CHALLENGES FACED BY
PRACTISING ANAESTHESIOLOGISTS
DR.C.RATHNA KUMAR
CONSULTANT ANAESTHESIOLOGIST
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NOTHING IN THE WORLD IS WITHOUT A
CHALLENGE
TO BE A SUCCESSFUL ANAESTHESIOLOGIST ONE
SHOULD HAVE A HIGH DEGREE OF KNOWLEDGE ,
SKILL AND MENTAL AND PHYSICAL STAMINA TO
FACE THE CHALLENGES
OUR PROFESSION IS MANY A TIMES EQUATED
TO THAT OF THE PILOTS.
CLASSIFICATION OF CHALLENGES
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PROFESSIONAL
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HEALTH
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FAMILY LIFE & OTHER SOCIAL ACTIVITIES
PROFESSIONAL
WORKING SET UP
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PRIMITIVE SET UP - ATTRACTING MIDDLE CLASS
POORLY EQUIPPED THEATRES
LITTLE IMPORTANCE TO ANAESTHESIA & I C U
FORCED TO WORK TAKING ALL RISKS &
COMPROMISES
ANYTHING GOES WRONG WE ARE BLAMED
SET UP CONTINUES TO WORK WITHOUT ANY
CHANGE BUT FOR THE ANAESTHESIOLOGIST
THANKS TO THE C P A AND M C I
MINIMUM MANDATORY REQUIREMENTS IN
THE OPERATION THEATRE
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A WELL MAINTAINED ANAESTHESIA MACHINE
MINIMUM 2 O2 AND N2O CYLINDERS ATTACHED
TO THE MACHINE AND 1 EACH KEPT STANDBY
TWO WORKING LARYNGOSCOPES WITH BLADES
OF ALL SIZES
AIRWAYS OF ALL SIZES
ENDOTRACHEAL TUBES OF ALL SIZES
SUCTION APPARATUS
TILTABLE OPERATING TABLE
DIFFICULT INTUBATION AIDS LIKE STYLET ,
MAGILL’S FORCEPS
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AN ANAESTHETIST’S ASSISTANT
UNINTERRUPTED POWER SUPPLY FOR ESSENTIAL
EQUIPMENTS
ALL EMERGENCY DRUGS & AMBU BAG WITH O2
TUBINGS
A STETHOSCOPE , SPHYGMOMANOMETER , PULSE
OXIMETER , ECG MONITOR
A DEFIBRILLATOR
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ESSENTIAL NARCOTICS & VAPOURIZERS
N P O FOR ATLEAST 6 HOURS
MAINTAINENCE OF ANAESTHESIA RECORD
INFORMED & WRITTEN CONSENT
A MECHANICAL VENTILATOR
TIMING OF SURGERY
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UNLESS AN EMERGENCY,DISCUSS AND FIX
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DAY TIME IS BETTER
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VIGILANCE IS ESSENTIAL
PREOPERATIVE
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EVALUATION
OFTEN NEGLECTED
EVALUATE AS EARLY AS POSSIBLE
GOOD HISTORY
RELEVANT INVESTIGATIONS
SPECIALISTS OPINION AS REQUIRED
IMPORTANT IN MEDICOLEGAL CASES
FITNESS IS OUR DECISION
OPTIMIZATION BEFORE SURGERY
GOOD RAPPORT WITH THE PATIENTS AND
FAMILIES
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IS THE CENTRE APPROPRIATE FOR A CASE?
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NO PROTOCOL
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ISA SHALL FORMULATE ONE
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CAREFUL PREOPERATIVE INSTRUCTIONS
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NO ANTIBIOTICS JUST BEFORE ANAESTHESIA
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NO DRUG WITHOUT OUR KNOWLEDGE TO BE
GIVEN IN THE PERIOPERATIVE PERIOD
ANAESTHETIC MANAGEMENT
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CHOICE OF ANAESTHESIA SHOULD BE OURS
PERFECT COCKPIT DRILL
ENSURE GOOD I/V LINES
ASSURE THE SAFETY OF PTS POSTOP AND LEAVE
MOST RISKY PERIOD-WHILE SHIFTING TO POSTOP
WARD
FOR ICU CARE GOOD NETWORK IS REQUIRED
INSTITUTE AND FREELANZING PRACTICE
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SCHEDULE
CONTOL OF OT
CONTROL OF STAFFS
OPTIMIZATION
REPLACEMENT RISK
OFFS FROM DUTY
INCOME
HEALTH PROBLEMS
STRESS
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HYPERTENSION-HR>100/MT, DBP>1OOMM HG
INSOMNIA AND OTHER SLEEP DISTURBANCES
IRRITABLITY
ANXIETY
HEADACHE
ASTHMA
LACK OF CONCENTRATION
ACIDITY
BODYACHE
DEPRESSION AND OTHER CHANGES IN BEHAVIOUR
SUICIDAL TENDENCY
SUBSTANCE ABUSE
CAUSES OF STRESS
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SENSE OF INSECURITY
CHANGING WORKING ENVIRONMENT
LACK OF CONTROL OVER WORKING TIME
LACK OF CONTROL OVER OT MANAGEMENT
UNSATISFIED EGO
MANAGEMENT OF STRESS
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A BREAK FROM ROUTINE
MENTAL RELAXATION TECHNIQUES LIKE YOGA
MAINTAIN PHYSICAL FITNESS
SOME LEISURE ACTIVITY
DISCIPLINED ANAESTHETIC PRACTICE
FAMILY AND OTHER SOCIAL ACTIVITIES
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PLANNING OF HOLIDAYS
RISE IN PRACTICE
COMPETITION
CATASTROPHES
ILLNESS AND DISABILITY
INVESTING IN EQUIPMENTS
ALLOTING TIME FOR SELF & FAMILY
ATTENDING CME AND CONFERENCES
PRACTICE PRESSURES-UNETHICAL METHODS
INCREASED RISKS OF ACCIDENTS
TAKE HOME MESSAGE
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DO A DIGNIFIED & SAFE PRACTICE OF
ANAESTHESIA
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FACE CHALLENGES WITH A BRAVE HEART
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BE CONTENDED
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OUR SPECIALITY HAS THE POTENTIAL TO DO GREAT
BENEFIT & HARM TO THE PATIENT