PEDIATRIC ANESTHESIOLOGY
GOALS AND OBJECTIVES
CA 2 Level
DEFINITION
Pediatric anesthesiology is a 2 month rotation for CA-2 residents. The rotation will focus on the
basic and some of the more advanced considerations when anesthetizing children for all types of
procedures
CURRICULUM
Development of the skill and knowledge necessary to administer anesthesia to infants and
children may be encountered in a general anesthesia practice. The anesthesia techniques and
problems unique to the pediatric practice will be the principle concern. In addition, the resident
will be assigned to either surgical or diagnostic procedures for children with CHD under the
direct supervision of the staff.
MEDICAL KNOWLEDGE
At the conclusion of this rotation, the resident should be able to:
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Describe a preoperative assessment and prepare an anesthetic plan for an ASA I
or II pediatric patient.
Discuss the different breathing circuits used in pediatrics including indications
and contraindications.
Discuss options and reasons for premedication in the pediatric patient.
Describe differences in anesthetic drug effect for the pediatric patients at different
ages compared to adult patient, including MAC, sensitivity, uptake and
distribution
Calculate fluid replacement therapy, estimated blood volume and maximal
allowable blood loss.
List alternatives for management of the difficult/problematic pediatric airways,
i.e., Pierre-Robin, treacher-collins, Down’s syndrome.
Summatize alternatives for induction of anesthesia in the pediatric patient.
List common congenital anomalies and define the effect they will have on their
anesthetic management, i.e., diaphragmatic hernia, gastroschisis, omphalocele.
Choose the appropriate endotracheal tube size and length for intubation.
Select appropriate laryngoscopy blade options used for intubation for children.
Describe indications for invasive monitoring.
Discuss considerations in the choice of anesthetic agents.
List common postoperative problems in children.
PATIENT CARE
At the conclusion of this rotation, the resident should be able to:
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Manage the airway in children with a normal airway utilizing appropriate mask,
bag and oral airway.
Intubate children with a normal pediatric airway with reasonable skill and speed
using the appropriate equipment in the majority (>75%) of cases.
Obtain LMA placement where appropriate in the majority of cases (>75%).
Obtain appropriate intravenous access in the majority (>75%) of cases.
Assemble a pediatric anesthesia circuit.
Assemble blood warming equipment and filters for transfusion in pediatric
patients.
Manage an appropriate anesthetic for routine pediatric cases, i.e. hernia repair,
tonsillectomy, myringotomy tube placement.
Attempt simple pediatric regional anesthesia with staff supervision.
Manage laryngospasm in the pediatric patient.
Recognize and treat post-intubation croup/stridor.
Administer appropriately dosed and timed premedication...
Maintain stabilization on arrival to PACU.
INTERPERSONAL AND COMMUNICATION SKILLS
At the conclusion of this rotation, the resident will:
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Discuss important differences in treating neonates, children and adolescents in all
areas mentioned above.
Access current literature to delineate specific concerns regarding the perioperative
care of all scheduled complex cases assigned.
Perform preoperative consultations of seriously ill children and communicate with
staff anesthesiologists, surgeons and family.
Describe the combination of techniques and therapies for providing analgesia,
unawareness and a non-moving surgical field of the child during planned
procedures.
Demonstrate reasonable rapport with parents, caretakers, patients and surgeons...
Determine which children require pre-medication.
Communicate effectively with parents before and after the anesthetic.
Develop a reasonable anesthetic plan with attending staff.
Follow the postoperative course of their patients.
Communicate effectively with caregivers on the acute pain service.
PROFESSIONALISM
At the conclusion of this rotation, the resident will:
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Function effectively in the O.R. with the surgical team.
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Safely transfer the children to the PACU or ICU.
Effectively communicate immediate postoperative plans.
Be able to secure consent and provide assurance to the parents of pre-anesthetic
children.
Arrange and participate in a parent-present induction of anesthesia for a child.
Provide consultative services preoperatively for all kinds of pediatric surgery.
Establish reasonable analgesia plans specific for pediatric patients and their
operations.
Function as a liaison on the acute pain service between the primary service, the
nursing staff, and the patient and their family.
Rev. 7/2009
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