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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.
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