Approved by UGNCC November 2022

Title of the assignment Double jump exam

Detailed description It will assess the students’ clinical problem solving and decision-making
processes, predominantly nursing care processes including assessment,
outcomes, interventions, and evaluation.
Due date 14th, 15th, 16th May 2024, 0830-1730 hours
Instructions Assessment grading= 30 %, Total marks= 135

Assessment Criteria
Aga Khan University
School of Nursing and Midwifery
BScN Degree Programme 2022
Year IV, Semester 1
Critical Care Nursing Course

DOUBLE JUMP EXAM CRITERIA

Student: GN# Faculty: Date:

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Total Marks: 135

STEP I: HISTORY: 5 MIN (16 MARKS)
Student interview client/family for exploring chief concern and present complaints

GREETING, INTRODUCTION & PURPOSE OF INTERACTION

0 1 2 3
0. None of the above
1. 1. One of the above
2. Two of the above
3. All of the above

ATTENTIVENESS AND RESPECT

i. maintaining eye contact

ii. open posture
iii. nodding
2. iv. leaning forward

0. Showed no relevant gestures of attentiveness and respect

0 1 2 3
1. Showed 1-2 relevant gestures of attentiveness and respect
2. Showed 2-3 of the mentioned relevant gestures of attentiveness and
respect
3. Showed almost all of the mentioned relevant gestures of attentiveness and
respect

QUESTIONING SKILLS 0 1 2 3

i. open ended questions

3. ii. general lead
iii. follows clue
iv. probing
v. allows patient to talk without interrupting
vi. seeking clarification
vii. summarization
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0. Did not use any of the mentioned therapeutic communication skills

1. Used 1-2 of the mentioned therapeutic communication skills.
2. Used 3-4 of the mentioned therapeutic communication skills.
3. Used almost all the mentioned therapeutic communication
skills,throughout

4.
ORGANISATION IN DATA COLLECTION
0 1 2 3
i. Relevance
ii. Depth
iii. Logical flow

0. None of the above

1. One of the above
2. Two of the above
3. All of the above

5.
COMPREHENSIVENESS OF THE DATA COLLECTED 01 2 3 4

Takes history about:

i. Presenting complaint and its history
ii. Associated problems
iii. Review of systems
iv. Past history/co-morbid
v. Family history
vi. Use of medications, including OTC
vii. Lifestyle (diet, exercise, habits)

0. None of the above

1. Took history for at least 2
2. Took history for 3 to 4
3. Took history for 5 to 6
4. Took history for all 7
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STEP II: PHYSICAL EXAMINATION: 10 MIN (23 MARKS)

Student perform a related system examination on patient

RELEVANCE FOR SYSTEM TO BE EXAMINED ON DATA

COLLECTED 0 1 2 3

0. Did not identify and rationalize any relevant system to be

1. examined to the client situation.
1. Identified and rationalized at least 01 relevant system to be
examined to the client situation.
2. Identified and rationalized at least 02 relevant systems to be
examined to the client situation.
3. Identified and rationalized 03 relevant systems to be examined to
the client situation

EXAMINATION PREPARATION

i. asks for permission

ii. standing on the right side of the patient
iii. ensuring patient’s comfort
iv. maintained privacy
v. raise bed to waste level
2.
vi. washed and warmed hands
vii. offered patient time to go to washroom
viii. prepared tray

0. performed none of the above 0 1 2 3 4

1. performed 2-3 of the above
2. performed 3-4 of the above
3. performed 4-5 of the above
4. performed all of the above

COMPREHENSIVENESS (Inspection, Palpation, Percussion,

Auscultation) 0 1 2 3 4

3. 0. performed none of the above

1. performed 1 of the above
2. performed 2 of the above
3. performed 3 of the above
4. performed All of the above

ORGANIZATION
4.
i. Demonstrated effective equipment handling
ii. Approached client in organized manner
iii. Applied correct examination technique
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iv. Verbalized finding simultaneously

0. none of the above

1. 1 of the above
2. 2 of the above
3. 3 of the above 0 1 2 3 4
4. All of the above

5. OVER ALL EXAMINATION TECHNIQUE

0. Poor
1. Satisfactory 0 1 2 3 4
2. Good
3. Excellent
4. Outstanding

6. ABILITY TO REPORT PE FINDINGS (accurately and systematically)

0. Poor 0 1 2 3 4
1. Satisfactory
2. Good
3. Excellent
4. Outstanding

STEP III: VIVA- (TOTAL 15 minutes)

STEP III A: MEDICAL HYPOTHESIS: 5 MIN (03 MARKS)

Hypothesize any 3 Medical diagnoses about this patient? Identify rationale for choice

1. MEDICAL DIAGNOSIS

0. Did not identify any relevant medical diagnosis 0 1 2 3

1. Identified at least 01 relevant medical diagnosis
2. Identified 02 relevant medical diagnosis
3. Identified 03 relevant medical diagnosis

STEP III B: ASSESSMENT OF CLINICAL REASONING: 10 MIN (24 MARKS)

1. DISEASE SIGN & SYMPTOM: Review patient’s scenario and his Medical
Diagnoses. Identify at least three presenting signs and symptoms, and
integrate them with patient’s condition/disease.
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Identification of all the sign and symptom shared by the patient

(1 mark for one correctly identified sign and symptom) 012 3

Rationalization of the presenting sign and symptoms with the disease using
critical thinking and clinical reasoning

(1 mark for correct rationalization of sign & symptoms of the disease. 012 3

PATHOLOGICAL CONCEPTS: Ask how does this disease affect body

functions Pathological Processes?
0 1 2 3
Demonstrates critical thinking & reasoning ability in describing disease 4
pathology
2. 0. Poor
1. Satisfactory
2. Good
3. Excellent
4. Outstanding
3. LABORATORY INVESTIGATION INTERPRETATION: What will be the
changes in Laboratory Tests? At least three
0 1 2 3
Demonstrates critical thinking & reasoning ability in laboratory investigation 4
interpretation

0. Poor
1. Satisfactory
2. Good
3. Excellent
4. Outstanding

TREATMENT(Medical/Surgical) 0 2 4
4.
Zero (0) for not identifying any medical and / or surgical treatment
1 mark each for identification of correct medical and / or surgical treatment
(at least 2)
Drug i
PHARMACOLOGY
0 1 2 3
5. What Drugs may be ordered for this patient and their action, side effect &
nursing responsibilities (maximum 2 drugs) Drug ii

0. Unable to provide complete information about drug indication, side 0 1 2 3

effect & nursing care knowledge.
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1. Provide superficial information about drug indication, side effect &

nursing care knowledge.
2. Provide optimum information about drug indication, side effect &
nursing care knowledge.
3. Provide all the possible information about drug indication, side effect
& nursing care knowledge.

STEP IV: X-RAY INTERPRETATION 15 MINUTES (3 MARKS)

STEP V: ECG-INTERPRETATION 15 MINUTES (4 MARKS)

Maximum
X-RAY INTERPRETATION: Marks 3
1.
0.5 mark for each correct response

2. ECG INTERPRETATION: Maximum

Marks 4
0.5 mark for each correct response

STEP VI: CIM DEVELPOMENT AND DOCUMENTATION OF HISTORY: 45 MIN

STEP VI A: NURSING HYPOTHESIS AND SUPPORTING DATA: (21 MARKS)

Hypothesize 3 priority Nursing diagnosis / possible patient problems and identify

supporting data

Problem 1

Problem 2

Problem 3

1. STATEMENT OF NURSING DIAGNOSIS

0. Does not identify any relevant Nursing diagnosis 0 1 2 3

1. Identify at least one relevant Nursing diagnosis
2. Identify two relevant Nursing diagnosis
3. Identify three relevant Nursing diagnosis
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2. ACCURATE DIAGNOSTIC AND SUPPORTIVE STATEMENTS Diagnosis 1

1 2 3
Related Factor
Secondary Factor Diagnosis 2
As evidenced by 1 2 3

One mark for each of the correct component in each of the three Diagnosis 3
diagnosis 1 2 3

3. SUPPORTED ASSESSMENT DATA

The subjective and objective data provided for all three nursing Diagnosis 1
diagnosis 0 1 2

0. not relevant to the problem and not comprehensive Diagnosis 2

1. relevant but not comprehensive 0 1 2
2. relevant and comprehensive
Diagnosis 3
0 1 2
4. NURSING PROBLEM LIST PRIORITIZED AND HOLISTIC
0 1 2 3
0. Problem list is not holistic and was not prioritized.
1. Problem list is somewhat holistic but not prioritized
2. Problem list is holistic and somewhat prioritized
3. Problem list is holistic and prioritized

STEP VI B: EXPECTED OUTCOMES AND NURSING INTERVENTIONS:

(24 MARKS)

Identify Expected Outcomes and Possible or Actual Interventions (3 at least) for the
identified nursing problems.
Problem 1 Nursing Interventions
STG:
LTG:
Problem 2 Nursing Interventions
STG:
LTG:
Problem 3 Nursing Interventions
STG:
LTG:

1. EXPECTED OUTCOME/GOALS in SMART format Problem 1

Specific STG
Measurable 0 0.5 1 1.5 2
Achievable 2.5
Realistic LTG
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Time-bound 0 0.5 1 1.5 2

2.5
0.5 mark for each for correct component of SMART
Zero for goal not SMART at all Problem 2
STG
0 0.5 1 1.5 2
2.5
LTG
0 0.5 1 1.5 2
2.5
Problem 3
STG
0 0.5 1 1.5 2
2.5
LTG
0 0.5 1 1.5 2
2.5

2. NURSING INTERVENTIONS Problem 1

i. relevant with diagnosis 1 2 3
ii. comprehensive & practical enough to achieve goal
iii. prioritized Problem 2
1 2 3

1 mark for each of the three component present in interventions of each Problem 3
problem 1 2 3

STEP VI C: INTEGRATION OF ALL THE ESSENTIAL COMPONENETS OF CIM (12

MARKS)

1. PATIENT DEMOGRAPHIC AND CURRENT MEDICAL 1 2 3 4

DIAGNOSIS

i. Name
ii. Age
iii. Current Medical diagnosis
iv. Co morbid * years

1 mark for each component

2. CAUSES FOR THE DISEASE UNDER TREATMENT WITH 0 1 2 3 4
FOLLOWING ELEMENTS FOR EACH CAUSE
i. Pathophysiology
ii. Evidence
iii. Any medical treatment
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iv. Any nursing diagnosis at least one and nursing intervention at

least one
v. Any relevant teaching need

0. Poor integration of causes

1. Satisfactory integration of causes
2. Good integration of causes
3. Excellent integration of causes
4. Extra ordinary integration of causes

3. SIGNS AND SYMPTOMS (S/S) OF THE DISEASE AS OBSERVED 0 1 2 3 4

BY STUDENT OR VERBALIZED BY PATIENT WITH
FOLLOWING ELEMENTS FOR EACH S/S

i. Pathophysiology
ii. Evidence
iii. Any medical treatment
iv. Any nursing diagnosis at least one and nursing intervention at
least one
v. Any relevant teaching need

vi. Poor integration of S/S

vii. Satisfactory integration of S/S
viii. Good integration of S/S
ix. Excellent integration of S/S
x. Extra ordinary integration of S/S

STEP VI D: HISTORY DOCUMENTATION: (5 MARKS)

1. HISTORY DOCUMENTATION
Accurate 1 2 3 4 5
Succinct
Relevant
Comprehensive
Signature and Date and time

1 mark for each correct component

Reviewed by CCN Team - 2022

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Assessment Criteria (Clinical):

Clinical will be evaluated as pass/fail based on the objective evidence of

performance and 100% attendance. Clinical Performance will assess students’
knowledge, attitude, skills, and practices while providing nursing care to patients.
Clinical portfolio for both midterm and final term must be submitted timely on
VLE. Clinical portfolio includes reflective logs, Concept Integrated Maps, patient
teaching plan and resources, clinical objectives, skills signoff checklist, post
conference assignments, clinical evaluation, appreciation letters/notes, and any
other significant clinical document. Students must fill evaluation forms (self-
evaluation) for midterm and final term clinical and submit to their respective
clinical faculty/ preceptor.

List of Skills for BScN students:

https://vpn.aku.edu/PK/akuh/cno/Documents/Resources/,DanaInfo=one.aku.edu,S
SL+Year%20%20Wise%20%20Skills%20Checklist.pdf

Clinical Evaluation Form:

https://www.aku.edu/sonampk/programmes/Documents/SONAM%20Supplement
ary%20Handbook%20-%20Sept%202021.pdf

Theory objectives :

Unit objectives:

Unit I: Conceptual foundation and critical care nursing

By the end of the session students will be able to:
• Understand psychosocial implications in the care of critically ill patient and family
• Discuss principles of critical care and emergency nursing
• Understand contemporary issues in critical care area
• Discuss complementary therapies
• Review scope of practice of critical care and emergency nursing.
• Describe role of nurse in critical care nursing.
• Explore holistic and interdisciplinary approach
• Understand standards of healthy work environment in critical care
• Explain nutrition in critical care

Unit II: Care of patients of Ventilator

By the end of the session students will be able to:

• Review the anatomy & physiology of respiration.
• Describe methods for assessing the respiratory system,
including physical assessment, and non-invasive
techniques.
• Understand the concept of oxygenation, ventilation and gas exchange.
• Compare commonly used oxygen delivery devices.
• Discuss method for maintaining an open airway.
• Identify indication for initiation of invasive and noninvasive ventilation.
• Describe negative and positive pressured ventilation.
• Describe the safety factors while plugging electrical
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equipment in a room where oxygen is in use.
• Describe the application of the gas laws to the process of respiration.
• Describe types and modes of mechanical ventilation.
• Define different parameters of ventilators i.e.
o Tidal volume (TV)
o Minute volume (MV)
o Fraction of Inspired Oxygen (FiO2)
o I:E ratio
o Positive End Expiratory Pressures (PEEP)
o Sensitivity
o Humidity and Temperature
• Discuss trouble shootings in the mechanical ventilation.
• Relate complications associated with mechanical ventilation.
• Discuss the nursing care of patients with mechanical ventilation.
• Explain methods and criteria for weaning the patient from mechanical
ventilation

Unit III: Basic to advance ECG interpretation

❖ Overview of cardiac system, Basics of 12 ECG interpretation

By the end of the session students will be able to:
• Review the ECG wave component and intervals of normal ECG.
• Relate each component of ECG complex with cardiac contraction.
• Measure the atrial rate (AR) and ventricular rate (VR).
• Demonstrate ECG electrode placement for 12 lead ECG.
Identify the purpose of different leads.

❖ Performance of 12 lead ECG and Interpretation

By the end of the session students will be able to:
• Perform the skills of 12 lead ECG
• Interpreting normal features of 12 lead ECG
• Interpret ECG changes in cardiac hypertrophy.
• Identify the causes of axis deviation.
• Interpret ECG changes in axis deviation

❖ ECG Interpretation in Arrhythmias

By the end of the session students will be able to:

• Differentiate between normal sinus rhythm, sinus
bradycardia, sinus tachycardia, atrial and sinus
arrhythmias.
• Discuss the different types of dysrhythmias
o Atrial Arrhymias,
o Juntional Arrhtmias
o Ventricular Arrhytmias.
• Interpret 12 lead ECG for
o Sinus Arrhythmias
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o Atrial Flutter
o Atrial Fibrillation
o Supraventricular Tachycardia
o Ventricular Arrhymia
o Ventricular Tachycardia
o Ventricular Fibrillation
o Junctional Arrhythmia

❖ ECG Interpretation in Conduction disorder

• Describe and identify the changes in 12 lead ECG.

o First Degree Heart Block.
o Second Degree Heart Block type I, Mobitz I
o Second Degree Heart Block type II or Mobitz II.
o Complete or Third-Degree Heart Block.
o Pace maker
• State the primary indication for insertion of a temporary cardiac
pacemaker.
• State the primary indication for insertion of a
permanent pacemaker and implantable Cardioverter -
defibrillators

Unit IV: Critical concepts in care of patients with specific conditions

By the end of the session students will be able to:

• Review the pathological cause and mechanism that

produce acute cardiac alterations such as Cardiac
Myopathy, Cardiac Tamponade, Hypertensive Crisis,
and Pulmonary Embolism.
• Discuss the diagnostic procedures and radiologic changes used for
cardiac alterations.
• Discuss the pharmacological Management of Patient
having Cardiac alterations in Emergency Department
and Critical Care Units.
• Review the pathological cause and mechanism that
produce neurological alterations such as, head injury
and spinal cord injuries.
• Discuss nursing diagnoses, interventions, and
clinical management guidelines of patients
experiencing cardiac alterations, head injury, and
spinal cord injuries.

Unit V: Methods of hemodynamic management

By the end of the unit the students will be able to

• Discuss various methods available to monitor different variables of

hemodynamics
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• Intra-arterial pressure monitoring
• CVP care
• Left arterial pressure monitoring
• Pulmonary arterial pressure monitoring
• Cardiac output monitoring

Unit VI: ER Concepts

By the end of the session students will be able to:

• Discuss the concept and scientific rationales of triaging in emergency
setting.
• Describe the roles and responsibilities of triage nurse.
• List priority setting/Triage categories in emergency situation.
• Relate the concept of internal and external diversion in emergency nursing.
• Learn to utilize the effective communication skills during
triaging and diversion, Disaster management, mass casualty,
and resource management.
• Define mass casualty incidents and Mass Casualty Management (MCM)
system.
• Describe and anticipate various types of disasters.
• Identify the chain of communication and need for
multidisciplinary interventions during a disaster.
• Describe the role of an In-Charge Nurse, Triage Nurse and
other Emergency Room nurses in ensuring a non-panic, well-
coordinated management during a disaster.
• Discuss AKUH policy and dynamics in relation to disaster management.
• List the core competencies for a health care worker at the time of disaster.
• Differentiate different color codes and their meaning of disaster at AKUH.
• Identify and locate the agency’s emergency response plan.
• Discuss the immediate action required in different type of disaster.
• Describe systemic approach for a response to MCM.
• Discuss planning for MCM at various levels
(National, Community & Health Care Facility).
• Explore issues, challenges and strategies for MCM.
• Discuss resource management in phases of emergency.

Unit VII: Code Management and Review of Critical Care Drugs

By the end of the session students will be able to:
• Understand the difference between life threatening Dysrhythmias.
• Identify the indications for initiating Cardio Pulmonary Resuscitation (CPR).
• Identify / perform different roles of care givers in
managing cardiopulmonary arrest situations.
• Learn to utilize the crash cart and the equipment such as defibrillator used
during a code.
• Differentiate basic and advanced life support measures used during a code.
• Identify medications used in code managements,
including use, action, side effects and nursing
implications.
 20
• Identify the pertinent documentation during a code.
• Describe post resuscitation management.
• Identify psychosocial, legal and ethical issues related to code management.
• Discuss the care and involvement of the family during a code.
Unit VIII: Multisystem Alterations

By the end of the unit, students will be able to:

• Describe common pathophysiological processes involved in generalized
shock response.
• Compare and contrast the etiology and clinical
manifestations of the major categories of shock
(cardiogenic, hypovolemic, obstructive, septic, MODS).
• Explain the anticipated medical and management, and
rationale for treatment of the various shock states.
• Identify nursing management principles for patients
experiencing different type of shocks and MODS
Unit XI: Advanced Treatment Modalities

❖ Intracranial Pressure Monitoring and ICD management

By the end of the session students will be able to:

• Understand the mechanism of auto regulation and its

effects on cerebral blood flow, intracranial pressure
(ICP) and Cerebral Perfusion Pressure (CPP).
• Discuss immediate neurological assessment and management in
emergency situation.
• Identify the etiology, clinical manifestations, and complications of ICP
variations
• Discuss indication and monitoring of intra-abdominal pressure

❖ Intra-abdominal Pressure Monitoring

By the end of the session students will be able to:

• Define abdominal pressure and discuss the associated abdominal

assessment
• Assessment of risk factors for elevated Intra-abdominal pressure
• Discuss the medical and nursing management of elevated intra-abdominal
pressure.
• Discuss the process of intra-abdominal pressure
monitoring and associated trouble shooting during
the process.

Unit X: Intra-aortic balloon pump monitoring (IABP)

By the end of the session students will be able to:

 21
• Discuss Hemodynamics of IABP
• Describe the hemodynamic benefits of properly timed balloon pumping
• List indications, contraindications and complications of IABP
• Discuss Nursing responsibilities associated with IABP

Unit XI: Toxicology in Critical Care

By the end of the session students will be able to:

• Identify the signs and symptoms of drug, overdose, and withdrawal.
• Discuss the classification of drugs that may produce signs
and symptoms of overdose and withdrawal.
• Discuss the treatment modalities of drug overdose with rationales.
• Discuss the Medico-legal process in drug over dose with
known psychiatric history and without psychiatric history.

Clinical/ simulations/ lab/ skills Objectives:

By the end of the clinical/ simulations/ lab/ skills, learners will be able to:

1. Apply the nursing process and critical thinking in delivering culturally sensitive holistic
nursing care to patients/clients with various medical/surgical conditions in critical care
setting by utilizing evidenced-based practices.
2. Familiarize self with Critical Care unit set up including equipment, supplies, use of
various types of monitors and ventilators, and documents.
3. Explore physiological, psychosocial, and spiritual needs of critically ill patients/families and
intervene accordingly and provide realistic teaching to clients and families in collaboration
with other health team members.
4. Incorporate cognitive, interpersonal, and technical skills from the humanities, natural and
behavioral sciences while providing nursing care to clients.
5. Integrate diagnostic procedures and provide safe individualized care to patients requiring
critical care modalities such as mechanical ventilation (invasive and noninvasive),
hemodynamic monitoring, pacemaker, Intra-Aortic Balloon Pump (IABP), and
pharmacological support.
6. Integrate conceptual models and theories applicable to nursing practice in critical care.
7. Demonstrate personal and professional attributes, leadership abilities, and awareness of
legal and ethical standards required to work in critical care areas.
8. Document all assessments, nursing care and discharge teaching provided to the clients in
appropriate sheet.
 22
Course Schedule:

Mode of Teaching
(Online,
Face to face,
TIME AND blended
DATE Week* Concept of Study Faculty
DURATION Clinical,
Simulation,
Skill based) + T/L
Pedagogy
Unit I: Conceptual foundation and
critical care nursing
a. Psychosocial implications in the
care of critically ill patient and
family
b. Stress and coping
c. Individual and family response to
7th
0900-1300 the critical care experience Face to face/Online Ms. Zahira Amir
February 1st
hours d. Death and Dying theories Ali
2024
e. Sleep and sensory balances in
4 hours critically ill patient
f. Infection control in critical care
g. Nutrition in critical care
h. Contemporary issues in critical
care area
i. Complementary therapies
Unit II: Care of a patient with Ventilator
0900-1300 a. Compliance versus elasticity Guest Speaker/
9th hours b. Modes of ventilator Ms. Zahira Amir
February 1st c. Trouble shooting mechanical Synchronous/ online Ali
2024 4 hours ventilation
d. Complications of mechanical
ventilation

14th 0900-1300
Unit V: Methods of Hemodynamic Ms. Zahira Amir
February hours 2nd Face to face
monitoring Ali
2024
4 hours

1100-1300
and
15th 1400-1600 Unit VIII: Multisystem Alterations Face to face Ms. Zulekha
February hours 2nd Saleem
2024
4 hours
 23
0900-1300
hours Unit IX: Advanced Treatment Modalities
16th a. ICD management, Intracranial
February 4 hours 2nd pressure monitoring Face to face Ms. Zahira Amir
2024 b. Intra-abdominal pressure Ali
monitoring

Guest Speaker/
20th
0900-1300 Unit III: Electrocardiography (ECG) Ms. Zulekha
March 7th
hours Online/ Synchronous Saleem/ Ms.
2024
Zahira Amir Ali
4 hours
1100-1300 Unit VII: Code management (A)
and a. Medications used in code
1400-1600 managements
21st hours b. Documentation during a code.
March 7th c. Post resuscitation management Face to face Ms. Zahira Amir
2024 4 hours d. Psychosocial, legal and ethical Ali
issues
e. Involvement of the family during
a code
0900-1300 Unit VII: Code management (B)
hours a. Life threatening Emergencies/
Dysrhythmias
22nd 4 hours b. Indications for initiating Cardio
Ms. Zahira Amir
March 7th pulmonary resuscitation Face to face
Ali
2024 c. Roles of care givers in managing
cardiopulmonary arrest situations.
d. Utilization of crash cart and
defibrillator
0900-1300 Ms. Zahira Amir
27th hours Ali
March 8th Review class Face to face
Ms. Zulekha
2024 4 hours Saleem
1400-1600
28th hours
March 8th Mid term
2024 (2 hours)
0900-1300 Unit IV: Critical Concepts in care of
hours patient with specific conditions:
3rd April Ms. Zulekha
9th a. Pulmonary Embolism Face to face
2024 4 hours b. Hypertensive Crisis Saleem
c. Cardio Myopathies
d. Cardiac Tamponade
1100-1300 Unit VI: Spinal Cord Nursing
Emergency Injuries concepts
and a. Disaster, Triage, and trauma
4th April Ms. Zulekha
1400-1600 9th management Face to face
2024 Saleem
hours b. Nursing management of medical
and surgical emergencies
4 hours
 24
0900-1300
22nd May hours
16th Unit X: IABP monitoring Face to face Guest Speaker
2024
4 hours

1100-1300
and
23rd May Asynchronous/ Ms. Zulekha
1400-1600 16th Unit XII: Toxicology
2024 online Saleem
hours

4 hours
Ms. Zahira Amir
1500-1600 Ali
23rd May
hours 16th Review class Face to face Ms. Zulekha
2024
Saleem
1.5 hours
0930-1130
31st May hours
17th Final Exam
2024
2 hours
Total Hours: 48 hours

Clinical / Skill / Simulation Schedule:

Venue Simulation Details

(CIME/Skills lab) Describe Type of
DATE Clinical Skills/ Simulation
Total hours Faculty
/ Week competencies (SP, Mannequin,
Task trainer, or
any other)
Ms. Zahira Amir
20th February, Ali, Ms. Zulekha
Morning shift=
21st February, Saleem, Ms.
27 hours/week
22nd February Clinical In-patient hospital Clinical practice on Maheen Ali, Ms.
2024 real patients Kiran Hirani, Ms.
Evening shift=
Shenila
27 hours/week
3rd week Shamsuddin, New
CP
Ms. Zahira Amir
27th February, Ali, Ms. Zulekha
Morning shift=
28th February, Saleem, Ms.
27 hours/week
29th February Clinical In-patient hospital Clinical practice on Maheen Ali, Ms.
2024 real patients Kiran Hirani, Ms.
Evening shift=
Shenila
27 hours/week
4th week Shamsuddin, New
CP
 25
Skills sign off using Ms. Zahira Amir
th
5 March, mannequin/ task Ali, Ms. Zulekha
6th March, Basic Skills* trainers, CIM Saleem, Ms.
7th March CIME and AKU- refresher, Drug Maheen Ali, Ms.
27 hours/week
2024 Advanced Skills/ SONAM Dosage calculation Kiran Hirani, Ms.
Skills and Pharmacology, Shenila
5th week Bootcamp** Medication Shamsuddin, New
management review CP
Simulation= 2 Ms. Zahira Amir
hours/ day Ali, Ms. Zulekha
12th March, Simulation on Saleem, Ms.
13th March, Morning shift= High Fidelity mannequin (high Maheen Ali, Ms.
14th March 27 hours/week Simulation CIME and In-patient fidelity simulation) Kiran Hirani, Ms.
2024 Education*** hospital Shenila
Evening shift= and Clinical Clinical practice on Shamsuddin, New
6th week 27 hours/week real patients CP

Simulation= 2 Ms. Zahira Amir

hours/ day Ali, Ms. Zulekha
16th April Simulation on Saleem, Ms.
17th April Morning shift= High Fidelity mannequin (high Maheen Ali, Ms.
18th April 27 hours/week Simulation CIME and In-patient fidelity simulation) Kiran Hirani, Ms.
2024 Education *** hospital Shenila
Evening shift= and Clinical Clinical practice on Shamsuddin, New
th
11 week 27 hours/week real patients CP

Simulation= 2 Ms. Zahira Amir

hours/ day Ali, Ms. Zulekha
23rd April, Simulation on Saleem, Ms.
24th April, Morning shift= High Fidelity mannequin (high Maheen Ali, Ms.
25th April 27 hours/week Simulation CIME and In-patient fidelity simulation) Kiran Hirani, Ms.
2024 Education *** hospital Shenila
Evening shift= and Clinical Clinical practice on Shamsuddin, New
12th week 27 hours/week real patients CP

Ms. Zahira Amir

Ali, Ms. Zulekha
30th April, Morning shift=
In-patient hospital Clinical practice on Saleem, Ms.
2nd May, 18 hours/week
real patients Maheen Ali, Ms.
2024 Clinical
Kiran Hirani, Ms.
Evening shift=
Shenila
13th week 18 hours/week
Shamsuddin, New
CP
7th May, Ms. Zahira Amir
Morning shift=
8th May Ali, Ms. Zulekha
27 hours/week
9th May, In-patient hospital Clinical practice on Saleem, Ms.
Clinical
2024 real patients Maheen Ali, Ms.
Evening shift=
Kiran Hirani, Ms.
27 hours/week
14th week Shenila
 26
Shamsuddin, New
CP
Double jump on Ms. Zahira Amir
th
14 May, simulated patients Ali, Ms. Zulekha
15th May, Double jump= 2 CIME and case-based Saleem, Ms.
16th May, hours/ day Double jump scenarios Maheen Ali, Ms.
2024 exam Kiran Hirani, Ms.
Shenila
15th week Shamsuddin, New
CP
Ms. Zahira Amir
Ali, Ms. Zulekha
21st May, Morning shift= 9
In-patient hospital Clinical practice on Saleem, Ms.
23rd May, hours/week
real patients Maheen Ali, Ms.
2024 Clinical
Kiran Hirani, Ms.
Evening shift= 9
Shenila
16th week hours/week
Shamsuddin, New
CP
Total Hours: 204 hours

Note: Clinical master plan, grouping, and placements as well as skills, simulation and double
jump planner/ schedules will be shared on VLE. Any deviation/ modification in the course
schedule due to holidays that are subjected to the appearance of Moon and / or unrest city
situation will be shared with students on VLE through announcements.

Basic Skills*: NG insertion/ Feeding /Removal, Oral nasal Suctioning, IV cannula and
medication, Catheterization insertion and removal
Advanced Skills/ Boot camp**: Hemodynamic Monitoring (CVP & Art Line), Inline Suctioning
+ Ventilator trouble shooting, Code Management/ Crash Handling (Tachycardia and bradycardia
with pulse), Code Management/ Crash Handling (Cardiac arrest), BIPAP modes/ Handling, B-
Brown (syringe pumps + infusion sets)
High Fidelity Simulation Education***: Ventilator Management, Sepsis Management, Advanced
Cardiovascular Life Support

References:

Required Text Books:

1. NANDA booklet for nursing diagnosis (2014).
2. Suzzane M. Burns (3rd Edition). Essentials of Critical Care
Nursing, American Association of Critical Care Nurses
3. Urden, Linda Diann. (2018). Critical care: Diagnosis and management (8th
ed.).
4. Sole, M. (2017). Introduction to critical care nursing (7th ed.)
5. Black, Perry. (2017). Professional Nursing: Concepts and challenges.
6. Baird, M. (2016). Manual of critical care nursing
[electronic resource]: nursing interventions and collaborative
management. (7th. Ed.)

Recommended Texts and Articles:

 27
Unit I: Conceptual Foundation and Critical Care Nursing

Chulay, M., Suzanne, M., Chulay, M., & Suzanne, M. (2020).

AACN Essentials of Critical Care Nursing Pocket Handbook
(80). Stikes Perintis Padang. Retrieved from
http://repo.stikesperintis.ac.id/1072/1/80%20Marianne%20C
hulay%20%282010%29%20 Essentials%20of%20Critical-
Care%20Nursing%20Pocket%20Handbook%2C%20Second
%20Edition.pdf
Droogh, J. M., Smit, M., Absalom, A. R., Ligtenberg, J. J., &
Zijlstra, J. G. (2015). Transferring the critically ill patient:
are we there yet?. Critical Care, 19(1), 1-7. Retrieved from
https://link.springer.com/article/10.1186/s13054-015-0749-
4
Fabiś, A., & Klimczuk, A. (2017). Death and Dying, Theories of.
The Wiley‐Blackwell Encyclopedia of Social Theory, 1-7.
Haines, K. J., Denehy, L., Skinner, E. H., Warrillow, S., &
Berney, S. (2015). Psychosocial outcomes in informal
caregivers of the critically ill: a systematic review.
Critical care medicine, 43(5), 1112-1120. Retrieved
from
https://journals.lww.com/ccmjournal/Fulltext/2015/0500
0/Psychosocial_Outcomes_in_In
formal_Caregivers_of.24.aspx?casa_token=Mq_uPFbGP
K0AAAAA:IgpkmC_i4xmdYG
No14eAnZLTFvcV5b81Fi6bQFAOeZ2srX-d-
VkXNTLyBggxjibZwXzgq2_vv0cbh4RTYWVlgOFcmc
s
Meghani, S., Karmaliani, R., Ajani, K., Bhamani, S. S., Khan, N. U., & Lalani, N.
(2019).
Knowledge, attitude, and practice of healthcare
professionals regarding family presence during
resuscitation: An interventional study in a tertiary care
setting, Karachi, Pakistan. Connect: The World of Critical
Care Nursing, 13(1), 46-55. Retrieved from
https://connect.springerpub.com/content/sgrwfccn/13/1/46
.full.pdf
Meghani, S. (2022). Witnessed resuscitation: A concept analysis.
Intensive and Critical Care Nursing, 103003. Retrieved
from
https://www.sciencedirect.com/science/article/pii/S0964339
720302068?casa_token=A41
prVlMnN8AAAAA:drLvp9z67KgSriVF3yPPIG_DvoD04Iq
PrP5Y1vBOZC659LVmKp
1RMVr0PrAomWmoPo29ytY6iQM
McClave, S. A., Martindale, R. G., Rice, T. W., & Heyland, D. K.
(2014). Feeding the critically ill patient. Critical care
medicine, 42(12), 2600-2610. Retrieved from
https://journals.lww.com/ccmjournal/Fulltext/2014/12000/Fe
eding_the_Critically_Ill_Pat
ient.16.aspx?sessionEnd=true&casa_token=7D2UinATIFkA
AAAA:TCzm-
 28
PBZdWrQEj_gFNIFQMjs8nOb3sb_LszEW0a9NDVEcPPe
LhG24eFj3_e3IJjYGr0Lqtyar mz1rgBdnNFiYcle4tY

Unit II Care of Patients with Ventilator

Bruni, A., Garofalo, E., Pelaia, C., Messina, A., Cammarota, G.,
Murabito, P., ... & Navalesi, P. (2019). Patient-ventilator
asynchrony in adult critically ill patients. Minerva
anestesiologica, 85(6), 676-688. Retrieved from
https://www.minervamedica.it/en/getfreepdf/RGw0VVJPL1
RBbnpaaG4xb2JRT25aZlZ5
dEdXMi80K0RUM2ZzaVlCZEd4LzB1R1pxazVSTlZ0aW
VsVkt4WHkxWQ%253D%2 53D/R02Y2019N06A0676.pdf

Walter, J. M., Corbridge, T. C., & Singer, B. D.

(2018). Invasive mechanical ventilation.
Southern medical journal, 111(12), 746.
Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284234/pdf/nihms-
1509140.pdf

Ramirez, I. I., Arellano, D. H., Adasme, R. S., Landeros, J. M.,

Salinas, F. A., Vargas, A. G., ... & Restrepo, R. D. (2017).
Ability of ICU health-care professionals to identify
patient- ventilator asynchrony using waveform analysis.
Respiratory care, 62(2), 144-149.
Retrieved from http://rc.rcjournal.com/content/respcare/62/2/144.full.pdf

Unit III: Electrocardiography (ECG)

Kusumoto, F. (2020). ECG interpretation: from pathophysiology to clinical

application.
Springer Nature. Retrieved from
https://books.google.com.pk/books?hl=en&lr=&id=xNDaD
wAAQBAJ&oi=fnd&pg=PR
3&dq=ecg+interpretation&ots=RUUa7E8-
V3&sig=9EX2PJ_7WrLTZEWa5eDtUdigASM&redir_esc=
y#v=onepage&q=ecg%20int erpretation&f=false
Harris PR. The Normal Electrocardiogram: Resting 12-Lead and
Electrocardiogram Monitoring in the Hospital. Crit Care
Nurs Clin North Am. 2016 Sep;28(3):281-96. doi:
10.1016/j.cnc.2016.04.002. Epub 2016 Jun 22. PMID:
27484657. Retrieved from
https://www.clinicalkey.com/nursing/#!/content/playContent
/1-s2.0-
S0899588516300284?returnurl=https:%2F%2Flinkinghub.el
sevier.com%2Fretrieve%2F
pii%2FS0899588516300284%3Fshowall%3Dtrue&referrer=
https:%2F%2Fpubmed.ncbi. nlm.nih.gov%2F
 29

Unit IV: Critical Concepts in care of patient with specific conditions

Pulmonary Embolism

Konstantinides, S. V., Barco, S., Lankeit, M., & Meyer, G. (2016).

Management of pulmonary embolism: an update. Journal
of the American College of Cardiology, 67(8), 976-990.
Retrieved from
https://www.jacc.org/doi/pdf/10.1016/j.jacc.2015.11.061
Hékimian, G., Lebreton, G., Bréchot, N., Luyt, C. E., Schmidt, M.,
& Combes, A. (2020). Severe pulmonary embolism in
COVID-19 patients: a call for increased awareness. Critical
Care, 24, 1-4.
Agnelli, G., & Becattini, C. (2010). Acute pulmonary
embolism. New England Journal of Medicine,
363(3), 266-274. Retrieved from
https://www.nejm.org/doi/pdf/10.1056/NEJMra0907
731?articleTools=true
Konstantinides, S. V., Barco, S., Lankeit, M., & Meyer, G. (2016).
Management of pulmonary embolism: An update. Journal
of the American College of Cardiology, 67(8), 976-990.
Retrieved from
https://www.jacc.org/doi/pdf/10.1016/j.jacc.2015.11.061

Hypertensive Crisis

Ipek, E., Oktay, A. A., & Krim, S. R. (2017). Hypertensive crisis: an

update on clinical approach and management. Current
opinion in cardiology, 32(4), 397-406. doi:
10.1097/HCO.0000000000000398. PMID: 28306673.
Retrieved from
https://journals.lww.com/co-
cardiology/Fulltext/2017/07000/Hypertensive_crisis
an_update_on_clinical.10.aspx Watkins, H., Ashrafian, H., &
Redwood, C. (2011). Inherited cardiomyopathies. New England
Journal of Medicine, 364(17), 1643-1656.
Retrieved from
https://www.nejm.org/doi/pdf/10.1056/NEJM
ra0902923?articleTools=true

Cardio Myopathies

Brieler, J., Breeden, M. A., & Tucker, J. (2017).

Cardiomyopathy: an overview. American Family
Physician, 96(10), 640-646. Retrieved from
https://www.aafp.org/afp/2017/1115/afp20171115p6
40.pdf

Cardiac Tamponade:

Appleton, C., Gillam, L., & Koulogiannis, K. (2017).

 30
Cardiac tamponade. Cardiology clinics, 35(4),
525-537. Retrieved from
https://www.clinicalkey.com/nursing/#!/content/
playContent/1-s2.0-
S0733865117300668?returnurl=https:%2F%2Flinkinghub.elsevier.com%2
Fretrieve%2F
pii%2FS0733865117300668%3Fshowall%3Dtrue&referrer=https:%2F%2
Fpubmed.ncbi. nlm.nih.gov%2F

Bodson, L., Bouferrache, K., & Vieillard-Baron, A. (2011). Cardiac

tamponade. Current opinion in critical care, 17(5), 416-424.
Retrieved from https://journals.lww.com/co-
criticalcare/Fulltext/2011/10000/Cardiac_tamponade.3.aspx

Spinal Code Injuries

Hagen, E. M., Rekand, T., Gilhus, N. E., & Grønning, M. (2012). Traumatic spinal
cord injuries-
-incidence, mechanisms and course. Tidsskrift for den
Norske laegeforening: tidsskrift for praktisk medicin, ny
raekke, 132(7), 831-837. Retrieved from
https://tidsskriftet.no/en/2012/04/traumatic-spinal-cord-
injuries-incidence-mechanisms- and-course

Unit V: Methods of Hemodynamic Management

Shaw, J. L. (2016). Practical challenges related to point of care

testing. Practical laboratory medicine, 4, 22-29. Retrieved
from
https://reader.elsevier.com/reader/sd/pii/S235255171530005
6?token=25DC3958DEA429
9980B1756474D5B1C7C96612EDD7DFFBCF2EA71C27A
2177E4686CE9621BFB970 C3DC71189021FD4310
Goble, J. A., & Rocafort, P. T. (2017). Point-of-care testing: future
of chronic disease state management?. Journal of pharmacy
practice, 30(2), 229-237. Retrieved from
https://journals.sagepub.com/doi/pdf/10.1177/08971900155
87696
Mohammed, H. M., & Abdelatief, D. A. (2016). Easy blood gas
analysis: Implications for nursing. Egyptian Journal of Chest
Diseases and Tuberculosis, 65(1), 369-376. Retrieved from
https://www.sciencedirect.com/science/article/pii/S0422763
815301175
Walker, M. D. (2016). Fluid and electrolyte imbalances:
Interpretation and assessment. Journal of Infusion Nursing,
39(6), 382-386. Retrieved from
https://journals.lww.com/journalofinfusionnursing/pages/arti
cleviewer.aspx?year=2016&
issue=11000&article=00007&type=Fulltext
 31

Unit VI: Emergency Nursing Concepts:

Concepts of disaster, triage and trauma

Dean, M. D., & Nair, S. K. (2014). Mass-casualty triage:

Distribution of victims to multiple hospitals using the
SAVE model. European Journal of Operational
Research, 238(1), 363-373.
Dolan B. &. Holte, L. (2013). Accident and Emergency:
Theory into practice 3. Edinburgh: Bailliere Tindall &
Royal College of Nursing.

Medical and surgical emergencies:

Trauma and Hemorrhage

Peitzman, A. B., Fabian, T. C., Rhodes, M., Yealy, D. M., &

Schwab, C. W. (Eds.). (2012). The trauma manual:
Trauma and acute care surgery. Lippincott Williams &
Wilkins.
Retrieved from
https://books.google.com.pk/books?hl=en&lr=&id=glFVZR
UmkTYC&oi=fnd&pg=PA1
&dq=nursing+care+in+medical+and+surgical+emergencies+
&ots=XNtlo41hNh&sig=hB
YnrMGQmqQxU9H87Bhc7PthfPY&redir_esc=y#v=onepag
e&q=nursing%20care%20in
%20medical%20and%20surgical%20emergencies&f=false
Johansson, P. I., Stensballe, J., & Ostrowski, S. R. (2012).
Current management of massive hemorrhage in trauma.
Scandinavian journal of trauma, resuscitation and
emergency medicine, 20(1), 1-10. Retrieved from
https://sjtrem.biomedcentral.com/articles/10.1186/1757-
7241-20-47

Airway Emergencies

Damrose, J. F., Eropkin, W., Ng, S., Cale, S., & Banerjee, S.
(2019). The critical response team in airway emergencies.
The Permanente journal, 23. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636511/
Keller, J. M., Steinbach, T. C., Adamson, R., Carlbom, D. J.,
Johnson, N. J., Clark, J., ... & Çoruh, B. (2018). ICU
emergencies simulation curriculum for critical care
fellows: the difficult airway. MedEdPORTAL, 14.
Retrieved from
https://www.mededportal.org/doi/full/10.15766/mep_237
4-8265.10744
 32
Cardio-pulmonary Emergencies

Chen, F. C., Lin, Y. R., Kung, C. T., Cheng, C. I., & Li, C. J.
(2017). The association between door-to-balloon time of
less than 60 minutes and prognosis of patients developing
ST segment elevation myocardial infarction and
undergoing primary percutaneous coronary intervention.
BioMed research international, 2017. Retrieved from
https://www.hindawi.com/journals/bmri/2017/1910934/
Fowler R, Chang MP, Idris AH. Evolution and revolution in
cardiopulmonary resuscitation. Curr Opin Crit Care. 2017
Jun;23(3):183-187. doi: 10.1097/MCC.0000000000000414.
PMID:
28398908. Retrieved from https://journals.lww.com/co-
criticalcare/Fulltext/2017/06000/Evolution_and_revolution
_in_cardiopulmonary.3.aspx
Nolan JP, Soar J, Perkins GD. Cardiopulmonary resuscitation. BMJ.
2012 Oct 3;345:e6122. doi: 10.1136/bmj.e6122. PMID:
23034844. Retrieved from
https://www.bmj.com/content/345/bmj.e6122

Contemporary issues in emergency nursing

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, &
management.
Elsevier Health Sciences. Retrieved from
https://books.google.com.pk/books?hl=en&lr=&id=vzzdCwAAQBAJ&oi=
fnd&pg=PP1
&dq=Contemporary+issues+in+emergency+nursing&ots=mOqfbhwtks&si
g=vKZvY4Kt
rxEcLPRT8Pz_R0Gr0gc&redir_esc=y#v=onepage&q=Contemporary%20i
ssues%20in% 20emergency%20nursing&f=false

Unit VII: Code Management:

Medications used in code managements

Papastylianou, A., & Mentzelopoulos, S. (2012). Current

pharmacological advances in the treatment of cardiac arrest.
Emergency medicine international, 2012. Retrieved from
https://downloads.hindawi.com/journals/emi/2012/815857.pdf

Lundin, A., Djarv, T., Engdahl, J., Hollenberg, J., Nordberg, P., & Ravn-Fischer,
A. et al. (2016).
Drug therapy in cardiac arrest: a review of the
literature. European Heart Journal – Cardiovascular
Pharmacotherapy, 54–75. doi:
doi:10.1093/ehjcvp/pvv047.
 33
Vallentin, M. F., Granfeldt, A., Holmberg, M. J., & Andersen,
L. W. (2020). Drugs during cardiopulmonary
resuscitation. Current opinion in critical care, 26(3),
242-250.

Indications, Post-resuscitation management and documentation

Girotra, S., Chan, P. S., & Bradley, S. M. (2015). Post-

resuscitation care following out-of- hospital and in-
hospital cardiac arrest. Heart, 101(24), 1943-1949.
Retrieved from
https://heart.bmj.com/content/heartjnl/101/24/1943.fu
ll.pdf
Nielsen, N., Wetterslev, J., Cronberg, T., Erlinge, D., Gasche, Y.,
Hassager, C., ... & Friberg, H. (2013). Targeted temperature
management at 33 C versus 36 C after cardiac arrest. New
England journal of medicine, 369(23), 2197-2206.
Retrieved from
https://www.nejm.org/doi/full/10.1056/nejmoa1310519
Nolan, J. P., Soar, J., Cariou, A., Cronberg, T., Moulaert, V. R.,
Deakin, C. D., ... & Sandroni, C. (2015). European
resuscitation council and European society of intensive care
medicine 2015 guidelines for post-resuscitation care.
Intensive care medicine, 41(12), 2039-2056. Retrieved from
https://link.springer.com/article/10.1007/s00134-015-4051-3
Pothiawala, S. (2017). Post-resuscitation care. Singapore medical
journal, 58(7), 404. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523091/

Psychosocial, legal, and ethical issues

Mancini, M. E., Diekema, D. S., Hoadley, T. A., Kadlec, K. D.,

Leveille, M. H., McGowan, J. E., ... & Sinz, E. H. (2015).
Part 3: ethical issues: 2015 American Heart Association
guidelines update for cardiopulmonary resuscitation and
emergency cardiovascular care. Circulation,
132(18_suppl_2), S383-S396. Retrieved from
https://www.ahajournals.org/doi/full/10.1161/CIR.000000
0000000254

Magnus, D. C., Wilfond, B. S., & Caplan, A. L. (2015). Accepting

brain death. Replacement parts: The ethics of procuring and
replacing organs in humans, 49. Retrieved from
https://books.google.com.pk/books?hl=en&lr=&id=txk2CwA
AQBAJ&oi=fnd&pg=PA4
9&dq=legal+and+ethical+issues+brain+death&ots=8n5Ly16
FjT&sig=RVCtaEk8jAWQv
u1etqAV40bCGlc&redir_esc=y#v=onepage&q=legal%20and
%20ethical%20issues%20b rain%20death&f=false

Poole, K., Couper, K., Smyth, M. A., Yeung, J., & Perkins, G.
D. (2018). Mechanical CPR: who? when? how?.
 34
Critical Care, 22(1), 1-9. Retrieved from
https://ccforum.biomedcentral.com/articles/10.1186/s1
3054-018-2059-0
Santonocito, C., Ristagno, G., Gullo, A., & Weil, M. H. (2013). Do-
not-resuscitate order: a view throughout the world. Journal
of Critical Care, 28(1), 14-21. Retrieved from
https://www.sciencedirect.com/science/article/pii/S0883944
112002249?casa_token=6Oc Ych-
in7IAAAAA:PKnq9xE3FxGVcBn08qzz7-
CEQsqpTobq0jcrRNHsaTTszBhIaObOX2nH4zynrGAuCH
Sumeq9MIw

Role of caregivers and family during cardio-pulmonary resuscitation

Meghani, S., Karmaliani, R., Ajani, K., Bhamani, S. S., Khan, N. U., & Lalani, N.
(2019).
Knowledge, attitude, and practice of healthcare
professionals regarding family presence during
resuscitation: An interventional study in a tertiary care
setting, Karachi, Pakistan. Connect: The World of Critical
Care Nursing, 13(1), 46-55. Retrieved from
https://connect.springerpub.com/content/sgrwfccn/13/1/46
.full.pdf

De Stefano, C., Normand, D., Jabre, P., Azoulay, E., Kentish-

Barnes, N., Lapostolle, F., ... & Adnet, F. (2016). Family
presence during resuscitation: a qualitative analysis from a
national multicenter randomized clinical trial. PloS one,
11(6), e0156100. Retrieved from
https://www.sciencedirect.com/science/article/pii/S2210844
017301193?casa_token=xpw
5utkcz0UAAAAA:jszgDVwO1T1rTPpSsXkGiXzZ_0BxJA
dfQKwTBNb6gUBLq03coo 6i41zrZWgMoxKUCQL8-
lHnw8w

Zavotsky, K. E., McCoy, J., Bell, G., Haussman, K., Joiner, J., Marcoux, K. K., ...
& Tortajada,
D. (2014). Resuscitation team perceptions of family
presence during CPR. Advanced Emergency Nursing
Journal, 36(4), 325-334. Retrieved from
https://journals.lww.com/aenjournal/FullText/2014/10000/R
esuscitation_Team_Perceptio
ns_of_Family_Presence.7.aspx?casa_token=d4kMJWaWjW
8AAAAA:t5zQoU7iMgmo
mt7e52ZWEPAiov3y7RJEBHJBML1BnNTjh6nKprpWRz6
rrS_rraJDnuoApWththNF3m rzA-uOq04Ex5s

Utilization of crash cart and defibrillator

Banks, D., & Trull, K. (2012). Optimizing patient

resuscitation outcomes with simulation.
 35
Nursing2022, 42(3), 60-61. Retrieved from
https://journals.lww.com/nursing/FullText/2012/03000/Optimizing_patient
_resuscitation
_outcomes_with.18.aspx?casa_token=6U6FFv6zZM4AAA
AA:MbEDaXH0PKg3dyuNE
K1Ex9XqCTRQ0wiYvUFJbAIUFBEDr-
0npfzkPWMah06VwF2msPyK4xL4xK6_BXrLNAGAxHBbAoE
Jacquet, G. A., Hamade, B., Diab, K. A., Sawaya, R., Abou Dagher, G., Hitti, E.,
& Bayram, J.
D. (2018). The Emergency Department Crash Cart: A
systematic review and suggested contents. World journal of
emergency medicine, 9(2), 93. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847507/

Unit VIII: Advanced Treatment Modalities

Intra-abdominal pressure monitoring

Blaser, A. R., Regli, A., De Keulenaer, B., Kimball, E. J.,

Starkopf, L., Davis, W. A., ... & Starkopf, J. (2019).
Incidence, risk factors, and outcomes of intra-
abdominal
hypertension in critically ill patients—a
prospective multicenter study (IROI study).
Critical care medicine, 47(4), 535. Retrieved
from
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C6426342/

Hunt, L., Frost, S. A., Hillman, K., Newton, P. J., & Davidson, P.
M. (2014). Management of intra-abdominal hypertension
and abdominal compartment syndrome: a review. Journal
of trauma management & outcomes, 8(1), 1-8. Retrieved
from https://link.springer.com/article/10.1186/1752-2897-
8-2

Intra-cranial pressure monitoring

Chesnut, R. M., Temkin, N., Carney, N., Dikmen, S., Rondina, C.,
Videtta, W., ... & Hendrix, T. (2012). A trial of intracranial-
pressure monitoring in traumatic brain injury. New England
Journal of Medicine, 367(26), 2471-2481. Retrieved from
https://www.nejm.org/doi/full/10.1056/NEJMoa1207363

Forsyth, R. J., Raper, J., & Todhunter, E. (2015). Routine

intracranial pressure monitoring in acute coma.
Cochrane Database of Systematic Reviews, (11).
Retrieved from
https://www.cochranelibrary.com/cdsr/doi/10.1002/146
51858.CD002043.pub3/full
 36
Tavakoli, S., Peitz, G., Ares, W., Hafeez, S., & Grandhi, R. (2017).
Complications of invasive intracranial pressure monitoring
devices in neurocritical care. Neurosurgical focus, 43(5), E6.
Retrieved from
https://thejns.org/focus/view/journals/neurosurg-
focus/43/5/article- pE6.xml

Unit IX: Intra-aortic balloon pump monitoring

Unverzagt, S., Buerke, M., de Waha, A., Haerting, J., Pietzner, D.,
Seyfarth, M., ... & Prondzinsky, R. (2015). Intra‐aortic
balloon pump counterpulsation (IABP) for myocardial
infarction complicated by cardiogenic shock. Cochrane
Database of Systematic Reviews, (3). Retrieved from
https://www.cochranelibrary.com/cdsr/doi/10.1002/1465185
8.CD007398.pub3/epdf/full

Maccioli, G. A., Lucas, W. J., & Norfleet, E. A. (1988). The

intra-aortic balloon pump: a review. Journal of
cardiothoracic anesthesia, 2(3), 365-373.

Ahmad, Y., Sen, S., Shun-Shin, M. J., Ouyang, J., Finegold, J. A.,
Al-Lamee, R. K., ... & Francis, D. P. (2015). Intra-aortic
balloon pump therapy for acute myocardial infarction: a
meta-analysis. JAMA internal medicine, 175(6), 931-939.
Retrieved from
https://jamanetwork.com/journals/jamainternalmedicine/art
icle-abstract/2210888

Unit X: Multisystem Alterations

Shock Management

Nordkamp, L. R. O., Brouwer, T. F., Barr, C., Theuns, D. A.,

Boersma, L. V., Johansen, J. B., ... & Knops, R. E. (2015).
Inappropriate shocks in the subcutaneous ICD: incidence,
predictors and management. International journal of
cardiology, 195, 126-133. Retrieved
from
https://www.sciencedirect.com/science/article/pii/S01675273
15011985?casa_token=X2Z
3vF1a6IsAAAAA:zhI4MOR0SWYoYBHbnJIjt1ZGtDLgha
SeKW3v82UMSb8IK0pLyD
R7fY6pon K_h76h64O4RhRx8
Taha, M., & Elbaih, A. (2017). Pathophysiology and
management of different types of shock. Narayana
Med J, 6, 14-39. Retrieved from
https://d1wqtxts1xzle7.cloudfront.net/60292394/Final_
Puplicated_shock20190814- 70950-
 37
lk02k4.pdf?1565802546=&response-content-
disposition=inline%3B+filename%3DPathophysiology_and
_management_of_differ.pdf
&Expires=1613489264&Signature=FXMXtv5RQ~Rg4O5H
xw6q~PlfZ3btHoi2R0NuyQ QVD-
wuKFSoFvFYR0czWvZZKbIe0P06-
x2rQJWknMgLGmfeS7D-
BMRuiAn8FK18ybWQC1P2yb29sxPoQKlkXLCprmL5-
iAc1ov7CBa1hFB75VXvu6bedfDqUvZqAI6MDrTNLFAb-
pA~zsXzPcDJjvB7mk07H0o6tdXP7-Lq5-
rcAZZWDNC4XZCBPkGRJBh9VegOo0CEjO4sj9iIi36nG
SLE3tGRaCVEv0GShfeUOT
99nQmbZapUH5kgxz2T3-
Tp9gplRBQaLv8Jn50oSbG9ZPxRUiiynFsIFahB2qQ10x39
KxNZaw &Key-Pair- Id=APKAJLOHF5GGSLRBV4ZA
Sharma, S. K. (2016). Lippincott Manual of Medical-Surgical
Nursing Adaptation of Nettina: Lippincott Manual of
Nursing. Wolters kluwer india Pvt Ltd. Retrieved from
https://books.google.com.pk/books?hl=en&lr=&id=pDnvD
wAAQBAJ&oi=fnd&pg=PA
1&dq=Lippincott+manual+of+nursing+practices&ots=a_Cv
dwCUl9&sig=_Ja-It9W1Pa-
YyeGdRR64A3tUi4&redir_esc=y#v=onepage&q=Lippincot
t%20manual%20of%20nursi ng%20practices&f=false

Unit X: Toxicology in Critical Care

Jennifer, SB., Laura, KB., & Christopher, PH. Management of the critically
poisoned patient.
Scand J Trauma Resusc Emerg Med. 2009 Jun 29;17:29.
doi: 10.1186/1757-7241-17-29. Retrieved from
ncbi.nlm.nih.gov/pmc/articles/PMC2720377/pdf/1757-
7241-17-29.pdf
Skolnik, A., & Monas, J. (2020). The Crashing Toxicology Patient.
Emergency Medicine Clinics, 38(4), 841-856. Retrieved
from
https://www.clinicalkey.com/nursing/#!/content/playContent
/1-s2.0-
S0733862720300717?returnurl=https:%2F%2Flinkinghub.el
sevier.com%2Fretrieve%2F
pii%2FS0733862720300717%3Fshowall%3Dtrue&referrer=
https:%2F%2Fpubmed.ncbi. nlm.nih.gov%2F

Reference:
https://www.aku.edu/sonampk/programmes/Documents/Supplementary%20Student%20Handbo
ok%202020.pdf#search=student%20handbook (Page # 43)
 38
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Revised: August 20, 2021,
January 20, 2023 (UGNCC)

Course Grid Prepared and Reviewed by: CCN Course team, 2024