Anaesthesia

Contact person: Dr. Arif Al-Areibi, Rm. C3-120, LHSC-UH
Tel: Secretary, Linda Szabo

The objectives for this elective can be made quite flexible according to the needs of the candidate. Previous elective candidates from the Dept. of Family Medicine have done this rotation with a view to:

  • Simply learn what the anaesthesia experience is all about so they can better prepare and inform their future patients
  • Enhance their airway management skills and resuscitation skills with a view to practicing in an acute care situation in the future
  • Explore the field of anaesthesia as an area for future professional development such as a PGY3 Family Medicine year in Anaesthesia

Thus the objectives listed below can be modified readily in order to accommodate the needs of the candidate doing the elective.

Skills (Core skills will be taught and other skills are based on available cases):

Airway Management:

  1. upper airway management including airway maneuvers and airway adjuncts (Core)
  2. airway control focusing on intubation (Core)
  3. use of techniques to enhance oxygenation in both the nonintubated and intubated patient (Core)
  4. the candidate will develop skills of bag/mask ventilation as well as the use of mechanical ventilators (Core)

Vascular Access:

  1. venous --

        a) peripheral intravenous catheters of varying sizes (Core)
        b) central venous catheterization.

     2. arterial puncture and catheterization

Knowledge:

  1. the candidate will be able to describe the therapeutic uses and risks of the use of supplemental oxygen
  2. the candidate will be able to discuss normal cardiovascular and respiratory physiology and the disease associated changes that will affect the management of an anaesthetic
  3. Pharmacology

a) Central Nervous System - the candidate will be able to describe the use of anaesthesia induction agents and sedatives including indications, dosages, contra-indications and side-effects

b) Inhaled Anaesthetics - the physics and pharmacology of the inhaled anaesthetic agents will be understood.

c) Analgesics - the candidate will be able to describe the use of various analgesic agents in the maintenance of anaesthesia and in the management of postoperative pain, including a physiologic rationalization for the selection of various agents.       

d) Peripheral Nervous System - the candidate will be able to discuss the pharmacology of local anaesthetic agents including mechanism of action, uptake and distribution, and toxicity.

e) Chronic Pain - the candidate will have an exposure to basic concepts in chronic pain management including the agents useful in the management of chronic pain syndrome.

f) Respiratory - the candidate will understand the effects of various pharmacologic agents on the respiratory system when used in anaesthesia. This will include being able to describe respiratory depressant effects, the suppression of airway reflexes and effects on broncho dilation.

g) Cardiovascular - the candidate will understand the pharmacology of common cardiovascular agents including inotropes, vasodilators, vasoconstrictors and chronotropes.

Regional Anaesthesia:

  • describe the common regional blocks
  • list indications, contraindications and complications

Attitudes:

The candidate will become familiar with the operating room culture from the point of view of the anesthesiologist. This will include:

  1. Pre-operative assessment and preparation of the patient for surgery
  2. Assessing perioperative risk
  3. Prioritizing preoperative care
  4. Collaborating the Pre-assessment Clinics, Daycare Surgical Units and the Post-Anaesthetic Recovery Room

Evaluation:

  1. Daily ongoing feedback from consultants
  2. End of rotation discussion with hospital Program Coordinator and completion of written evaluation form

 

Scheduling: Space is limited.