Rtatin Specific Learning Objectives CCFP-EM Residency Prgram Anaesthesia Rtatin Overall Gal f the Rtatin T utilize the relevant cmpetencies cntained within the CanMEDS-FM rles t develp anesthesia skills relevant t the emergency physician including the management f airway emergencies, perfrmance f prcedural sedatin and reginal anesthesia. Residents will manage patients as a member f the anaesthesia team in the periperative and perative setting. Specific Educatinal Objectives: Rle f Family Medicine - Emergency Medicine (FM-EM) Expert The CFPC Emergency Medicine Enhanced Skills Pririty Tpics (http://www.cfpc.ca/pririty_tpics_in_em/) that residents shuld fcus n during this rtatin are: Airway Management: #1-6 Analgesia/Sedatin: #4-6 The resident shuld develp expertise in the fllwing prcedure clusters during the anaesthesia rtatin: Airway assessment Prcedural Sedatin Direct laryngscpy Vide laryngscpy Airway adjuncts (bugie, LMA) Pre-xygenatin techniques Bag-valve-mask ventilatin Peripheral intravenus access Spinal anaesthesia (as LP surrgate) Nerve blcks (pssibly)
Cricthyrtmy (at least discussed) The resident shuld: Develp expertise in airway management skills Describe the ptimal timing and methd f airway interventin in emergency situatins such as CNS depressin, trauma, shck, respiratry infectins, asthma, and COPD Demnstrate the ability t assess airway prtectin and patency Describe the hallmarks f a difficult airway and discuss the management f the difficult airway Recgnize and manage an bstructed airway Cmpare adult, adlescent, pediatric and nenatal airways and differentiate their management Perfrm interventins (e.g. patient psitining, xygen delivery, airway adjuncts) apprpriate t the situatin t maintain airway patency Perfrm bag valve mask ventilatin effectively Discuss equipment and apprpriate sizes required fr intubatin f adult and pediatric patient Perfrm endtracheal intubatin, understanding the indicatin, cntraindicatins, and cmplicatins Perfrm rapid sequence intubatin (RSI) with apprpriate preparatry steps and medicatins Demnstrate skill with bth direct and vide laryngscpy and describe the advantages and disadvantages f each in specific clinical settings Describe variatins f RSI in patients with hemdynamic cmprmise, intracranial pathlgy and acute brnchspasm Describe maneuvres t cnfirm endtracheal tube placement Describe the technique f an awake endtracheal intubatin Discuss and/r demnstrate the use f airway assist/rescue devices such as gum elastic bugie, laryngeal mask airway (LMA), King LT / Cmbitube, and trans-tracheal jet ventilatin while understanding the indicatins, cntraindicatins, and cmplicatins f each Demnstrate an understanding f the indicatins and the technique f btaining a surgical airway Describe the criteria fr extubatin, and perfrm extubatin and pstextubatin care Understand the rle f measuring end tidal CO2 and xygen saturatin in intubated patients Demnstrate the ability t assess respiratry failure Understand the basic cncepts and use f mechanical ventilatrs Develp knwledge and skills required fr prcedural sedatin Discuss the rle f prcedural sedatin including risks and benefits Understand the ASA classificatin system Discuss and perfrm prcedural sedatin fr adult and pediatric patients, including indicatins and cntraindicatins Describe the indicatins, cntraindicatins, side effects, advantages and disadvantages f the pharmaclgic agents used fr prcedural sedatin Describe the standard mnitring techniques required fr prcedural sedatin Describe the varius levels f sedatin Develp familiarity with pharmaclgical agents used in airway management, prcedural sedatin, and pain management
Discuss cncepts f cmmn inhalatinal agents including advantages, disadvantages and relative cntraindicatins Discuss cncepts f inductin agents (i.e.: ketamine, prpfl, etmidate). Discuss cncepts f neurmuscular blcking drugs (deplarizing and nndeplarizing) and reversal drugs Discuss cncepts f pst fasciculatin myalgia and pseudchlinesterase deficiency Discuss vaspressrs and intrpes including epinephrine, ephedrine, phenylephrine, vasdilatrs, NTG, nitrprusside, hydralazine Cmpare and cntrast the classes f lcal anaesthetics Classify lcal anaesthetics and describe their mechanism f actin Discuss the maximum dse and side effects f lidcaine and bupivacaine Describe an apprach t smene with pssible lcal anaesthetic systemic txicity (LAST) Describe the indicatins, cntraindicatins and technique fr tpical anaesthesia Discuss the dse, metablism, and systemic effects f piids and benzdiazepines used in the emergency department setting Discuss the indicatins, ptential side effects and dse f piids and benzdiazepine antagnists in an emergency setting Perfrm a relevant pre-perative histry and physical exam Perfrm a pre-perative histry and physical exam Discuss pre-perative preparatin, sedatin, and perative mnitring Perfrm a safety check n the anaesthetic machine Demnstrate relevant peripheral and central venus anatmy knwledge Demnstrate skill in btaining peripheral venus access Assess and manage prblems under general anaesthetic including hyptensin, hypertensin, and arrhythmias Discuss anaesthetic prblems assciated with specific cnditins including diabetes, asthma, myasthenia, and malignant hyperthermia Develp and enhance skills fr reginal anaesthesia Identify the landmarks and describe an apprach t cmmn reginal nerve blcks Describe the indicatins, cntraindicatins and cmplicatins f reginal nerve blcks Perfrm spinal anesthesia Rle f Cmmunicatr Overall Gal The resident will cmmunicate effectively with members f the healthcare team. The resident will act t facilitate the dctr-patient relatinship and establish psitive therapeutic relatinships with patients and their families that are characterized by understanding, trust, respect, hnesty and empathy. The resident shuld: Demnstrate an ability t discuss the risks and benefits f varius anaesthetic techniques relevant t the patient and prcedure
Cmmunicate effectively with the patient and family in the periperative perid in a manner that is sensitive t the patient s perspective (feelings, expectatins, fears, ideas) and cnsiderate f such factrs as age, gender, sci-ecnmic status, cultural and religius/spiritual values Demnstrate an ability t cmmunicate with the members f the emergency and surgical health care team in a way that respects the skills f team members and facilitates an ptimal team-based apprach t the care f the patient underging an anesthetic Dcument and share written and e-infrmatin abut the periperative/prcedural sedatin encunter t ptimize clinical decisin making, patient safety, cnfidentiality, and privacy Develp rapprt, trust, and ethical relatinships with patients and their families Elicit and synthesize accurate & relevant infrmatin frm, and perspectives f, patients and families Rle f Cllabratr Overall Gal The resident will wrk cperatively with patients, families and ther members f the healthcare team t achieve ptimal patient care. The resident shuld: Develp a pre-perative, perative, and pst-perative care plan fr a patient in cllabratin with the surgical health care team Maintain cllegial and respectful relatinships with surgens, physicians and ther health care prfessinals Identify and describe the rle, expertise and limitatins f the members f the emergency and surgical health care team including anesthesia technicians, respiratry technicians and OR and pst-p nurses Cultivate and maintain psitive wrking envirnments thrugh prmting understanding, managing differences, minimizing misunderstandings, and mitigating cnflicts Recgnize and facilitate necessary transitins in care with ther clleagues in the health prfessins, including but nt limited t shared care, transfer f care, and/r handver f care t enable cntinuity and safety Rle f Leader Overall Gal The resident will play a central rle in the rganizatin f the anaesthesia care delivered t the patient. They will crdinate the members f the health care system and utilize resurces in a way that sustains and imprves the health f their patient ppulatin. The resident shuld be able t: Apprpriately triage and priritize patients requiring urgent airway interventin Effectively assemble the health care team and prepare fr prcedural sedatin in a busy department Understand cmmn issues arund managing patients pre-peratively, in the perating rm and recvery rm
Make clinical decisins and judgments based n sund evidence fr the benefit f individual patients and the ppulatin served Wrk effectively as a member f the health care team, whether as a team leader r team member Effectively use patient-related databases, access cmputer-based infrmatin and understand the fundamentals f medical infrmatics Emply effective time management and self-assessment skills t frmulate realistic expectatins and a balanced lifestyle Rle f Health Advcate Overall Gal The resident will use their rle as a resident in anaesthesia t influence and advance the health and well-being f patients The resident shuld be able t: Identify pprtunities fr health prmtin and disease preventin in preperative assessments Respnd t an individual patient s health needs by advcating with the patient within and beynd the clinical envirnment Advcate fr individual determinants f health in system Identify the determinants f health, including barriers t accessing care and resurces Demnstrate prficiency in btaining infrmed cnsent Advcate fr patient safety in the perating rm Rle f Schlar Overall Gal T demnstrate a cmmitment t self-learning and the creatin, translatin, and disseminatin f medical knwledge. The resident shuld be able t: Demnstrate an enthusiasm fr learning Identify learning issues during the rtatin Access the available resurces t address a learning issue, including staff anaesthetists, respiratry therapists, nurses as well as medical databases. Critically appraise the literature and Integrate new knwledge and skills int clinical care Prvide effective feedback t teachers Rle f Prfessinal Overall Gal T display cmmitment t an ethical practice and high persnal standards f behavir in a manner that is cmmensurate with the imprtance f the dctrpatient relatinship.
The resident shuld: Demnstrate a cmmitment t patients thrugh clinical excellence and high ethical standards Exhibit prfessinal behaviurs in practice including hnesty, integrity, reliability, cmpassin, respect, altruism, and a sincere cmmitment t patient well-being Be punctual fr clinical and educatinal events Fllw thrugh n assigned tasks Demnstrate respect fr clleagues and team members Adheres t the principles f patient cnfidentiality and privacy Maintain apprpriate prfessinal bundaries Demnstrate a cmmitment t physician health and well-being t fster ptimal patient care Demnstrate a cmmitment t reflective practice