CA-3 TRAUMA/BURN ROTATION Regions Hospital Rotation Site Director: Dr. Matthew Layman Rotation Duration: 4 weeks

Transcription

1 CA-3 TRAUMA/BURN ROTATION Regions Hospital Rotation Site Director: Dr. Matthew Layman Rotation Duration: 4 weeks Introduction: The purpose of this rotation is to provide residents with a focused exposure to the preoperative and intraoperative care of the acutely injured patient. This rotation meets the RRC requirement for trauma and is designed to train residents for their unique role as trauma anesthesiologists. The importance of meaningful trauma anesthesia training cannot be overemphasized. Residents will learn to become an active member of the trauma team, the basic principles of trauma care, and to develop a plan for the proper evaluation of the trauma patient. GOALS: o To train residents who are capable of providing high quality anesthesia care in a high-pressure and high-stress environment of trauma/burn; o To train residents who use the bio-psychosocial model and life-long learning principles in providing high quality, effective, expeditious, and appropriate care to patients who have suffered acute trauma or burn injury. o Put special emphasis on importance of care based on principles of teamwork, communication and collaboration in acutely injured patients. Approximate Training Level Assessment Methods/Tools OBJECTIVES (by ACGME Competency) Patient Care Clinical Skills and Reasoning: o Use of primary and secondary trauma survey techniques to perform a preoperative assessment of acutely injured/burned patient o Formulates a safe anesthetic induction and maintenance management and monitoring plan for acutely injured/burned patient, considers all pathophysiologic principles specific to o Direct Observation o Chart- review o Case logs Page 1 of 5

2 trauma/burn patient, including risk of aspiration, unrecognized injuries, massive bleeding, airway difficulties, etc. (perception to complex overt response) o Formulates and discusses postoperative management plan for a trauma/burn patient o Able to interpret hemodynamic data and waveforms and demonstrates ability to make clinical decisions about future treatment plan based on the information obtained (perception to complex overt response) Technical/Device Related Skills o Skillfully prepares anesthesia work area for a trauma/burn patient in an expeditious manner First week of the rotation o Demonstrates expert skill in use of rapid fluid infusing devices and blood warming devices Patient Management o Participates in initial resuscitation of trauma patients in the ER with Trauma Team Activation o Independent placement of invasive monitors with minimal staff supervision: arterial, central line, (perception to complex overt response) o Skillfully secures airway in a trauma/burn patient, with special emphasis on traumatized airway management and unstable cervical spine management o Provide safe, expeditious and appropriate anesthetic management for patients who suffered acute trauma or burn injury, cerebral or spine injury o Correctly diagnoses, monitors and treats different causes of hypotension in a trauma/burn patient (perception to complex overt response) o Safely and efficiently transports and transfers care to a secondary provider o Direct Observation o Chart- review o Case logs Page 2 of 5

3 Medical Knowledge o Discusses principles of primary, secondary and tertiary survey of trauma patients (knowledge to application) o Discusses principles of safe airway management in trauma patients including cervical spine protection techniques and considerations (knowledge to application) o Discusses principles of safe anesthesia induction and appropriate anesthetic medications and agent to use in a trauma/burn patient (knowledge to application) o Discusses physiology of different shock states frequently associated with trauma (knowledge to application) o Discusses volume resuscitation principles and massive transfusion principles (knowledge to application) o Discusses clinical implications of hypotension, hypothermia, acute respiratory failure, coagulopathy, renal failure and fat embolisms on patient outcomes (knowledge to application) Practice Based Learning and Improvement o Actively analyzes own learning deficits, develop a learning plan and carry it out, is proficient in literature search and interpretation (receiving to valuing) o Analyzes own practice and determine ways in which they can improve your comprehensive anesthetic plan (analysis, valuing) o Introductory lecture series test o Anesthesia knowledge test o Annual in-training examination o Informal oral questioning o Oral case presentations o Written essay describing an analysis of patient management (areas of deficiencies, room for improvement) o Immediate formative feedback from attending o Direct observation o Journal club presentations and case presentations Page 3 of 5

4 Interpersonal and Communication Skills o Use of expeditious and effective listening, questioning, and explanatory skills in gathering information from patients and in providing information to patients, families, the public, and other health care providers in a short period of time available in an acutely injured patient (receiving to valuing) o Effectively and efficiently communicates pertinent patient information to other care providers (receiving to valuing) o Skill in working as a member of a patient care team including other physicians, nurses, other health care professionals, social workers (receiving to valuing) Professionalism o Direct observation with patient o Direct observation in simulation o 360 global rating o Learner classroom presentation o Awareness and management of his/her own values and attitudes, which might interfere with appropriate patient care specific to management of cardiac and vascular patient (receiving to valuing) o Responsiveness to and management of issues that relate to sociocultural aspects of family life, and social adjustment related to ethnicity, religion, culture, gender or sexual preference (receiving to valuing) o Consistent compassion, honesty, integrity and respect for others in all professional activities (receiving to valuing) System Based Practice o direct observation o 360 o Shows understanding and appreciation for work in interprofessional teams to increase patient safety and quality of care o Skillfully coordinates patient care in the settings of cardiac surgery o Discusses system-based problems as they pertain to patient care at M&M conferences (knowledge to analysis) o direct observation o 360 o M&M conference presentation with system analysis Page 4 of 5

5 Scholarly/Research Activities Reading Requirements The resident should read the following chapters while taking : Text: Chapters: CRITICAL CARE MEDICINE by Murray, Coursin 2nd Edition Assessments The resident will receive a summative written evaluation form at the end of from the Site Director, as well as verbal feedback informally throughout. The case-logs of the resident will also be evaluated periodically by the clinical competency committee for the number and type of procedures and anesthetic techniques entered to ensure they are obtaining adequate experience. Notes Page 5 of 5