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CLINICAL NURSING IN CRITICAL CARE

Academic year and teacher
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Versione italiana
Academic year
2022/2023
Teacher
CARLO FEO
Credits
8
Didactic period
Secondo Semestre

Training objectives

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Modulo: 006051 - RADIOPROTEZIONE
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The aim of the modules MEDICAL AND SURGICAL EMERGENCIES, RESUSCITATION, NURSING IN THE CRITICAL AREA, AND CLINICAL NURSING SEMINAR IN THE CRITICALLY ILL is to provide to the students the skills needed to recognize, evaluate, and treat a person in an emergency-urgency setting. Specifically, the student must be able to:
- Use triage to evaluate patients in urgent/emergency situations;
- Guarantee a correct intensive monitoring and to assist a critically ill patient in cardiorespiratory arrest;
- Assist people in a critical condition with acute respiratory failure;
- Assist people in a critical condition with polytrauma in extra hospital and intra hospital, shock, and pneumothorax;
- Assist people in critical condition with head trauma and/or coma;
- Assist people with a surgical airway.
The objective of the RADIOPROTECTION module is to provide the main concepts related to the risks from ionizing radiation used in healthcare and the precautions needed according to the current legislation.

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Modulo: 53456 - INFERMIERISTICA CLINICA IN AREA CRITICA
------------------------------------------------------------
The aim of the modules MEDICAL AND SURGICAL EMERGENCIES, RESUSCITATION, NURSING IN THE CRITICAL AREA, AND CLINICAL NURSING SEMINAR IN THE CRITICALLY ILL is to provide to the students the skills needed to recognize, evaluate, and treat a person in an emergency-urgency setting. Specifically, the student must be able to:
- Use triage to evaluate patients in urgent/emergency situations;
- Guarantee a correct intensive monitoring and to assist a critically ill patient in cardiorespiratory arrest;
- Assist people in a critical condition with acute respiratory failure;
- Assist people in a critical condition with polytrauma in extra hospital and intra hospital, shock, and pneumothorax;
- Assist people in critical condition with head trauma and/or coma;
- Assist people with a surgical airway.
The objective of the RADIOPROTECTION module is to provide the main concepts related to the risks from ionizing radiation used in healthcare and the precautions needed according to the current legislation.



------------------------------------------------------------
Modulo: 53469 - LE URGENZE MEDICO CHIRURGICHE
------------------------------------------------------------
The aim of the modules MEDICAL AND SURGICAL EMERGENCIES, RESUSCITATION, NURSING IN THE CRITICAL AREA, AND CLINICAL NURSING SEMINAR IN THE CRITICALLY ILL is to provide to the students the skills needed to recognize, evaluate, and treat a person in an emergency-urgency setting. Specifically, the student must be able to:
- Use triage to evaluate patients in urgent/emergency situations;
- Guarantee a correct intensive monitoring and to assist a critically ill patient in cardiorespiratory arrest;
- Assist people in a critical condition with acute respiratory failure;
- Assist people in a critical condition with polytrauma in extra hospital and intra hospital, shock, and pneumothorax;
- Assist people in critical condition with head trauma and/or coma;
- Assist people with a surgical airway.
The objective of the RADIOPROTECTION module is to provide the main concepts related to the risks from ionizing radiation used in healthcare and the precautions needed according to the current legislation.



------------------------------------------------------------
Modulo: 53471 - RIANIMAZIONE
------------------------------------------------------------
The aim of the modules MEDICAL AND SURGICAL EMERGENCIES, RESUSCITATION, NURSING IN THE CRITICAL AREA, AND CLINICAL NURSING SEMINAR IN THE CRITICALLY ILL is to provide to the students the skills needed to recognize, evaluate, and treat a person in an emergency-urgency setting. Specifically, the student must be able to:
- Use triage to evaluate patients in urgent/emergency situations;
- Guarantee a correct intensive monitoring and to assist a critically ill patient in cardiorespiratory arrest;
- Assist people in a critical condition with acute respiratory failure;
- Assist people in a critical condition with polytrauma in extra hospital and intra hospital, shock, and pneumothorax;
- Assist people in critical condition with head trauma and/or coma;
- Assist people with a surgical airway.
The objective of the RADIOPROTECTION module is to provide the main concepts related to the risks from ionizing radiation used in healthcare and the precautions needed according to the current legislation.



------------------------------------------------------------
Modulo: 53472 - SEMINARIO DI INFERMIERISTICA CLINICA NELLA CRITICITA' VITALE
------------------------------------------------------------
The aim of the modules MEDICAL AND SURGICAL EMERGENCIES, RESUSCITATION, NURSING IN THE CRITICAL AREA, AND CLINICAL NURSING SEMINAR IN THE CRITICALLY ILL is to provide to the students the skills needed to recognize, evaluate, and treat a person in an emergency-urgency setting. Specifically, the student must be able to:
- Use triage to evaluate patients in urgent/emergency situations;
- Guarantee a correct intensive monitoring and to assist a critically ill patient in cardiorespiratory arrest;
- Assist people in a critical condition with acute respiratory failure;
- Assist people in a critical condition with polytrauma in extra hospital and intra hospital, shock, and pneumothorax;
- Assist people in critical condition with head trauma and/or coma;
- Assist people with a surgical airway.
The objective of the RADIOPROTECTION module is to provide the main concepts related to the risks from ionizing radiation used in healthcare and the precautions needed according to the current legislation.

Prerequisites

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Modulo: 006051 - RADIOPROTEZIONE
------------------------------------------------------------
The knowledge acquired in the areas covered by the previous exams are fundamental, in particular: Morphological basis of life, Functional bases of life and General clinical nursing and clinical nursing in the surgical area.

------------------------------------------------------------
Modulo: 53456 - INFERMIERISTICA CLINICA IN AREA CRITICA
------------------------------------------------------------
The knowledge acquired in the areas covered by the previous exams are fundamental, in particular: Morphological basis of life, Functional bases of life and General clinical nursing and clinical nursing in the surgical area.

------------------------------------------------------------
Modulo: 53469 - LE URGENZE MEDICO CHIRURGICHE
------------------------------------------------------------
The knowledge acquired in the areas covered by the previous exams are fundamental, in particular: Morphological basis of life, Functional bases of life and General clinical nursing and clinical nursing in the surgical area.

------------------------------------------------------------
Modulo: 53471 - RIANIMAZIONE
------------------------------------------------------------
The knowledge acquired in the areas covered by the previous exams are fundamental, in particular: Morphological basis of life, Functional bases of life and General clinical nursing and clinical nursing in the surgical area.

------------------------------------------------------------
Modulo: 53472 - SEMINARIO DI INFERMIERISTICA CLINICA NELLA CRITICITA' VITALE
------------------------------------------------------------
The knowledge acquired in the areas covered by the previous exams are fundamental, in particular: Morphological basis of life, Functional bases of life and General clinical nursing and clinical nursing in the surgical area.

Course programme

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Modulo: 006051 - RADIOPROTEZIONE
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RADIATION PROTECTION
- Properties of ionizing radiation.
- Interaction of radiation directly and indirectly ionizing. Biological effects of radiation. Risk Analysis / Benefits. Optimal dose. Absorbed dose, equivalent dose, effective dose and their units of measurement.
- Legislation on radiation protection.
- Use of personal protective equipment. Potential exposure. Accidents involving overexposure to ionizing radiation, radiological practices that require special attention: pregnancy and potential pregnancy in place. Babies and Children. Medical and biomedical.
- Screening activities.
- Techniques involving the use of other doses, patient management and its radiation protection: justification and individual exposure.
- Informed consent. Appropriate use of previous clinical and technical information and alternative procedures.
- Definition and use of diagnostic reference levels.
- Nuclear Medicine.

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Modulo: 53456 - INFERMIERISTICA CLINICA IN AREA CRITICA
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RESUSCITATION, CLINICAL NURSING IN CRITICAL AREA AND SEMINAR
- Trauma system and Emergency Department - Urgency 118; the Operations Center;
- Triage and its tools; assessment and monitoring of the critically ill patient;
- Specific emergency drugs;
- ABCDE-F approach and Pulmonary resuscitation maneuvers; Acute respiratory failure: symptoms, diagnosis, treatment; Nursing care in acute respiratory failure; Modalities of invasive ventilation; techniques and management of non-invasive ventilation; blood gas analysis (EGA);
- Approach and treatment in politrauma, both in the pre and intra-hospital settings;
- Techniques for emergency mobilization and immobilization;
- The pneumothorax (PNX): diagnosis, treatment, complications (already treated in the surgical module);
- The management of a patient with head injury;
- The management of a patient with a surgical airway; tracheostomy tube; bronchoaspiration with closed and open systems; post-anoxic coma; therapeutic hypothermia; vascular accesses management; brain death;
- Humanization of care;
- Healthcare-Related Infections (ICA).
PATHOPHYSIOLOGY OF ORGAN FAILURE IN CRITICAL CARE (Integrated with clinical nursing) )
- Pathophysiology and classification of respiratory failure
- Pathophysiology and classification of shock: Hypovolemic, Cardiogenic and high-flow shock
- Sepsis and septic shock (Sofa e Quick Sofa score)
- Pathophysiology of Acute renal failure and CRRT
- Pathophysiology of Acute and Chronic hepatic failure: portal hypertension, hepatic encephalopathy
- Diabetes acute complication: hypoglicemia, diabetic ketoacidosis, hyperosmolar-hyperglycemic syndrome

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Modulo: 53469 - LE URGENZE MEDICO CHIRURGICHE
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MEDICAL AND SURGICAL EMERGENCIES
- Shock
- Bowel obstruction
- Acute abdomen, intra-abdominal infections (diffuse peritonitis and abscesses), acute appendicitis
- Pulmonary embolism
- Thoracic trauma
- Abdominal trauma (including fractures of the pelvis)
- Musculoskeletal trauma (including fractures and compartment syndrome)
- Digestive bleeding

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Modulo: 53471 - RIANIMAZIONE
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RESUSCITATION, CLINICAL NURSING IN CRITICAL AREA AND SEMINAR
- Trauma system and Emergency Department - Urgency 118; the Operations Center;
- Triage and its tools; assessment and monitoring of the critically ill patient;
- Specific emergency drugs;
- ABCDE-F approach and Pulmonary resuscitation maneuvers; Acute respiratory failure: symptoms, diagnosis, treatment; Nursing care in acute respiratory failure; Modalities of invasive ventilation; techniques and management of non-invasive ventilation; blood gas analysis (EGA);
- Approach and treatment in politrauma, both in the pre and intra-hospital settings;
- Techniques for emergency mobilization and immobilization;
- The pneumothorax (PNX): diagnosis, treatment, complications (already treated in the surgical module);
- The management of a patient with head injury;
- The management of a patient with a surgical airway; tracheostomy tube; bronchoaspiration with closed and open systems; post-anoxic coma; therapeutic hypothermia; vascular accesses management; brain death;
- Humanization of care;
- Healthcare-Related Infections (ICA).
PATHOPHYSIOLOGY OF ORGAN FAILURE IN CRITICAL CARE (Integrated with clinical nursing) )
- Pathophysiology and classification of respiratory failure
- Pathophysiology and classification of shock: Hypovolemic, Cardiogenic and high-flow shock
- Sepsis and septic shock (Sofa e Quick Sofa score)
- Pathophysiology of Acute renal failure and CRRT
- Pathophysiology of Acute and Chronic hepatic failure: portal hypertension, hepatic encephalopathy
- Diabetes acute complication: hypoglicemia, diabetic ketoacidosis, hyperosmolar-hyperglycemic syndrome

------------------------------------------------------------
Modulo: 53472 - SEMINARIO DI INFERMIERISTICA CLINICA NELLA CRITICITA' VITALE
------------------------------------------------------------
RESUSCITATION, CLINICAL NURSING IN CRITICAL AREA AND SEMINAR
- Trauma system and Emergency Department - Urgency 118; the Operations Center;
- Triage and its tools; assessment and monitoring of the critically ill patient;
- Specific emergency drugs;
- ABCDE-F approach and Pulmonary resuscitation maneuvers; Acute respiratory failure: symptoms, diagnosis, treatment; Nursing care in acute respiratory failure; Modalities of invasive ventilation; techniques and management of non-invasive ventilation; blood gas analysis (EGA);
- Approach and treatment in politrauma, both in the pre and intra-hospital settings;
- Techniques for emergency mobilization and immobilization;
- The pneumothorax (PNX): diagnosis, treatment, complications (already treated in the surgical module);
- The management of a patient with head injury;
- The management of a patient with a surgical airway; tracheostomy tube; bronchoaspiration with closed and open systems; post-anoxic coma; therapeutic hypothermia; vascular accesses management; brain death;
- Humanization of care;
- Healthcare-Related Infections (ICA).
PATHOPHYSIOLOGY OF ORGAN FAILURE IN CRITICAL CARE (Integrated with clinical nursing) )
- Pathophysiology and classification of respiratory failure
- Pathophysiology and classification of shock: Hypovolemic, Cardiogenic and high-flow shock
- Sepsis and septic shock (Sofa e Quick Sofa score)
- Pathophysiology of Acute renal failure and CRRT
- Pathophysiology of Acute and Chronic hepatic failure: portal hypertension, hepatic encephalopathy
- Diabetes acute complication: hypoglicemia, diabetic ketoacidosis, hyperosmolar-hyperglycemic syndrome

Didactic methods

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Modulo: 006051 - RADIOPROTEZIONE
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Case method, lectures, working groups.

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Modulo: 53456 - INFERMIERISTICA CLINICA IN AREA CRITICA
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CLINICAL NURSING IN CRITICAL AREA AND SEMINAR: Method of cases, seminars, laboratories of gestures and relationships, working groups.

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Modulo: 53469 - LE URGENZE MEDICO CHIRURGICHE
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Case method, lectures, working groups.

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Modulo: 53471 - RIANIMAZIONE
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Case method, lectures, working groups.

------------------------------------------------------------
Modulo: 53472 - SEMINARIO DI INFERMIERISTICA CLINICA NELLA CRITICITA' VITALE
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CLINICAL NURSING IN CRITICAL AREA AND SEMINAR: Method of cases, seminars, laboratories of gestures and relationships, working groups.

Learning assessment procedures

MEDICAL AND SURGICAL EMERGENCIES, RESUSCITATION, NURSING IN THE CRITICAL AREA and SEMINAR OF CLINICAL NURSING IN VITAL CRITICISM
- Integrated oral exam for the Modules “Medical and surgical emergencies”, “Resuscitation”, “Clinical nursing in critical area” and “Clinical nursing seminar in vital criticality”.
- The test will be passed only if the judgment is positive with respect to all 4 modules, otherwise the student will have to repeat the exam entirely.

RADIATION PROTECTION
- Written exam: 30 multiple choice questions.
- Rating: one point for each question.
- Time: 40 minutes.

THE FINAL GRADE IS A WEIGHTED AVERAGE OF THE MARKS OBTAINED IN EACH PART.

Reference texts

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Modulo: 006051 - RADIOPROTEZIONE
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RADIATION PROTECTION
Materials provided by the teacher in the classroom.

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Modulo: 53456 - INFERMIERISTICA CLINICA IN AREA CRITICA
------------------------------------------------------------
NURSING IN THE CRITICAL AREA and SEMINAR OF CLINICAL NURSING IN VITAL CRITICISM
- I. Comisso, A. Lucchini, S. Bambi, G.D. Giusti, M. Manici - Nursing in Critical Care Setting: An Overview from Basic to Sensitive Outcomes - Casa Editrice Springer, 2017 (lingua inglese)
- I. Comisso, A. Lucchini, S. Bambi, G.D. Giusti, M.Manici - Infermieristica in terapia intensiva. Principi di assistenza di base e avanzata- Giunti editore - 2021
- Paul L. Marino - The ICU Book Terapia intensiva Principi fondamentali - Masson Edra Edizioni Milano 2014
- Paul L. Marino, G. Conti (a cura di) - The ICU Book Terapia intensiva (italiano) - Masson Edra Edizioni Milano 2018
- Linee di Indirizzo Regione E-R gestione vie aeree difficili nell'adulto https://salute.regione.emilia-romagna.it/assistenza-ospedaliera/sicurezza-cure/copy_of_sale-operatorie-sicure-sos-net/copy_of_LineediindirizzoVieAeree_def.pdf
- Linee di indirizzo Regione E-R Accessi vascolari https://www.sicp.it/wp-content/uploads/2021/06/RER_Delibera-801_20gen21_LI-accessi-vascolari_cpr.pdf
- NANDA International - Diagnosi infermieristiche - undicesima edizione (2018-2020)
Websites
www.burnsurgery.org
https://www.infermiereonline.org/
https://assr.regione.emilia-romagna.it/Indice_A...Z
https://www.gimbe.org/pagine/294/it/evidence
http://www.ventilab.org/
https://medest118.com/
http://www.rossoemergenza.it/
https://gavecelt.it/nuovo/
http://www.intensiva.it
https://casereports.bmj.com/
https://www.empillsblog.com/
https://litfl.com/own-the-airway/
https://intensiveblog.com/
https://edecmo.org/
https://www.propofology.com/
https://litfl.com/
https://criticalcarenorthampton.com/
https://ecmoed.blog/
https://pulmccm.org/
https://emcrit.org
https://www.thebottomline.org.uk/
https://intensivecarenetwork.com/
https://rebelem.com/
https://onepagericu.com/
https://www.ircouncil.it/per-sanitari/coronavirus/
https://www.siaarti.it/news?category_id=30448

Research
https://www.uptodate.com/home
https://www.cochranelibrary.com/
https://www.cdc.gov/
http://www.ihi.org/
https://www.nice.org.uk/guidance
https://www.tripdatabase.com/
www.emedicine.medscape.com

Calculators
Crash:
http://www.crash.lshtm.ac.uk/Risk%20calculator/index.html
E-prognosis:
https://eprognosis.ucsf.edu/calculators.php
IMPACT TBI:
http://www.tbi-impact.org/?p=impact/calc
COVID19:
https://qxmd.com/calculate/calculator_731/covid-19-prognostic-tool
GOS-E:
https://qxmd.com/calculate/calculator_721/glasgow-outcome-scale-extended-gos-e

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Modulo: 53469 - LE URGENZE MEDICO CHIRURGICHE
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MEDICAL AND SURGICAL EMERGENCIES
- Andreoni B, Chiara O., Coen D, Vesconi S. Diagnosi e trattamento delle emergenze medico - chirurgiche. Elsevier-Masson; Milano: 2009.

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Modulo: 53471 - RIANIMAZIONE
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RESUSCITATION
- Rosa G, Bilotta F., Argomenti di anestesia e rianimazione. Piccin, Padova 2006
- Kirby R, Gravestein N., Lobato E., L'anestesia nella pratica clinica, Delfino Antonio Editore II ed. Roma 2005
- Sasso L., Silvestro A., Rocco G., Tibaldi L. Moggia F., Infermieristica in area critica, McGraw-Hill, Milano 2012
- Ranieri V.M. Mascia L.; Terragni P; Urbino CG Elementi di Anestesiologia e Terapia Intensiva. Edizioni Medico Scientifiche; Torino: 2007.

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Modulo: 53472 - SEMINARIO DI INFERMIERISTICA CLINICA NELLA CRITICITA' VITALE
------------------------------------------------------------
NURSING IN THE CRITICAL AREA and SEMINAR OF CLINICAL NURSING IN VITAL CRITICISM
- I. Comisso, A. Lucchini, S. Bambi, G.D. Giusti, M. Manici - Nursing in Critical Care Setting: An Overview from Basic to Sensitive Outcomes - Casa Editrice Springer, 2017 (lingua inglese)
- I. Comisso, A. Lucchini, S. Bambi, G.D. Giusti, M.Manici - Infermieristica in terapia intensiva. Principi di assistenza di base e avanzata- Giunti editore - 2021
- Paul L. Marino - The ICU Book Terapia intensiva Principi fondamentali - Masson Edra Edizioni Milano 2014
- Paul L. Marino, G. Conti (a cura di) - The ICU Book Terapia intensiva (italiano) - Masson Edra Edizioni Milano 2018
- Linee di Indirizzo Regione E-R gestione vie aeree difficili nell'adulto https://salute.regione.emilia-romagna.it/assistenza-ospedaliera/sicurezza-cure/copy_of_sale-operatorie-sicure-sos-net/copy_of_LineediindirizzoVieAeree_def.pdf
- Linee di indirizzo Regione E-R Accessi vascolari https://www.sicp.it/wp-content/uploads/2021/06/RER_Delibera-801_20gen21_LI-accessi-vascolari_cpr.pdf
- NANDA International - Diagnosi infermieristiche - undicesima edizione (2018-2020)
Websites
www.burnsurgery.org
https://www.infermiereonline.org/
https://assr.regione.emilia-romagna.it/Indice_A...Z
https://www.gimbe.org/pagine/294/it/evidence
http://www.ventilab.org/
https://medest118.com/
http://www.rossoemergenza.it/
https://gavecelt.it/nuovo/
http://www.intensiva.it
https://casereports.bmj.com/
https://www.empillsblog.com/
https://litfl.com/own-the-airway/
https://intensiveblog.com/
https://edecmo.org/
https://www.propofology.com/
https://litfl.com/
https://criticalcarenorthampton.com/
https://ecmoed.blog/
https://pulmccm.org/
https://emcrit.org
https://www.thebottomline.org.uk/
https://intensivecarenetwork.com/
https://rebelem.com/
https://onepagericu.com/
https://www.ircouncil.it/per-sanitari/coronavirus/
https://www.siaarti.it/news?category_id=30448

Research
https://www.uptodate.com/home
https://www.cochranelibrary.com/
https://www.cdc.gov/
http://www.ihi.org/
https://www.nice.org.uk/guidance
https://www.tripdatabase.com/
www.emedicine.medscape.com

Calculators
Crash:
http://www.crash.lshtm.ac.uk/Risk%20calculator/index.html
E-prognosis:
https://eprognosis.ucsf.edu/calculators.php
IMPACT TBI:
http://www.tbi-impact.org/?p=impact/calc
COVID19:
https://qxmd.com/calculate/calculator_731/covid-19-prognostic-tool
GOS-E:
https://qxmd.com/calculate/calculator_721/glasgow-outcome-scale-extended-gos-e