Anesthesiology topics ,ILO’s and Reading List for Semester 142 Title of the lectures Airway Management 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 1|Page Intended Learning Outcomes (ILOs) Describe the basic structural anatomy of the upper airway Describe the uses and disadvantages of the face mask Learn how to choose the appropriate mask size for adults and pediatric patients Learn how to choose the appropriate size of oropharyngeal airway Describe the parts of LMA and technique of insertion Describe advantages, disadvantages, indications, contraindications of LMA usage Learn how to choose the proper size of the LMA Describe the technique of insertion of LMA Recognize common causes of difficult ET intubation Describe ET tube and learn how to select proper size Outline the equipment required to be immediately available to perform endotracheal intubation Describe the optimal patient position for intubation Describe pre-oxygenation, including its physiological basis List indications and contraindications of ET intubation Describe the technique of orotracheal intubation Outline methods used to confirm ET proper placement List complications of ET intubation Outline advantages, disadvantages and contraindications of nasotracheal intubation Outline management of the difficult airway Reading List Chapter 23, page 444 and Chapter 22, page 462, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Anesthesiology topics ,ILO’s and Reading List for Semester 142 Title of the lectures Perioperative Fluid Management 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Preoperative Evaluation 2|Page Intended Learning Outcomes (ILOs) Describe total body water and its division between different body compartments Calculate body fluid in each compartment based on the body weight Outline solute composition of fluid in each compartment Outline composition of commonly used IV fluids Calculate volume replacement based on the IV fluid used calculate the distribution of IV fluids between different compartments Describe daily water turnover Outline perioperative fluid requirements Outline 4-2-1 rule for calculation of maintenance fluid requirements Outline the chemical composition of crystalloids and colloids used in clinical practice and their effects when used in volume replacement Outline clinical evaluation of fluid replacement 1. Outline how to take a focused history and physical examination, including anesthetic history 2. Describe the ASA physical status classification system 3. Describe preoperative fasting requirements and the common measures employed to decrease the risk of pulmonary aspiration 4. Outline preoperative investigations and interpretation of these investigations Reading List Chapter 12, page 199, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Chapter 17, page 357, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Anesthesiology topics ,ILO’s and Reading List for Semester 142 Title of the lectures General Anesthesia: Inhalational agents, IV agents, Positioning, Muscle relaxation, reversal& Recovery 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 3|Page Intended Learning Outcomes (ILOs) Outline preparation for anesthesia Outline the methods of induction of anesthesia and indication, complications and difficulties of each method List the basic positions of patient for surgery List the potential hazards and safety precautions that relate to each position Outline techniques of maintenance of anesthesia Outline minimum alveolar concentration of anesthetics (MAC) and its clinical application Describe signs of anesthesia Outline delivery of inhalational agents and maintenance of airway Outline anesthesia using neuromuscular blocking drugs Understand the differences between depolarizing and non-depolarizing muscle relaxants Outline the factors that influence the choice between controlled ventilation and spontaneous breathing Outline ventilator settings during controlled ventilation of anesthetized patients Describe reversal of muscle relaxants Outline TIVA Describe the conduct of extubation and its complications Outline emergency and recovery from anesthesia Outline the pharmacology and dosages of induction agents, relaxants, analgesics, and inhalational agents Learn the pharmacokinetic factors affecting the rate of induction and emergence from inhalational anesthesia Outline the relative advantages of each of the commonly used intravenous induction agents (propofol, etomidate, ketamine, thiopental) Outline the management of accidental intraarterial injection of harmful substances (e.g. Thiopentone) Identify the criteria for discharge of patients to the ward Reading List Chapter 21, page 444, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Anesthesiology topics ,ILO’s and Reading List for Semester 142 Title of the lectures Anesthetic Equipment 1. 2. 3. 4. 5. 6. Monitoring 4|Page Intended Learning Outcomes (ILOs) Recognize the components of the anesthetic machine Recognize the high and low pressure systems Outline specifications of compressed gas cylinders Outline the functions of the vaporizer of the different components of the machine and factors affecting its proper function Recognize types of ventilators and settings during operation Outline the anesthesia machine checking list 1. Recognize the goals of anesthetic monitoring 2. Outline the ASA standards for basic anesthetic monitoring 3. Understand the principles behind each of the key physiologic monitors 4. Know the limitations associated with various types of monitoring Reading List Chapter 15, page 262, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Chapter 15, page 262, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Anesthesiology topics ,ILO’s and Reading List for Semester 142 Title of the lectures Local Anesthetic Techniques 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. PONV 5|Page Intended Learning Outcomes (ILOs) Outline local Anesthetics Pharmacology and toxicity (Lidocaine, Bupivacaine) Understand the basic mechanisms of action of local anesthetic Describe anatomy of spinal canal Describe contraindications of a central neuraxial block Outline the technique of spinal and epidural anesthesia Distinguish level of anesthesia after administration of regional anesthesia Describe how to assess the adequacy of a regional technique Outline the management of hypotension associated with a central neuraxial block Identify anatomic landmarks for proper placement of a spinal needle Define the risks and benefits of regional (epidural/spinal) anesthesia/analgesia List contraindications to regional anesthesia List surgical procedures that can be done with a spinal anesthetic Outline differences between spinal and epidural anesthesia Describe the techniques and complications of intravenous regional anesthesia 1. Define nausea, retching and vomiting 2. Outline mechanism of vomiting 3. Outline afferent inputs involved in the vomiting reflex 4. Describe phases of vomiting 5. List risk factors of PONV 6. Describe Apfel risk stratification of PONV 7. List important causes of PONV 8. Outline prevention and treatment of PONV Reading List Chapter41, Page 822, Aitkenhead, Textbook of Anaesthesia, 6th edition Chapter 42, page 843, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Anesthesiology topics ,ILO’s and Reading List for Semester 142 Title of the lectures Pain Management 1. 2. 3. 4. 5. 6. 7. 8. Pediatric Anesthesia 6|Page Intended Learning Outcomes (ILOs) Outline criteria of postoperative pain Define causes of poor postoperative pain control in traditional management Describe physiology of pain sensation Outline changes occur within the nervous system following prolonged noxious stimuli Outline causes of patient variation in analgesic requirements Outline measurement of pain List methods used for treatment of postoperative pain Outline patient controlled analgesia (PCA) 1. List physiologic differences between infants and adults by organ system 2. Describe differences between adult & pediatric airway anatomy in relation to intubation 1. Calculate fluid requirements for pediatric cases 2. Outline preoperative management including NPO timings of different foods 3. Outline anesthetic managements of pediatric cases induction techniques, airway management and intraoperative monitoring 4. Learn common anesthetic techniques used in pediatric patients Reading List Chapter 41, page 822, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Chapter 36, page 731, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Anesthesiology topics ,ILO’s and Reading List for Semester 142 Title of the lectures Obstetric Anesthesia 1. 2. 3. 4. 5. 6. Malignant Hyperthermia 7|Page Intended Learning Outcomes (ILOs) Outline physiological changes of pregnancy and discuss their impact on anesthetic management Describe supine hypotensive syndrome. List the causes of pain during the first and second stages of labor and the dermatomes with which they are associated List the various methods of pain control available during labor Discuss the risks, benefits and side-effects of of epidural analgesia Compare the safety of general anesthesia with neuraxial anesthesia for cesarean section. 1. Outline etiology of MH syndrome 2. Describe the clinical features of MH including early intraoperative signs 3. Outline management of MH in the OR Reading List Chapter 35, page 690, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition Chapter 43, page 853, Smith& Aitkenhead, Textbook of Anaesthesia, 6th edition