UNDER GRADUATE ANESTHESIA
COURSE (ORIENTATION AND OUTLINE)
Dr. Jumana. M. Baaj
Ass. professor , Anesthesia consultant
Dept. of Anesthesia
KKUH- KSU
Riyadh, Saudi Arabia
TABLE OF CONTENTS:
u Welcome
u The roles of the Anesthesiologist
u Goals and learning objectives of anesthesia lectures all over the course
u Goals and learning objectives of clinical skills all over the course
u Orientation about the schedule of the course and area to attend
u The anesthetic plan and stages of peri- operative periods
u Code of conduct in the operating theater
u Learning Resourses
u Key of success
u Student Assesment at the End of the course
COURSE AIM
u To graduate medical students having the basic knowledge & clinical skills to
deal with the peri-anaesthetic measures for simple surgical procedures.
Welcome
u Welcome to this two week introduction to Clinical
Anesthesiology.
u You will learn the use technical and analytical skills to
look after patients in many situations.
Goals and LEARNING objectives
Academic and Clinical skills:
v Preoperative evaluation and clinical skills
v Patient safety
v Airway and ventilation
v Fluid and volume resuscitation , blood transfusion
v Pharmacology of anesthetic drugs
v Principles of general anesthesia
v Principles of regional anesthesia
v Pain management
v Monitoring in anesthesia
v Anesthesia emergencies (intraoperative , Post operative period)
Specific Objectives:
u Know the role of anesthetist in preoperative assessment and the implications
of pre-existing disease for the patient who is to undergo anaesthesia.
u Describe the basic airway and circulatory management in patients under
anaesthesia including resuscitative measures as well as post-operative care.
u Recognize the clinical application of physiology and pharmacology in
anaesthesia.
u Manipulate some anaesthesia-related problems and their management.
u Acquire some clinical skills in patient assessments and to demonstrate
competence in the performance of basic technical procedures related to
anesthesia practice
Preoperative evaluation and Clinical
skills
Students should be able to:
v Obtain a relevant medical, surgical and
anesthetic history and examination on the
patient. ( Airway assessment, and factors
predisposing to difficult intubation)
v Provide a summary and formulate a
relevant problem list.
v Understanding of the indications for both
routine and special pre-operative
investigations.
v Understand the basics of an anesthetic
plan and how it relates to the clinical
work-up, ASA classification of pre-
operative physical status.
Clinical Objectives for Medical Students in (045) Anesthesia
At the end of the course the student will
be able to understand
u Pre-anesthesia assessment and evaluation
1. History from patient
2. Open iSHi System to get information and
investigation.
3. Interpretation of preoperative data relevant to
anaethetic plan.
4. Consultations
u Orientation with anesthesia equipment in O.R
1. Anesthesia machine
2. Anesthesia circuits
3. Laryngoscopes – tubes – LMA – Airways
4. Epidural set and Spinal set
5. Monitors- Anesthesia Record
6. Anesthetics Drugs- I.V. Inhalational and Muscle
Relaxants
7. Resuscitation Drugs During Anesthesia
8. fluids (Crystalloids & Colloids Fluids)
Airway and ventilation
Know the anatomy of the airway and basic
airway assessment.
Be familiar with the various techniques of
airway management and equipment
involved in routine and difficult intubation.
Review basic respiratory physiology in the
context of anesthesia.
Be familiar with the principles of manual
and mechanical ventilation.
Fluid and electrolyte balance
Know the main principles of:
v Fluid replacement and volume
resuscitation (crystalloid,
colloid, blood transfusion)
v Electrolyte and acid-base
balance
Pharmacology of anesthetic drugs
u AQUIRE a basic knowledge of COMMONLY
USED DRUGS IN ANESTHESIA
v Intravenous agents (sedative/
hypnotics, narcotics, muscle
relaxants)
v Volatile agents.
v Local anesthetics
Principles of general Anesthesia
Understand the principles of
general anesthesia and the
delivery of volatile anesthetics.
Have a basic understanding of
the structure, function and
safety features of the
anesthesia machine.
Regional anesthesia and
Pain management
Be familiar with the concept
of local and regional
anesthesia and commonly
used local anesthetic agents.
Be familiar with
perioperative pain
management techniques and
drugs.
Ultra-sound guided
peripheral nerve block
Local anesthesia toxicity
Monitoring In anesthesia
Be familiar with the BASIC international
monitoring standards and be able to
interpret basic information gained from the
monitoring of:
u Blood pressure
v Pulse oximetry
v ECG
v Capnography
v Ventilation (parameters, spirometry)
v Temperature
v Invasive pressure monitoring ( CVP, arterial line,
pulmonary artery catheter)
v Neuromuscular functioning monitoring
v Bispectral index
v Non invasive advance monitoring cerebral
oximetry , pressure variation index , non invasive
hemoglobin monitoring
Intra and post operative management
u Learn basic management of
common intra-operative problems
such as:
v Hypoxia, hypercarbia,
v Hyper/hypotension, cardiac
arrhythmias,
v High and low airway pressure alarm.
u Understanding of the requirements for
safe emergence from general anesthesia
and common problems and complications
in the PACU
v Pain
v Post –op nausea and vomiting, pain
etc
Vascular access
u Indication
u Types and size of intravenous Cather
u Intravenous compartments
u Steps for IV Cather insertion complications and complication related
u Central venous access , technique anatomical and Ultra sound giuded
centra- line insertion
u Indication , contraindications
u Complication related
u Arterial line catheterization indication , contraindication complication
The anesthetic plan
The anesthetic plan
Type of anesthesia
u General
Induction
Airway management
Maintenance and analgesia
Muscle relaxation
u Sedation
Supplemental oxygen
Agents
u Local or regional anesthesia
Technique
Agents
The anesthetic plan
u Intraoperative management
Monitoring
Positioning
Fluid management
Special techniques
u Postoperative
Oxygen therapy
Pain control
Complication management
Intensive care
Postoperative ventilation
Hemodynamic monitoring
Stages of the Peri-Operative Period
Pre-Operative
u From time of decision to have
surgery until admitted into
the OR theatre.
Stages of the Peri-Operative Period
Intra-Operative
u Time from entering the OR
theatre to entering the
Recovering Room or Post
Anesthetic Care Unit (PACU)
Stages of the Peri-Operative Period
Post-Operative
u Time from leaving the PACU
until time of follow-up
evaluation (often as out-
patient)
Code of conduct
Professionalism
v Attendance and punctuality are mandatory.
v Students are expected to be aware of the limitations of
their role in the operating room and to be diligent in the
OR environment.
Code of conduct
1. Professionalism and
Respectful Workplace
1. All students are expected to
demonstrate respect for the
patients and staff encountered
during the rotation.
2. We also expect all students to be
treated with respect during their
rotation.
3. Health has clear policies regarding:
1. Maintenance of patient
confidentiality.
2. Mutual respect in the workplace.
Code of conduct
Dress code
v When in the OR, students must
respect the rules of the sterile
environment and wear greens,
mask, gloves and bootes.
v If you have not previously been
in the OR, please notify us so
we can make you aware of
appropriate protocol.
v You are expected to bring your
stethoscope to the OR. Other
medical instruments are not
mandatory.
LEARNING RESOURCES Anesthesia course
Exposure to anesthesia learning in the following areas:
v Adult OR
v Pediatric OR
v Teaching at the bedside in the OR:
v Clinical teaching modules to cover basic anesthesia knowledge.
v Enabling objectives for technical skills.
v Case based clinical teaching
v Independent learning:
v Reference material- texts and web-based
v Simulator based learning:
v Low and high fidelity simulation to facilitate technical skills, crisis resource
management, and critical anesthesia events.
Key Success Factors
u Attendance
u Realistic Expectations
u Maintains communication with the faculty member
u Good organizational skills
u Expect to work beyond the classroom
u Stay on track/understand commitment required
u Ask questions
Books recommended
Anaesthesiaat a Glance
Julian Stone
Consultant Anaesthetist
Great Western Hospital NHS Foundation Trust
Swindon, UK;
Senior Clinical Lecturer University of Bristol, Bristol
UK
William Fawcett
Consultant Anaesthetist
Royal Surrey County Hospital NHS Foundation Trust;
Senior Fellow
Postgraduate Medical School, University of Surrey
Guildford, UK
Books recommended as a Text
u Morgan and Mekhails clinical
anesthesiology 5th Edition .
John Butterworth,
G. Morgan,
John Wasnick,
Mikhail Maged,
David C. Mackey,
Hans-Joachim Priebe
End of the course ASSESMENT
u LOG BOOK SUBMISSION
u OSCE EXAMINATION
u WRITTEN EXAMINATION
