anesthesiology medical students

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Anesthesiology:An IntroductionFor Medical

Students

James Lamberg


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2 / 38Anesthesiology: An Introduction For Medical Students

What Do You Know?

Where Do Anesthesiologists Work?

Who Do They Care For?

What Do They Do? Common Misconceptions:

Just Push The White Stuff (propofol)

A Very Narrow Sub-Specialty

Just Put People To Sleep

Too Competitive

Boring


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Common Stereotype


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So What Do They Do?

Work In Every Area Of Medicine

OR, PACU, ICU, OB, Peds, Pain Clinic

Work With The Most Diverse PatientPopulation

Premature Infants To Geriatrics

Provide Medical Care & Critical Care

Prior To, During, And After SurgicalProcedures

Work With Advanced Technology


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You Might Like Anesthesia If

You Enjoy Performing Procedures

You Are Interested In Critical Care

You Had Prior Experience (e.g. EMT)

You Enjoyed:

Pharm, Physio, Cardiology, Pulmonology

You Like All Areas Of Medicine

You Can Specialize Though You Like To See Immediate Results


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Ether Day October 16th, 1846


7/387 / 38Anesthesiology: An Introduction For Medical Students

Brief History

Pre-1800: Surgery Without Anesthesia

1846: First Ether Anesthetic

1884: Cocaine For Local Anesthesia 1921: Epidural Anesthesia Described

1942: Curare Clinical Trial Success

1960: Short Acting Opioids 1982: Transesophageal Echo

1983: Laryngeal Mask Airway



In The Operating Room




Pre-Anesthesia

History & Physical Exam

Positioning & Patient Setup

Induction

Put Patient To Sleep

Manage Airway

Create Best Operating Conditions ForThe Surgery Team


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Maintenance

Anesthesia Machine

Inhaled Anesthetics

Emergence

Safe Awakening

Transfer To PACU


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In The Post-Anesthesia Care Unit


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In The Post-Anesthesia Care Unit

Reduce The Risk Of Post-OperativeComplications (e.g. Stroke, MI)

Reduce The Risk Of Post-OperativeNausea & Vomiting

Reduce Post-Surgical Pain

Safely Discharge Patients Home Or

To Other Parts Of The Hospital


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In The Intensive Care Unit


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In The Intensive Care Unit

Founded Critical Care Medicine

Overlapping Skills:

Airway Management

Ventilator Management

Analgesia & Sedation

Management Of:

Respiratory Emergencies Cardiac Emergencies

Common Critical Care Issues (e.g. sepsis)


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In The Pain Management Clinic


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In The Pain Management Clinic

Diagnosis Of Pain

Treatment Of Pain

Pharmacologic

Procedural Injections

Pumps

Stimulators Non-Pharmacologic

Biofeedback

OMT


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Obstetric Anesthesia


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Obstetric Anesthesia

Risks To Mother & Fetus

Pharmacology

Physiology

Pain Management

Awake C-Sections

Obstetric Emergencies


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Cardiothoracic Anesthesia


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Cardiothoracic Anesthesia

Cardiac Anesthesia

Cardiopulmonary Bypass Multiple Vascular Lines

Transesophageal Echo Performed By Anesthesiologist

Thoracic Anesthesia

Dual Lumen Tubes


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Neuro Anesthesia


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Neuro Anesthesia

Physiology

Aneurysm Clipping

Awake Craniotomy

Lumbar CSF Drain

Specific Disorders

Electroconvulsive

Therapy


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Pediatric Anesthesia

Anatomical Differences

Otolaryngology

Congenital Heart Defects

Gastrointestinal Disorders


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Trauma Anesthesia


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Trauma Anesthesia

Airway Management

Transfusion Medicine

Tension Pneumothorax


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Acute Pain Management


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Acute Pain Management

Local Anesthesia

Neuraxial Anesthesia

Epidural

Spinal

Combined

Peripheral Blocks

Upper Extremity Lower Extremity


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Simulation


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What About Research?

CA-3 Research Track

Advances In Safety & Technology

Deaths Per 10,000 Anesthetics:

1950: 17.9

1975: 2.2

1980: 0.7

1989: 0.04


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Its Too Competitive For Me

ROAD: Radiology, Ophthalmology,Anesthesiology, Dermatology

Freeman Book: Competitive Not Very orExtremely Competitive

NRMP Match Data

Anesthesiology In The Middle

Academic Medicine (Mar 2009, Vol84, #3): Competitive Not Most orLease Competitive


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Choosing A Medical Specialty byFreeman (2004)

By Unmatched Rate: Emergy Med 6.5%

General Surgery 5.4%

Anesthesiology 5.2%

Ob/Gyn 4.3%

Psychiatry 4.3%

Neurology 3.0%


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NRMP Data 2008

Preferred Step 1 Score: 220

NRMP Data 2009 Preferred Step 1 Score: 222

Preferred Step 2 Score: 230

Similar To:

Internal Medicine, Pathology, GeneralSurgery, Emergency Medicine, Pediatrics,Obstetrics & Gynecology, Neurology


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Academic Medicine (Mar 2009, Vol 84,#3), Selection Criteria for Residency:Results of a National ProgramDirectors Survey.

Most Competitive: Plastics, Orthopedics,Otolaryngology, Ophthalmology,Radiology, Rad/Onc, Neurosurgery.

Competitive: Emergency Medicine,Urology, Dermatology, General Surgery,Anesthesiology, Pediatrics, Ob/Gyn.

Less Competitive: Psychiatry, Pathology,PM&R, Internal Medicine, Neurology,Family Medicine.


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Dispelling Myths Medical Education Online (2005;10:17),

Residency Selection Criteria: WhatMedical Students Perceive As Important.

Academic Medicine (Mar 2009, Vol 84,#3), Selection Criteria for Residency:Results of a National Program DirectorsSurvey.

Academic Emergency Medicine (Jan2002, Vol 7, #1), Selection Criteria forEmergency Medicine ResidencyApplicants.


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But Isnt It Boring?

Different Areas Of The Hospital

Diverse Patient Population

Lots Of Procedures


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The Best Medical Specialty?


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Thank You

anesthesiology medical students

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