BACHELOR OF PARAMEDICAL TECHNOLOGY

BPMT Endoscopy

ROTATIONS (Students will be posted by parent department , i, e. department of surgery)

First Year

1. Introduction to Endoscopy/OT - Anaeshthesia 07 days

2. Obstetrics & Gynaecology 2 months

3. ENT 1 month

4. General / GI Surgery and Emergency 4 months ( Lap and Endo – basic)

5. Chest Medicine 1 month

6. Orthopaedics 1 months

Second Year

1. Obstetrics & Gynaecology 2 months

2. ENT 1 month

3. Gastroenterology 2 months

4. General / GI Surgery and Emergency/ Anest 3 months ( Lap and Endo – basic)

5 . Chest Medicine 1 month

6. Orthopaedics 1 months

Third Year

1. GI Medicine 2 months

2. Gen/ GI Surgery 3 month (Laparoscopy+ Endo. Advanced)

4. Urology, Ped surgery 2 months

5. Endoscopy/ Admin 2 month

1st Year

Theory Practicals Subject Total

Sr No

Paper Subject IA Final Theory Total

IA Final Total

-- -- Max: 90 Min: 45

-- -- Max: 110 Min: 55

Max: 200 Min: 100

1 Paper I Basic Sciences 30 60 90 30 80 110 200

2 Paper II Endoscopic anatomy 30 60 90 30 80 110 200

3 Paper III

Introduction to endoscopy, Instruments, general care

30 60 90 30 80 110 200

Paper I Subject: Basic Sciences

(These lectures are to be conducted by parent department)

Sr. No

Topic Theory Hours

1. Introduction to Anatomy 1

2. Introduction to body parts and systems

3. Bones of upper limb (Only nomenclature and major parts) 3

4. Bones of lower limb (Only nomenclature and major parts) 3

5. Bones of pelvis (Only nomenclature and major parts) 3

6. Bones of skull (Only nomenclature and major parts) 3

7. Bones of vertebral column (Only nomenclature and major parts) 3

8. Bones of thorax (Only nomenclature and major parts) 2

9. Dental Anatomy 1

10. Joints and classification (Only nomenclature) 3

11. Anatomy & Functions of respiratory System (Only Organ nomenclature and brief functions)

2

12. Anatomy & Functions of cardiovascular system (Only Organ nomenclature, important arteries and veins and their branches / tributaries)

2

13. Anatomy & Functions of Abdominal Organs , GI system (Only nomenclature and brief functions)

2

14. Anatomy & Functions of Pelvic Organs (Only nomenclature and brief functions)

2

15. Anatomy & Functions of Nervous System (Only nomenclature and brief functions)

2

16. Anatomy & Functions of Endocrine glands (only nomenclature, site and brief functions )

2

17. Important Surface Landmarks – Upper Limb 2

18. Important Surface Landmarks – Lower Limb 2

19. Important Surface Landmarks - Head 2

20. Important Surface Landmarks – Thorax and abdomen 2

21. Important Surface Landmarks - Joints 2

22. Important Surface Landmarks – Vertebral column 2

23. Introduction to concepts of Endoscopic anatomy 2

24. Meanings of axial, coronal, sagital and oblique planes 1

25. Prerequisites for the endoscopy procedure – General Principals 2

26. General care of patient before and after endoscopy 2

27. Introduction to Microbiology & Pathology in relation to endoscopic procedures

2

28. Legal aspects 2

Paper II: Endoscopic Anatomy (These lectures and demonstrations are to be conducted by respective departments during rotational postings)

Sr. No

Topic L / LCD Hours

1. Introduction to Endoscopic anatomy 2

2. Brief endoscopic anatomy of ear & nose 5

3. Brief endoscopic anatomy of oral cavity 5

4. Brief endoscopic anatomy of female genital tract 5

5. Brief endoscopic anatomy of oral cavity 5

6. Brief endoscopic anatomy of abdomen 5

7. Brief endoscopic anatomy of thorax 5

8. Brief endoscopic anatomy of joints 5

Paper III: Introduction to endoscopy, instruments, general care

Sr. No

Topic Sessions (per rotational postings *) Theory Practical

1 Orientation 01 01 2 Documentation 01 01 3 Familiarization to Endoscopy - 07 4 Endoscopy /OT etiquette and protocols 02 5 Pre and Post-operative/ procedure rooms 03 6 Introduction to endoscopes 03 03 7 General care in handling endoscopes 03 03 8 Endoscopes – different parts and their maintenance 05 05

(These lectures and practical can be conducted in respective departments during rotational postings)

* Number of sessions can be modified as per the individual department requirements)

2nd Year

Theory Practicals Subject Total

Sr No

Paper Subject IA Final Theory Total

IA Final Total

-- -- Max: 90 Min: 45

-- -- Max: 110 Min: 55

Max: 200 Min: 100

1 Paper I Endoscopy Techniques/ CSSD, Instrumentation, Stores & Inventory

30 60 90 30 80 110 200

2 Paper II Basic Specialities- Gen/ GI Surgery & ENT, Obs Gyn orthopaedics

30 60 90 30 80 110 200

3 Paper III

GI Medicine, Gen./GI Surgery, Chest medicine

30 60 90 30 80 110 200

Syllabus for Second Year

Paper I – Endoscopy Techniques/ CSSD, Instrumentation, Stores & Inventory

Sr. No

Topic Sessions Theory Practical

1 Layout of Endoscopy theatre 01 2 Revision of Microbiology 02 3 Cleanliness and sterilisation of ER/ operation theatre and annexes 01 4 Fumigation, Asepsis in endoscopy rooms 01 5 Fumigation continued 01 6 Principles of sterilization, modes of sterilization including

autoclaving, pressure sterilization, boiling, dry heat, gas chemical sterilization, Gamma ray sterilization.

02 02

7 Lighting in E.T. including emergency lighting 01 8 Helping endoscopist and others to wash up and drape for

operation; holding out cap, mask, gown and gloves for endoscopist and others and handling of sterilized articles

01 01

9 Washing, cleaning, testing and repairing of gloves and sorting -them out for packing and sterilization

01

10 Preparation of dressings, swabs and packs packing of drums and sterilization

02

11 Use, care, maintenance and sterilisation of the common types of instruments, needles, suture and ligatures used in operation theatre.

01 03

12 Procedure for sending specimen for biopsy and fluid for culture 01

13 Identification of instruments for common Endoscopic procedures operations and examinations, such as:- GI Scopy, Colonoscopy, Bronchoscopy, esophagoscopy, Fibre optic laryngoscopy, sinoscopy, basic laparoscopy

05 05

14 Setting up of tray/ trolleys for various endoscopic procedures / surgeries

- 05

15 Assisting the scrub nurse/surgeon - 05 16 Scrubbing, gloving & gowning 01 17 Laying tables for endoscopies 02 18 Endoscopy OT Stores – Indenting, storekeeping, accounting and

audit 04

19 Inventory Management 02 20 Physics of fiber optics, endoscopes and maintenance of

endoscopes 02

21 Bio hazards and safety in medical devices 01 01 Total 30 24

Paper II - Basic Specialities- General Surgery, ENT, Obst. Gyn & Orthopaedics

Sr. No

Topic Sessions Theory Practical

1 Organization of Human Body: Definition & subdivisions of anatomy, anatomical position and terminology, regions and system of the body, cavities of the body and their contents.

01

2 Structure of the body-cells-tissues. 01 3 Definition axial and Appendicular skeleton, Skull,

Vertebral column, Sternum, pelvic girdle (Male and Female), thoracic cage

02

4 Upper and lower extremity 02 5 Joints: Classification, joints of upper and lower limb 01 6 Muscles of upper and Lower limb 01 7 Muscles of thorax and abdomen 02 8 Anatomy of mouth, esophagus, stomach, small

intestine, large intestine, spleen, liver, gall bladder, Pancreas, and salivary glands, including parotids and tongue

02

9 Kidneys, Ureters, Bladder, Prostate, and Urethra. 02 10 Female & Male organs 01 11 Circulation of Lymph, Lymph glands, and Thoracic duct. 01 12 Basic surgical anatomy of nose & Larynx-Trachea

Bronchi Lungs.

02

13 Herniorrhapy: inguinal, epigastric, femoral, paraumbilical

14 Abdominal Laparotomy 03 15 Laparoscopy: cholecystectomy, appendicectomy 02 16 Vagotomy and Pyloroplasty , Gastrostomy,

lleostomy, Colostomy 02

17 Appendicectomy 01 18 Orthopaedic surgery:; arthroscopy; 05 20 19 Anatomy of uterus, ovaries and female genitalia 01 20 Anatomy of ENT 01 21 Physiology of hearing 01 22 ENT surgery: bronchoscopy & removal of foreign

bodies, polypectomies, 10 03

23 Obstetric surgery: Normal labour/Abnormal labour/ Ectopic pregnancy/ /MTP - MTP act - Legal and ethical aspect, Methods, complications, Tubectomy - Postpartum, Minilaparotomy and lap TL

20

24 Gynaecological operations:Hysterectomy /Cystectomy/ Myomectomy/ Sling surgery/SUJ repair/ Sacropexy/ Wertheim’s/ VVF repair/Tuboplasty/Cyto-reduction for ca ovary/Cx Bx /D&C/ Endometrial Bx/Bartholin Cyst excision. Diagnostic and gyn laparoscopy for infertility and other disorders, TL, LAVH, Ovarian cystectomy

10

25 Instruments & drugs: Specific instruments used in ENT Surgery

02

26 National Programmes in Ob-Gyn and family planning 02 Total 70 31

Paper III – GI Medicine, Gen./GI Surgery, Chest Medicine, Basic Endoscopy

Sr. No

Topic Sessions Theory Practical

1 Anatomy of Esophagus, stomach, Duodenum. Their anatomical relevance to Endoscopy

2 Anatomy of Anal Canal, Colon, their Relevance to Colonoscopy – Endoscopy

3 Common Diseases of Upper GI Tract, Dysphagia, Achalasia, Cancer of the esophagus, Diverticulae, T-O Fistulas, Bleeding lesions of the esophagus (Varices, Mallorie Weis Tears)

4 Polyps of stomach, gastric cancer, duodenal ulcers, Bleeding lesions, Helicobacter Pylorie infection and Antral Gastritis

10

5 Common diseases of the colon, cancer colon, polyps, diverticulae, granulomatous colitis, Ulcerative colitis, Crohn’s Disease, Functional diseases, benign strictures of the colon,

6 Anatomy of small bowel, common diseases from the point view of double balloon enteroscopy, capsule endoscopy

7 Anatomy of upper airways and their relevance to the Bronchoscopy

10

8 Common diseases of the Bronchopulmonary tree, Tuberculosis, polyps, cavities, malignancy, needing bronchoscopy

20

9 Basics of Video endoscopy Instrumentation, Mechanics, mechanics, magnification etc.

10

10 Diagnostic upper GI scopy, Biopsy, Injection Sclerotherapy Gastric Biopsy

02

11 Basics of Laparoscopy, Instrumentation, Technique 02 12 Common diseases needing diagnostic -- 13 Introduction to rigid scope, mechanicsETC 14 Common Laparoscopic procedures,

Appendix, Cholecystectomy etc

Total 54

3rd Year Paper I – GI Medicine, Gen/ GI surgery, Urology, Ped surgery

Sr. No

Topic Sessions Theory Practical

1 Fluids and Electrolyte Balance 01 2 Different types of IV infusions used 01 01 3 Composition and general functions of blood.

Descriptions of blood cells normal count and functions. 01 02

4 Steps of coagulation, Anti-coagulation Blood group, ABO and Rh, Basis for classification, Basis for determination, Importance of blood groups

01 02

5 Transfusion & hazards of blood transfusion 01 01 6 Definition of cardiac output, pulse, blood pressure. 01 01 7 Conducting pathways & electrocardiogram 01 01 8 Special Areas of the circulatory system- portal circulation 02 9 Mechanics of respiratory transport of oxygen & carbon

dioxide 01

10 Gastro Intestinal movement and functions, Composition and functions of saliva, gastric juice, pancreatic juice, Bile and succus entericus and their regulation Mastication and deglutition.

01

11 Digestion and assimilation of Fats, Carbohydrates and proteins and defaecation.

01

12 Formation & excretion of urine 01 13 Cardio-Pulmonary resuscitation 01 02 14 Drug used in premedication, antidotes, and complications 01 01

15 Preparation of patients for various types of anaesthesia including laying out of the trolleys for same

01 02

16 Stages of anaesthesia, mechanism of action of volatile anaesthetic, Intravenous agents, muscles relaxants & reversals, Opioids, Spinal analgesia drugs and complications, Care and maintenance of Gas cylinders, colour index, capacity of various cylinders,

01

17 Post anaesthetic care (After GA/regional Block) including instruments and drug in post op room.

01 02

18 Haemorrhage in OT, assessment management and nursing care

01 02

19 Preparation of sterile field. Preparation of skin for patient; Special Precaution in handlings patients with sepsis, blood borne infection – Hep.B, HCV, HIV etc; Cleaning and disinfection of the articles and OT (with special reference to HIV, & HCV Terminal disinfection of theatre).

01 02

20 Various positions during Endoscopy/ operations Lithotomy position, ante- Trendelenberg’s position, Kidney Position

01 02

21 Environmental Controls 01 01

22 Electrical and Fire Hazards Prevention of physical, electrical, chemical injuries / hazards to patient

01 01

23 ER/OT Pollution 01 24 Care of operating room – before, during & after

surgery; Maintenance of Septic Theatre 01 02

25 Use & maintenance of equipments such as defibrillator, cardiac pacemaker, heart lung machine, Cautery, O.T. Lights, Suction, Emergency Light, etc.

01 05

Sr. No

Topic Sessions Theory Practical

26 Monitoring: Blood pressure, heart rate, temperature, CVP, ECG, PAWP, Pulse Oxymeter (SPO2)

01 02

27 Ventilators- use and handling of machines and nursing management of patients on mechanical ventilation and anaesthesia

01 02

28 Pre-Operative room 01 01 29 Recovery room 01 01 30 Management of unconscious patient 01 05 31 Management of adult/ children on ventilators 01 05 32 Management in Intensive Cardiac care 01 01 33 Tracheostomy, intensive care of tracheostomy patients 01 01 34 Shock –pathophysiology, of different types of

shock and management 01

35 Pain- Pathophysiology of pain, nursing care & management of patients in pain

01

TOTAL 36 48

Paper II - Advanced Specialties, Basic Specialities II (Laparoscopy, Endoscopy, etc)

Sr. No

Topic Sessions Theory Practical

1 Gastrointestinal Surgery : Endoscopies, Vagotomy and Pyloroplasty , Gastrectomy, Pancreaticoduodenotomy (Whipple’s Procedure), Pancreatectomy, Drainage of pancreatic Cyst (pseudocyst), Resections of Small Bowel, Sigmoid Colon and rectum; Hemi & total Colectomy; Colostomy: Closure of colostomy, Rectopexy & abdominoperineal resection, Drainage of abscess(es) in the region of the liver, Hepatic Resection, liver transplant, Splenectomy; L-R Shunt, Surgery on adrenal gland.

05 10

2 Genito-urinary procedures: Cystectomy, pyelolithotomy, pyeloplasty, ureterolithotomy, nephrolithotomy, renal transplant, operation for vesical fistula, ureterocystostomy, ileal conduit, prostatectomy

05 10

3 Vascular surgery: AV shunt, arterial bypass, vascular repair, embolectomy

02 05

4 Neurosurgical: Principles of neurosurgical surgeries, positions & draping, brain tumours: pituitary, supratentorial, infratentorial, craniotomy, shunts, sterotaxic surgery, Cerebral abscess & AVM

05 10

5 Nerve surgeries: Classification & Management of nerve injuries, Cervical & lumbar sympathectomies, carpal tunnel syndrome

02 05

6 Reconstructive surgery: Skin grafting, tendon grafting; free flaps and micro vascular anastomosis; reconstructive surgery on ears, mammary glands ,craniosynostosis, rhinoplasty, abdominoplasty, liposuction, faciomaxillary reconstruction, Scar release operation

02 05

7 Paediatric surgery: Hydrocephalus, meningocoele, meningomyelocoele, TO fistula, Hirschsprung’s disease, ano-rectal malformations, congenital hernia, pyloric stenosis, duodenal atresia, diaphragmatic hernia, omphalocoele, hypospadiasis

02 05

8 Cardiac OT setup 01 01

9 Heart-lung machine & basics of cardiopulmonary bypass 01 02

Sr. No

Topic Sessions Theory Practical

10 Preoperative preparation of cardiac patient 01 01 11 Cardiac drugs used in cardiac surgery 02 02 12 Anaesthesia risk in cardiac surgery 01 01 13 Functioning & maintenance of cardiac monitors 01 01 14 Basics of one-lung anaesthesia including double-lumen tubes 01 01 15 Endoscopic procedures 02 02 16 Thoracotomy, thoracoplasty, Costal drainage, Lobectomy,

pneumonectomy, Decortication of the ung 02 02

17 Excision of mediastinal tumours including thymus, Constrictive pericarditis

01 01

18 Operations on TOF including shunts 01 01 19 Operations & Instrumentation on valves, ASD & VSD 02 01 20 Operations on Patent Ductus Arteriosus 01 01 21 Operations on aorta 01 01 22 Myocardial revascularization 02 01 23 Pacemakers 01 01 24 Cardiac catheterization 01 01 25 Laparoscopy & Endoscopy 05 10 26 Portal Hypertension, Esophageal Varices, Gastric Varices, 01 01 27 Indications of Treatement of Bleeding lesions in the

esophagus, Glue Injection and EVL 01 01

28 Gastric Polyp resection, Percutaneous Endoscopic Gastrostomy, Percuataneous Jejunostomy

01 01

29 Dilatation of strictures of esophagus, Balloon, bougies, CRE Balloons ETC

01 01

30 Dilatation of Achalsia cardia and injection of Botropase. 01 01

31 Placement of Various types of plastic and Expansile stents in the esophagus for benign and malignant lesions of Esopahgus

01 01

32 ERCP – Basic Introduction 01 01 33 Diseases of Billiary tract, Stones Tumors, Gall Bladder stone

and Cancer sequelae 01 01

34 Pancreatic diseases needing the ERCP procedure 01 01

35 Basic ERCP Procedure, Premedication, position, stone retrieval and placement of stent, removal of stones form PD and CBD

01 01

36 Gastroduodental stenting 01 01

37 Double balloon enteroscopy, capsule endoscopy, Differnet types of capsules

01 01

38 Colonoscopic Polypectomy Colonic dilatation of strictures by Balloon

01 01

39 Placement of Expansile stents in colo-rectum 01 01

40 Emergency de-rotation of colon in sigmoid volvulus 01 01

41 Hernia types, Laparoscopic Treatment of Inquinal and Ventral hernias

01 01

42 Laparoscopic URO Procedures, Ureteric stones, Lap Pyeloplasty Basic understanding of the urosurgical procedures and diseases needing laparoscopy

01 01

43 URS, LITHOtripsy Transurethral resection of Prostate, LASER treatment for BEP

01 01

44 NOTES – Advanced lap Surgery, Lap Liver resections etc 01 01

Paper III – Endoscopy OT administration, design, documentation, medicolegal, record keeping, IT

Sr. No

Topic Sessions Theory Practical

1 Organization of Hospital - Organization of Endoscopy rooms - Single and Multiple theatre units - Elective and emergency endoscopies , ambulatory surgery.

05 05

2 Admission & Transfer procedure; maintenance of Operative Records

02 02

3 Communication and health care provider – patient relationship, Methods of Effective Communication: Attending skills, Rapport building skills, Empathy skills, Barriers to effective communication

01

4 Management, need for scientific managements, delegation, decision making

01

5 Supervision –techniques 01 6 Assignments-Individual and team function 01

7 Moral- employee 01 8 Human relations, public relations, planning of courses

block training programme, weekly schedule 01

9 Ethical and legal issues in Operation theatre and Anaesthesia

01

TOTAL 14 07

3rd Year

Theory Practicals Subject Total

Sr No

Paper Subject IA Final Theory Total

IA Final Total

-- -- Max: 90 Min: 45

-- -- Max: 110 Min: 55

Max: 200 Min: 100

1 Paper I GI medicine, Surgery, Urology, Ped Surgery

30 60 90 30 80 110 200

2 Paper II Advanced Specialties, (Advanced Laparoscopy, Endoscopy, ERCP, EUS, Therapeutic endoscopy, URS etc)

30 60 90 30 80 110 200

3 Paper III

Endoscopy administration, design, documentation, medicolegal, record keeping, IT

30 60 90 30 80 110 200

TEXT-BOOKS & REFERENCES

1. Handbook Of Operation Theatre Techniques

Publisher: jaypee

2. Operating Room Technique - Berry And Kohn's

Publisher: Mosby Elsevier Health Science

3. Operating Room Technique – Raymond John Brigden

4. The Operating Room Aide

Publisher: Career Pub

5. Operating theatre nursing- MC Warren

Publisher: Lippincort Publishing series

6. Surgical Nursing and Technique: A book for nurses, dressers, house surgeons - Charles Plumley

Childe

7. Perioperative Nursing - Linda Shields, Helen Werder

8. Humphry and Reynolds Nurse's service digest: A Manual of Nursing

9. Textbook of Surgical Treatment including Operative Surgery - Charles Frederick William

Illingworth

10. Textbook for anaesthesia and operative technician by Department of Anesthesia Armed Forces

Medical Services