MS4: Objectives for Anesthesiology Elective

Objectives for MS 4 Anesthesiology Elective (ANE240C)

 

The intent of MS-4 Anesthesiology Elective is:

To expose the students to the practice of Anesthesiology and help prepare them for their practice of medicine as: primary care providers, medical or surgical specialists, or anesthesiologists.

Future professional responsibilities:

All MS 4s:

  • Become aware of the scope of Anesthesiology practice in general, and also be exposed to Anesthesiology subspecialty care.

Primary care provider:

  • Identify through history, physical and lab studies issues of interest to the anesthesiologist when your patient is scheduled for surgery.
  • Know that your patients having surgery need their co-morbidies clearly understood and optimized.

Medical/Surgical specialists:

Understand what Anesthesiologist needs to know about the patient that will impact on anesthetic care(this implies communication):

  • Define and quantify the exact nature of the pathophysiology
  • Determine if process is reversible/correctable
  • Suggest a plan to optimize patient preoperatively
  • Identify potential postoperative problems due to this disease, and suggest management

 

Goals of Anesthesiology:

1. Preoperative/preanesthetic assessment:

Through history, physical, and laboratory results identify disease states which impact on Anesthetic care.

CVS: CAD; HTN; Valvular Heart Disease
RESP: difficult airways; COPD; reactive airway disease; URI
GI: reflux; end stage liver disease; morbid obesity
GU: chronic renal insufficiency
Endocrine: DM adrenocortico insufficiency
Hematological: anemia; coagulopathy
Musculoskeletal: arthritis

Drug Abuse:

  • Explain why these disease states present problems for anesthetic care.
  • Describe how anesthetic care is altered to manage each co-morbid state.
  • Describe what steps should be taken by the primary care provider/specialist-consultant to facilitate anesthetic management with each disease state.
  • List the 5 categories of the ASA physical classification, and state why this system is used.

2. Anesthesia practice

Understand what general factors help determine the anesthetic plan:

  • Disease state and severity
  • Planned surgery, patient position in OR
  • Patient age, anesthetic preference
  • Post operative analgesia management

Justify your anesthetic plan for the patient with whom you are involved.

Understand the components of: MAC; GA; Regional Anesthetic; Local Anesthetic

Know the pharmacology of commonly used drugs in anesthesia:

  • Induction drugs
  • Maintenance: gases; narcotics; muscle relaxants
  • Reversal agents
  • Local anesthetics: esters & amides
  • Sedatives
  • Emergency drugs: Ephedrine, Atropine, and Phenylephrine
  • Demonstrate how to start a peripheral IV.

Describe how to assess a patient’s airway.

Outline the risks of deep sedation/general anesthesia in a patient with a difficult airway.

Demonstrate bag and mask ventilation, and endotracheal intubation in an anesthetized patient.

Describe two other techniques used to achieve and maintain a patient’s airway.

Explain the purpose each patient monitor used during anesthesia.

Describe how you decide when to begin administering blood to your patient, and plan his/her IV fluid management.

State the purpose of the PACU, and describe the discharge criteria for this unit.

Explain your regiment for post operative pain management, and justify your specific patient plan.

List regional anesthetic techniques, which you have seen, used, and be able to explain why they were chosen for your patient.