The Anesthesia Clerkship is a 2 week rotation. Students may be assigned to one or two of three teaching hospitals in London; LHSC University Hospital, LHSC Victoria Hospital and St. Joseph’s Health Care.
You will spend one day (usually the first Monday or Tuesday of your rotation) in Anesthesia Bootcamp at the CSTAR Facility in the Legacy Research Pavilion at London Health Sciences Centre. This experience will enhance your two week anesthesia rotation with an intensive and directed introduction to anesthesia in the operating room environment by providing high quality, highly realistic simulation scenarios and facilitated debriefing sessions.
You will also spend one day in the Cataract Suite at Saint Joseph’s Health Care for the purpose of comprehensive IV training. The remaining 8 days, you will be assigned to the operating room, preadmission clinic, obstetrical, endoscopy, or lithotripsy suites.
Students will be given ten (10) daily evaluation forms and a “Topics for Discussion” form to assist faculty members to discuss topics relevant to the third year anesthesia curriculum. A textbook, Ottawa Anesthesia Primer, edited by Patrick Sullivan MD, will be loaned to each student by the site office at each hospital. Your rotation will not be considered complete until this book is returned.
Students are also directed to another excellent text written by Dr. Karen Raymer of McMaster University. This eBook “Understanding Anesthesia: A Learner’s Guide” is available at http://www.understandinganesthesia.ca/. A free pdf can be downloaded at http://www.csen.com/learn.pdf.
Students on the surgery block are expected to attend Anesthesia seminars scheduled among seminars in other subjects related to surgery during the twelve-week block. It is recognized that the clinical rotation in Anesthesia may occur before these seminars take place.
The 3rd Year medical student will be able to:
Medical Expert
1. Demonstrate an understanding of the anesthetic considerations for a variety of medical conditions and perform the appropriate/necessary preoperative assessment/preparation of the patient.
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obtain and record pertinent medical history and perform a focused physical examination including assessment of the airway, the respiratory and cardiovascular system, and other systems as indicated by the clinical situation.
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interpret basic laboratory data and investigations relevant to the perioperative assessmentdevelop and problem list and assign appropriate physical status.
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recommend appropriate pre-medication (eg. aspiration prophylaxis) and recognize which medications to hold preoperatively (eg. anticoagulants)
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state recommended preoperative fasting guidelines, list risk factors for perioperative aspiration and describe risk reduction strategies
2. Acquire the knowledge necessary to conduct appropriate fluid and blood component therapy
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recognize and describe the physiologic and pathologic routes of fluid losses and be able to estimate these losses
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assess a patient’s volume status using history, physical exam and lab investigations
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demonstrate an understanding of the composition of commonly available intravenous fluids by selecting appropriate perioperative fluid and electrolyte replacement. While taking into account the patient’s deficits, maintenance requirements and ongoing losses
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insert a peripheral intravenous catheter
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state the indications and complications of the various blood products and describe the factors influencing decision making/thresholds to administer blood product therapy
3. Recognize and describe the main drug classes frequently used in the perioperative period
4. Review and describe the principles of acute pain management
5. Demonstrate the ability to manage the airway and ventilation of an unconscious patient
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label the basic structures of the oropharyngeal and laryngo-tracheal anatomy
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state the indications and complications of airway management by laryngeal masks, face mask and intubation
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identify the appropriate sizes of laryngeal masks, face masks, oral and nasal airways, laryngoscope blades and endotracheal tubes
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independently demonstrate bag-mask ventilation of an unconscious patient
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recognize upper airway obstruction and independently demonstrate appropriate use of face mask, oral and nasal airways, head positioning, jaw thrust and chin lift maneuvers
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successfully prepare appropriate equipment for intubation
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position and intubate a patient with minimal supervisory intervention
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correctly identify (within 15 seconds) those patients in whom endotracheal intubation was not successful
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recognize need for intubation/controlled ventilation using a combination of clinical circumstances, physical signs, and lab results
