Department Of Anesthesia Residency Training Program Rotation Goals And .
Department of AnesthesiaResidency Training ProgramRotation Goals andObjectivesCBD Program1
Table of ContentsTitlePage #Transition to DisciplineAdult Anesthesia4FoundationsAdult AnesthesiaPediatric AnesthesiaPediatric Emergency MedicineAdult Emergency MedicineAdult Intensive Care UnitENT SurgeryObstetric AnesthesiaObstetricsAcute Pain81118202226283133CoreCardiovascular AnesthesiaAirway/Thoracics AnesthesiaObstetric AnesthesiaNeonatal ICUPediatric AnesthesiaPediatric ICURegional AnesthesiaNeuroanesthesiaAcute PainChronic PainCoronary Care UnitCardiac ConsultEchocardiographyPalliative CareCommunity AnesthesiaAdult AnesthesiaClinical Mentorship/Simulation TeachingPulmonary Function TestingPulmonary ConsultAdult Intensive Care UnitResearchTransition to PracticePerioperative MedicineAdult AnesthesiaPediatric AnesthesiaObstetric 87909295991031061091161192
1Department of AnesthesiaTTD Rotation Goals andObjectives
2PGY1 ADULT ANESTHESIAMEDICAL EXPERT/CLINICAL DECISION-MAKER Demonstrate knowledge of the basic and clinical sciences as applicable toanesthesia:o Anatomy: Airway anatomy and assessment: ability to bag and/or intubate Anatomy of the back: epidural / spinal spaceso Physiology: Cardiac risk assessment - understand risks associated withcardiac disease in patients undergoing noncardiac surgery Pulmonary risk assessment - indications for PFTs Gastric emptying - NPO guidelines Fluid / electrolytes / acid-base physiology Hemostasis and transfusion medicineo Pharmacology and indications for use of drugs: common anesthesia drugs: Inhalational agents Induction agents Muscle relaxants Analgesics: opioids, NSAIDs, acetaminophen Local anaesthetics: lidocaine, bupivacaine common i.v. cardiac drugs: amiodarone, verapamil, diltiazem labetalol, esmolol atropine common vasopressors phenylephrine (Neosynephrine) ephedrine norepinephrine (Levophed) epinephrineDemonstrate knowledge of :o general internal medicine - cardiovascular, respiratory, renal,hepatic, endocrine, hematologic and neurologic co-existing diseaseso age-related variables in medicine - adult and geriatric patient care.o the principles and practice of anesthesia - patient support duringsurgery or obstetrics.o the principles of management of patients with acute painDemonstrate clinical skills necessary for the practice of anesthesia:preoperative assessment, intraoperative support and postoperativemanagement of patientso Perform appropriate preoperative assessment of adult patients ASA classification / emergency procedures Assessment of severity and stability of pre-existing organsystem disease Guidelines for ordering preop lab tests Airway assessment - Prediction of ease of ventilation/intubation Potential anesthesia risks: malignant hyperthermia, allergies
3Intraoperative patient management; Knowledge of the use of standard intraoperative monitors Airway management – see techniques Acquire clinical experience with various anaesthetictechniques : GA, Regional (spinal, epidural), sedationo Provide appropriate post-op care Transfer/transport/report of post-op patients Provision of post op analgesia and antiemesis therapyo Recognition and management of emergencies Anaphylaxis Upper airway obstruction Intraoperative bronchospasm ACLS protocoleDevelop increasing technical expertise ino Placement of peripheral IV’so (exposure to central lines, pulmonary artery catheter)o Insertion of arterial lineso Ventilation with bag and masko Laryngoscopy and intubation of the normal airway Use of airway equipment Stylets Bougies Laryngeal masko Spinals, lumbar epiduralsRecognize that prior to provision of anesthetic care, optimization involvingspecific medical intervention and modification of risk factors may be required.Demonstrate knowledge of basic legal and bioethical issues encountered inanesthetic practice including informed consento COMMUNICATOR Establish a professional and empathetic relationship with patients andfamiliesObtain and collate relevant history from patients, and families.Listen effectively.Discuss appropriate information with patients and families and othermembers of the health care teamKeep clear, concise, legible documentation.Ensure adequate information has been provided to the patient prior toundertaking invasive procedures as for informed consentCOLLABORATOR Consult effectively with other physicians and health care professionals toprovide optimal patient care
4MANAGER Demonstrate knowledge of the management of operating rooms:o Patient flow and post op disposition: work effectively and efficiently ina health care organizationo anesthetic expenditures: Allocate finite health care resources wiselyDemonstrate knowledge of Canadian anesthesia practice guidelines:o standard intraoperative monitorso BCLS/ACLSo Airway algorithmRecord appropriate information for anesthetics and consultations provided.Utilize information technology to optimize patient care, and life longlearning.Demonstrate principles of quality assurance, and be able to conductmorbidity and mortality reviewsHEALTH ADVOCATE Identify the important determinants of health affecting patients.Provide compliance with national practice guidelines and equipmentstandards for anesthesia.Recognize the opportunities for anesthesiologists to advocate for resourcesfor chronic pain management, emerging medical technologies and new healthcare practices in generalSCHOLAR Develop, implement, and monitor a personal continuing educationstrategy.Critically appraise sources of medical information: develop criteria forevaluating the anesthetic literatureFacilitate learning of patients, students, and other health professionalsPROFESSIONAL Deliver highest quality care with integrity, honesty and compassion.Exhibit appropriate personal and interpersonal professional behaviors.Practice medicine ethically consistent with the obligations of a physicianInclude the patient/family in discussions concerning appropriate diagnosticand management procedures.Respect the opinions of fellow consultants and referring physicians in themanagement of patient problems and be willing to provide means wherebydifferences of opinion can be discussed and resolved.Show recognition of limits of personal skill and knowledge by appropriatelyconsulting other physicians and paramedical personnel when caring for thepatient.
5Department of AnesthesiaFoundations Rotation Goalsand Objectives
6ADULT ANESTHESIAMEDICAL EXPERT/CLINICAL DECISION-MAKER Demonstrate knowledge of the basic sciences as applicable to anesthesia,including anatomy, physiology, pharmacology, biochemistry and physics.o Knowledge of the anatomy related to the anesthesia practice: Airway anatomy Central and peripheral blocks anatomy CVS/Respiratory physiology and anatomy Renal/hepatic anatomy and physiology Fluid/electrolyte/hematology/endocrinology physiologyo Knowledge of the pharmacology and indications for use of drugscommonly used in anaesthetic practice Inhalational agents Induction agents Muscle relaxants Narcotic analgesics Local anaestheticso Have a clear understanding of the function of the anaesthesia machineand basic anaesthesia monitorso Physics especially the physics of gases and fluids and the principles ofelectrical safetyDemonstrate clinical skills necessary for the practice of anesthesia, includingpreoperative assessment, intraoperative support and postoperativemanagement of patients of different physical status, for commonly performedsurgical and obstetrical procedureso Perform appropriate preoperative assessment of adult patients. This will include assuring optimal medical management incooperation with the patient's other physicians and involveconsultation when appropriate. Understand the pathophysiology of the patient's diseaseprocess and its relation to anaesthesia and surgery. ASA classification Assessment of severity and stability of pre-existingorgan system disease Make use of appropriate examinations and laboratorytests. Understand when delay to prepare the patient beforesurgery is beneficial and when it is deleterious Airway assessment Prediction of ease of ventilation/intubation Recognition of the difficult airway ASA Difficult Airway Algorithm Demonstrate knowledge of basic legal and bioethical issuesencountered in anesthetic practice including informed consento Perform appropriate intraoperative management of the patient takinginto account the patient's status. Select a safe effective anaesthetic technique, considering thepossibilities of local, regional and general anaesthesia andunderstanding the particular needs of the surgery planned.
7Demonstrate knowledge of age related variables in medicine asthey apply to neonatal, adult and geriatric patient care. Demonstrate knowledge of special concerns for different typesof surgical procedures (refer to list) Select appropriate monitoring methods, both invasive and noninvasive, and use additional equipment (e.g. heaters,humidifiers, and positioning aids) as required. Know the Canadian Anaesthesiologists Society practiceguidelines. Safely conduct the intraoperative anaesthetic management ofthe patient. Demonstrate technical expertise ino Venous and arterial cannulationo Difficult airway managemento Airway management adjuncts including stylets,bougies, laryngeal mask, FASTRACH, lightedstylet, and fibreoptic bronchoscope for intubation.o Regional anaesthesia including subarachnoidblock, epidural block, brachial plexus block, andIV (Bier) block Rationally manage perioperative fluid Rx Know the appropriate use and risks of blood products Safely manage anesthetic intraoperative complications andacute perioperative problems Know BCLS and ACLS protocols Maintain accurate and complete recordsProvide appropriate post-operative care Transfer/transport of post-op patients Transfer of care to PACU nurse (report) Provision of post op analgesia and antiemesis therapy Knowledge of PACU staffing, facilities, monitoring, standards Knowledge of PACU discharge criteria to ward or home Management of complications in PACU: Postoperative nausea and vomiting Respiratory: hypoxia/hypercarbia/obstruction CVS CNS, N.B. delayed awakening Pain Hypothermia Metabolic derangements oCOMMUNICATOR Establish a professional and empathetic relationship with patients and familiesObtain and collate relevant history from patients, and families.Listen effectively.Discuss appropriate information with patients and families and other membersof the health care teamKeep clear, concise, legible documentation.Ensure adequate information has been provided to the patient prior toundertaking invasive procedures
8COLLABORATOR Consult effectively with other physicians and health care professionals toprovide optimal patient careMANAGER Demonstrate knowledge of the management of operating rooms.Demonstrate knowledge of the contributors to anesthetic expenditures.Demonstrate knowledge of the guidelines concerning anesthetic practice andequipment in Canada.o Knowledge of the use of standard intraoperative monitors Monitoring standardso Knowledge of practice guidelines BCLS/ACLS ASA Airway algorithmRecord appropriate information for anesthetics and consultations provided.Allocate finite health care resources wisely.Work effectively and efficiently in a health care organizationUtilize information technology to optimize patient care, and life long learning.Demonstrate principles of quality assurance, and be able to conduct morbidityand mortality reviewsHEALTH ADVOCATE Identify the important determinants of health affecting patients.Provide direction to hospital administrators regarding compliance withnational practice guidelines and equipment standards for anesthesia.Recognize the opportunities for anesthesiologists to advocate for resources forchronic pain management, emerging medical technologies and new healthcare practices in generalSCHOLAR Develop, implement, and monitor a personal continuing education strategy.Critically appraise sources of medical information.Develop criteria for evaluating the anesthetic literatureFacilitate learning of patients, students, and other health professionalsPROFESSIONAL Deliver highest quality care with integrity, honesty and compassion.Exhibit appropriate personal and interpersonal professional behaviors.Practice medicine ethically consistent with the obligations of a physicianInclude the patient/family in discussions concerning appropriate diagnosticand management procedures.Respect the opinions of fellow consultants and referring physicians in themanagement of patient problems and be willing to provide means wherebydifferences of opinion can be discussed and resolved.Show recognition of limits of personal skill and knowledge by appropriatelyconsulting other physicians and paramedical personnel when caring for thepatient.
9PEDIATRIC ANESTHESIAThe pediatric anesthesia training at McGill consists of 3 to 4 months of clinical pediatricexposure at the Montreal Children’s Hospital and Shriners Hospital for Children. The residentwill participate in the delivery of care for pediatric patients undergoing various procedures.The objective of this rotation is to familiarize the resident with considerations and particulartechniques related to pediatric anesthesiology. The following goals and objectives list theminimum of what is expected of residents in terms of their knowledge base, proceduralskills, perioperative patient management, attitude and communication skills. The resident ishighly encouraged to formulate an anesthetic management plan for each procedure. Thedepth of comprehension of resident’s knowledge base, their technical skills, clinicaljudgment and decision making capacities as well as their ability to critically appraise medicalliterature are expected to increase as resident become more senior. By the end of thisrotation, the resident should be able to manage ASA class 1 and 2 patients greater than 2years of age (over 1 year of age for senior residents) with limited assistance foruncomplicated surgery including induction, maintenance, emergence, charting andtransportation to the PACU.The resident is expected to demonstrate adequate preparation in reading and chart reviewfor assigned clinical cases.Upon completion of this rotation, the resident should be able to:Medical Expert/Clinical Decision-maker Demonstrate knowledge and understanding of the basic anatomy and physiology, asapplicable to pediatric anesthesia, including the maturation process which takes place in allsystems.oCardiovascular system-Anatomy and physiology relevant to the transitional circulation-Maturation of the myocardium and the autonomic nervous system-Normal values for different stages of developmento-Pediatric basic and advanced life support (N.B. attendance at MCH PALS isencouraged)Pulmonary system-Anatomic features of neonatal, infant, pediatric and adolescent airway-Physiology of the respiratory system and its maturation over time withrespect to: control of respiration, compliance, lung volumes, oxygenconsumption/metabolic rate, normal values for different stages ofdevelopmentoCentral nervous system-Anatomy-fontanels-Physiology: intracranial pressure and volume, cerebral blood flow,autoregulationoGenitourinary system-Renal maturation-Fluid and electrolyte management/fluid distribution-Maintenance requirements
10oGastrointestinal system-Glucose control-Maturation of hepatic functionoThermoregulation-Body surface area-Heat loss-Ability to thermoregulateoPsychological issues-Anxiety and coping mechanism in different age groups-Separation anxiety, parental anxiety-Effects of hospitalization Demonstrate knowledge and understanding of pediatric pharmacology for ASA class 1 and2 neonatal and pediatric patients, includingoAbsorptionoVolume of distributionoProtein bindingoPharmacokinetics/ pharmacodynamics and calculation of drug dosage-Premedication-Inhaled anesthetics-Induction drugs-Sedative-hypnotic drugs-Narcotics-Muscle relaxantsoMetabolismoClearanceoExcretionoToxicity Demonstrate clinical skills necessary for the preoperative assessment of the pediatricpatient using relevant historical, physical and laboratory information.oDemonstrate knowledge of pediatric medicine for the assessment of children withconcomitant medical disease.oSummarize fasting guidelines of pediatric patients.oRecognize that prior to provision of anesthetic care, specific medical intervention ormodification of risk factors may be required.oDemonstrate knowledge of basic legal and bioethical issues encountered in pediatricanesthetic practice including informed consent (include blood transfusion consent forchild of Jehovah’s Witness parents).
11 Demonstrate knowledge of the anesthetic considerations and clinical skills to institute asafe anesthetic management for pediatric patients undergoing proceduresoPreoperative preparation (ventilator, equipment selection, routine and resuscitativemedications)oMonitoring the pediatric patientoInduction of anesthesiaoBag-mask ventilationoEndotracheal tubes/LMA placementoIntravenous fluid therapyoMassive transfusionoAppropriate timing of extubationoNeonatal anesthesiaoRegional anesthesia and analgesiaoFull stomach and emergency surgery Demonstrate knowledge of specific anesthetic considerations for pediatric patients withconcomitant disease/disorder and formulate an appropriate perioperative patientmanagement planooooooooooooooooooooooooooooNeonate/premature/ ex-prematureChild with recent upper respiratory tract infection (URTI)AsthmaCystic fibrosisObstructive sleep apneaChronic lung diseasePhysiology of repaired simple cardiac lesionsNon-cardiac surgery in patients with unrepaired ASD, VSD, PDAMediastinal massesHydrocephalus, raised ICPSpina bifidaCerebral palsySeizure disorderDevelopmental delayDown’s syndromeGastroesophageal refluxHepatobiliary diseaseRenal insufficiency or failureSickle cell/ thalassemia/ hemophiliaAnemiaMyopathiesMalignant diseaseSeptic shockDiabetesThyroid diseasesObesityMucopolysaccharidosisMalignant hyperthermia/ masseter spasm
12ooAtypical plasma cholinesterasesAnxiety Formulate an anesthetic management, describe the potential complications and initiateanesthesia care for common procedures (when applicable), includingo General surgeryInguinal hernia myNecrotizing enterocolitisOmphalocele/gastroschisisPectus excavatum repairThoracic surgeryCongenital diaphragmatic hernia repairTracheo-esophageal fistula repairoOtolaryngologyTonsillectomy and adenoidectomyPost-tonsillectomy/adenoidectomy copic sinus surgery/polyps excisionThyroidectomyRemoval of foreign body in airwayBronchoscopy (rigid/flexible)Epiglottitis/croupRetropharyngeal abscessTracheostomyoOphthalmologyStrabismus repairCataract surgeryOpen eye injuryoNeurosurgeryIntracranial/ posterior fossa tumor resectionDrainage of extra/subdural hematomaVP shunt /encephalocele repairSpinal cord tumour excisionoOrthopedic surgeryFracture reductionHip reconstructionSoft tissue surgeryScoliosis surgeryMultiple traumaoUrologyCircumcision, hypospadias repair
13HydrocelectomyUreteric reimplantationCystoscopyNephrectomyInsertion peritoneal dialysis catheteroPlastic surgeryBurns, debridement/skin graftCleft lip/palate repairCorrection of congenital limb deformitiesoOthersEndoscopiesDental extractions/restorationMuscle biopsyRemote location: sedation for MRI/CT, interventional radiology, BMA/LP,examination under anesthesia. Demonstrate competence in technical skills related to the pediatric patientoKnowledge and utilization of pediatric equipment and breathing systemsoAirway management of the neonate and pediatric patientoManagement of the difficult airwayoPeripheral and central venous accessoArterial line insertionoRegional anesthesia, including single shot caudal blocks and peripheral nerve blocks Demonstrate clinical skills necessary to evaluate and manage problems which may ariseperioperativelyoNeed for post-operative admissionoUncooperative ylaxisoPost extubation stridoroDeliriumoNausea and vomitingoNeed for resuscitation Demonstrate clinical skills necessary for the perioperative pain management of patientsundergoing pediatric surgeryoKnowledge of options for perioperative analgesia including systemic analgesia, localinfiltration, regional nerve blocks, neuraxial analgesia (their indications,contraindications, advantages and disadvantages in pediatric population).oDemonstrate competence in ordering the perioperative modalities.
14oDemonstrate competence in follow-up of pain management, conversion to enteralopioids and weaning.Communicator Establish a professional and empathetic relationship with patients and families. Use a variety of approaches in dealing with children of all ages, including developmentallydelayed children. Obtain and collate relevant history from patients and families, listen effectively. Discuss appropriate information with patients and families and other members of thehealth care team. Recognize the psychological impact of hospitalization, anesthesia and surgery on both thepatients and their families. Ensure informed consent is obtained prior to undertaking invasive procedures. Communicate an anesthetic plan effectively to all members of the anesthetic team in atimely manner. Communicate effectively peri-operatively with all members of the health care team. Keep clear, concise, legible documentation.Collaborator Consult effectively with other physicians and health care professionals to provide optimalpatient care. Work as an integral member of the perioperative team:o Interact and collaborate effectively with all health professionals by recognizing andacknowledging their roles and expertiseo Resolve conflicts if necessaryo Provide feedbacko Assume a leadership role where appropriate.Manager Demonstrate knowledge and practice according to national standards and guidelines.o Knowledge of the use of standard intraoperative monitorso Knowledge of practice guidelines: BCLS/ACLS/NALS/PALS, Pediatric Airway algorithm Record appropriate information for anesthesiology care and consultations provided. Allocate finite health care resources wisely. Work effectively and efficiently in a health care organization. Utilize information technology to optimize patient care and lifelong learning.Health Advocate Identify the important determinants of health affecting patients. Provide direction to hospital administrators regarding compliance with national practiceguidelines and equipment standards for anesthesia. Recognize the opportunities for anesthesiologists to advocate for resources for painmanagement, emerging medical technologies and new health care practices in general. Demonstrate principles of quality assurance and be able to conduct morbidity andmortality reviews.
15Scholar Develop, implement and monitor a personal continuing education strategy. Critically appraise sources of medical information. Develop criteria for evaluating the anesthesiology literature and make evidence-baseddecision. Demonstrate willingness and an ability to impart acquired knowledge to more juniorresidents, medical students, other health care professionals and patients, if necessary. Synthesize and present information to colleagues and the anesthesiology department inan effective way (during Grand rounds for example).Professional Deliver highest quality care with integrity, honesty, compassion and respect for diversity. Demonstrate an increasing sense of responsibility and “case ownership”. Exhibit appropriate personal and interpersonal professional behaviours. Introduce him/herself and other members of the anesthetic team appropriately to patientand their family. Include the patient/family in discussions concerning appropriate diagnostic andmanagement procedures, demonstrate respect for their opinion. Respect the opinions of fellow consultants and referring physicians in the management ofpatient problems and be willing to provide means whereby differences of opinion can bediscussed and resolved. Show recognition of limits of personal skill and knowledge by appropriately consultingother physicians and paramedical personnel when caring for the patient. Practice medicine ethically consistent with the obligations of a physician.
16PEDIATRIC EMERGENCY MEDICINEMEDICAL EXPERT/CLINICAL DECISION-MAKER Demonstrate knowledge of age related variables in medicine as they apply toneonatal and pediatric patient care.Demonstrate knowledge of normal physiologyNormal growth and developmentNormal feeding practices of infants and childrenNormal fluid and electrolyte requirements of infants and childrenNormal laboratory values for infants and childrenDemonstrate knowledge of common syndromes and exposure to the specialneeds of the chronically handicapped child/the child with multiple anomaliesDown’s syndromeDemonstrate assessment of the new-bornJaundiceFailure to thrive/feeding problemsPrematurityDemonstrate clinical skills necessary for basic resuscitation and life support aspracticed in pediatric emergency care facilitiesNALS/PALS/ATLS protocolsAcute respiratory distressComaSudden infant deathDevelop clinical expertise in the assessment of the severity of illness and thedegree of urgency of treatmentDemonstrate clinical skills necessary to pediatric emergency care includingthe ability to investigate, diagnose, and manage appropriately commonproblems seen in the Pediatric Emergency Room, includingRespiratory distress/Wheezing Foreignbody aspiration/Cystic fibrosisFebrile illnesses, infectionsGastro-enteritis/vomiting/ diarrhea/dehydrationAbdominal painDKA, Renal/Hepatic InsufficiencyMultiple trauma/PoisoningSeizure disorderChild abuse and deprivationDemonstrate competence in all technical procedures commonly employed inpediatric emergency room practice, including airway management, ivs,cardiovascular resuscitation, patient monitoring and life support.Understand the psychosocial problems affecting the health of a child, e.g.divorce, death, chronic illness in the familyCOMMUNICATOR Develop communication skills specifically related to the paediatric patientUnique interview and examination techniquesProviding information re: treatment, prevention to parentsEstablish a professional relationship with patients and families.Obtain and collate relevant history from patients, and families.Listen effectively.
17 Discuss appropriate information with patients and families and other membersof the health care teamAppreciate need for communication with child’s primary physician/pediatricianCOLLABORATOR Consult effectively with other physicians and health care professionalsFunction as active member of the health care team in the Emergency Room,including appropriate use of consultationMANAGER Organize efficient use of resources in ER to optimize diagnostic andtherapeutic processesWork effectively and efficiently in a health care organization.Manage disposition of child expeditiously (home, SSU, ward, PICU, OR)HEALTH ADVOCATE Identify the important determinants of health affecting patients.Contribute effectively to improved health of patients and communities.Use opportunities to educate parents and families concerning relevant healthissues.SCHOLAR Critically appraise sources of medical information.Demonstrate ability to use resources in ER to improve knowledgeFacilitate learning of patients, students, and other health professionalsPROFESSIONAL Deliver highest quality care with integrity, honesty and compassion.Exhibit appropriate personal and interpersonal professional behaviorsincluding need for confidentiality.Practice medicine ethically consistent with the obligations of a physicianPeriodically review his/her own personal and professional performance againstnational standards.Include the patient/family in discussions concerning appropriate diagnosticand management procedures.Respect the opinions of fellow consultants and referring physicians in themanagement of patient problems and be willing to provide means wherebydifferences of opinion can be discussed and resolved.Show recognition of limits of personal skill and knowledge by appropriatelyconsulting other physicians and paramedical personnel when caring for thepatient.
18EMERGENCY MEDICINEMEDICAL EXPERT/CLINICAL DECISION-MAKER Demonstrate clinical skills necessary for basic resuscitation and life support aspracticed in critical care facilitiesACLS protocolsATLS protocolAcute respiratory distressComaDevelop clinical expertise in the assessment of the severity of illness and thedegree of urgency of treatmentDemonstrate clinical skills necessary to general internal medicine andintensive care including the ability to investigate, diagnose, and manageappropriately common problems seen in the Emergency Room, includingMultiple traumaPoisoningChest painRespiratory distressSeizuresHeadacheSyncope, dizzinessNew onset neurological deficitAbdominal painDKA/diabetic comaThyrotoxicosis/ myxedemaRenal/Hepatic InsufficiencyAcute musculoskeletal painDemonstrate competence in all technical procedures commonly employed inemergency room practice, including airway management, cardiovascularresuscitation, patient monitoring and life support.COMMUNICATORooooEstablish a professional relationship with patients and families.Obtain and collate relevant history from patients, and families.Listen effectively.Discuss appropriate information with patients and families and othermembers of the health care teamCOLLABORATORooConsult effectively with other physicians and health care professionalsFunction as active member of the health care team in the EmergencyRoom, including appropriate use
o Regional anaesthesia including subarachnoid block, epidural block, brachial plexus block, and IV (Bier) block Rationally manage perioperative fluid Rx Know the appropriate use and risks of blood products Safely manage anesthetic intraoperative complications and acute perioperative problems Know BCLS and ACLS protocols
The shortage of qualified anesthesia providers and the increased demand for anesthesia services create a highly competitive marketplace. Weigh the compensation of the current anesthesia team against the local market rate. ANESTHESIA SUBSIDY Hospitals provide additional financial support in the form of anesthesia subsidies to
Dr. J. Davies Anesthesia And System Safety Professor GFT Dr. D. Archer Neuro-Anesthesia Professor GFT Dr. J.N. Armstrong Anesthesia, Stars Associate Professor GFT Dr. R. Eng Residency Program Director Clinical Assistant Professor MPT Dr. J. Hamming Medical Director, Acute Pain Service .
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