Anesthesia

Educational Goals and Objectives

The educational objectives for the Emergency Medicine resident while on the Anesthesia rotation are as follows:

Patient Care

  • Demonstrate correct use of the bag-valve-mask device.
  • Performs a minimum of 15 endotracheal intubations
  • Performs a minimum of 3 pediatric intubations
  • Is able to apply the Mallampati scale
  • Recognize and manage an obstructed airway.
  • Demonstrate ability to use standard monitoring techniques.
  • Demonstrate ability to manage a patient on a ventilator.
  • Demonstrate ability to administer local anesthetics and be familiar with agents, dosing, side effects, and techniques to monitor pain.
  • Demonstrate appropriate judgement regarding the need for airway intervention.
  • Demonstrate correct airway management including pediatric endotracheal intubation
  • Is able to perform rapid sequence intubation.
  • Perform conscious sedation under faculty supervision.

Medical Knowledge

  • Demonstrate basic familiarity with nasotracheal and endotracheal intubation as well as the indications and complications.
  • Demonstrates knowledge of the dosages, indications and contraindication of anesthetics and neuromuscular blocking agents.
  • Demonstrate knowledge of the anatomy of the upper airway.
  • Discuss and interpret results of all ancillary testing with supervisory faculty.
  • Demonstrates knowledge of the Mallampati scale

Practice Based Learning and Improvement

  • Demonstrate ability to locate and assimilate relevant studies in Anesthesiology

Communication and Interpersonal Skills

  • Demonstrate ability to create and sustain a therapeutic and ethically sound relationship with patients
  • Demonstrate effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills
  • Demonstrate ability to work effectively with others as a member or leader of a health care team or other professional group

Professionalism

  • Demonstrate respect, compassion, and integrity
  • Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities

Systems Based Practice

  • Advocate for quality patient care and assist patients in dealing with system complexities

The Emergency Medicine resident will accomplish these objectives in the following manner:

  • Attend and participate in daily Anesthesia teaching rounds, as well as all conferences given by the Department of Anesthesiology while on rotation.
  • Evaluate and manage patients under the supervision of Anesthesia faculty.
  • Progressive patient care responsibilities are at the discretion of the Anesthesia faculty based on the resident’s clinical experiences, didactic knowledge, psychomotor skills, procedural abilities and credentialing.
  • Perform procedures under faculty supervision commensurate with their post-graduate level of training and skill.

 

Rotation Information

Where: 3rd floor OR’s

When: Monday – Friday: 7/7:30 AM (Wed –Optional before conf); Thurs: 8-8:30am (Anesthesia Conference)

Supervisor: Harold Kim, MD, Chairman

  • Email: hkim@tbh.org
  • Ext: 8848

Attire: No outside scrubs.  Plan to change into paper scrubs, located in hallway by elevators outside of OR.  Wear masks with blue lines facing out and caps prior to entering OR hallways

Expectations: Prepare yourself for the rotation by reviewing relevant anatomy, airway equipment, medications, and techniques at Rich Levitan’s Airwaycam.com.  Your primary objective on the rotation is to become comfortable with different airway management techniques, primarily definitive airways.  Some attendings are more amenable to this than others.  Develop a relationship with the attendings (or CRNA’s) that are giving you the opportunities to learn.  The attendings can show you how to read the OR board for cases that are likely to be intubated, rather than LMA.  Laparoscopic cases are generally a safe bet.  Attendings will be hesitant to allow you to intubate on spinal or thoracic cases.   Always ask if there is any doubt.  Bring reading material for the downtime in between cases.  It is best to hang out in the anesthesia room to keep watch on useful cases.