0208007 Anesthesia

Location: Sinai/Grace Hospital

Coordinator: Dr. Theresa Stanton

Objectives:

Management of the Airway Use of Equipment to Ensure Airway Patency & Ventilate a Patient.

The medical student will be able to state the signs of the non-patent airway and state steps to be taken to manage the obstructed airway.
The medical student will be able to demonstrate the proper use of the bag valve mask set-ups on the patient as well as choose the proper size equipment to be used both for ventilation and intubation.
The medical student will be able to assess the patient during ventilation to determine that ventilation is adequate both by physical criteria and use of pulse oximetry.

Select Proper Anesthetic Agents
The medical student will be able to state what physical conditions would complicate giving anesthesia to a patient including: . Physical deformities . Underlying illness . Prior use of anesthetic agents . Current surgical procedure necessitating anesthesia.
Understanding Pharmacology of Agents Used for Anesthesia
The medical student will be able to discuss the pharmacology, indications, contraindications and complications of the following agents: . Drugs used for inhalation anesthesia . Drugs used for IV anesthesia . Neuromuscular blocking agents
Monitor a Patient Under Anesthesia

The medical student will be able to state what parameters to monitor during anesthesia.
The medical student will be able to discuss complications of intubations both early and late, what the patients clinical appearance will be and the necessary interventions to treat these complications.
Operating Room: All medical students will be assigned to work with an Anesthesiologist who will insure that they are given an adequate number of cases per day.
The medical student will be responsible for:

Inducing anesthesia

Managing the airway. - Ventilating the patient with bag valve mask device - Assessing patency of the airway. - Intubating the patient.

Monitor the patient while under anesthesia. Assess the Patient After Anesthesia for Complications

Check the patient postoperatively, and write necessary orders and progress notes in selected cases.
The medical student will see a selected number of patients postoperatively to assess them for post-anesthetic complaints.

Methods:

The student will be assigned to OR. rooms with an Anesthesiologist, Anesthesia Residents and CRNA and given hands-on instruction in airway management and intubation.
Induce Special Types of Anesthesia

Lumbar puncture will be demonstrated by the Anesthesiologist for purpose of inducing spinal anesthesia.
Rapid sequence anesthesia will induced in patients with full stomachs or bowel obstruction.

Recommended Reading Material: Dripps, Eckenhoff, Vandam, Introduction to Anesthesia the Principles of Saft Practice, 7th Ed. 1988. Stoelting, Miller. Basics of Anesthesia.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: to be discussed

Elective Begins: periods 1-10 (Year IV)

Maximum Number of Students: 1

0205009 Anesthesia

Location: Harper, Hutzel, and Detroit Receiving Hospitals

Coordinator: Dr. Jeffrey Clark

Contact Person: Monica Hoopingarner, Phone 313-745-7233; E-mail: mhooping@med.wayne.edu

Educational Experience:

Acquire an understanding of the basic physiology, pharmacology and clinical management involved in anesthesia care and perioperative medicine.

Objectives: The student will be expected to:

Learn what information must be elicited in the preoperative interview and appreciate the importance of this contact in the preparation of the patient for surgery.
Demonstrate the ability to adhere to a routine in the delivery of general anesthesia including equipment checks, institution of monitoring, induction and maintenance of surgical anesthesia.
Learn the principles and techniques of airway management including endotracheal intubation. Learn the management of use of airway equipment to ensure airway patency and ventilate a patient. At the end of the rotation, the medical student should be able: A. To state the signs of a non-patent airway and state steps to be taken to manage the obstructed airway; B. To demonstrate the proper use of the bag valve mask set-ups on the patient as well as choose the proper size equipment to be used both for ventilation and intubation; C. To assess the patient during ventilation to determine that ventilation is adequate both by physical criteria and use of pulse oximetry/capnography.
Learn how to select proper anesthetic agents. At the end of the rotation, the medical student should be able: A. To state what physical conditions would complicate giving anesthesia to a patient including: Physical deformities, underlying illness, prior use of anesthetic agents, current surgical procedures necessitating anesthesia; B. To have basic understanding of the pharmacology of agents used for anesthesia; C. To discuss the pharmacology, indications, contraindications, and complications of: 1. Drugs used for inhalation anesthesia; 2. Drugs used for IV anesthesia 3. Neuromuscular blocking agents.
Learn how to monitor a patient under anesthesia. At the end of the rotation, the medical student should be able to state what parameters to monitor during anesthesia.
Become familiar with the more common regional blocks and develop basic skills needed to produce regional anesthesia (such as spinal and epidural blocks).
Learn how to insert central lines and arterial lines, and become familiar with the basics of invasive monitoring.
Learn the methods of pain relief during labor and delivery, and understand the basics of anesthetic management in patients with obstetric complications.
Become acquainted with the modalities available to treat acute and chronic pain problems.
Develop an appreciation for the expanding role of the anesthesiologist as a problem solver in the hospital and outpatient settings.

Methods:

The medical student will be assigned to a senior anesthesiology resident every day. Schedules will be prepared and distributed at the beginning of the rotation. The medical student should expect to spend time (in 4-5 day rotation periods) on a variety of services (e.g. cardiac anesthesia, neuroanesthesia, pain management, obstetrical anesthesia, thoracic/vascular anesthesia, preop and postoperative evaluations).
The medical student will be required to attend weekly didactic lectures sponsored by the WSU Department of Anesthesiology. Voluntary participation in special lectures offered to anesthesiology residents available.