Super High Yield Anesthesia!

Hey guys!

I will be starting residency in two weeks, so I just want to relax a bit, play video games, hang out with friends and family, and basically just enjoy the free time as best as I can before the next leg of my training.

In this episode we will discuss considerations for OR setup, induction techniques, and maintenance in the pediatric patient.

Learning Objectives:

• State the preop checklist for OR setup in peds cases
• Describe how to determine ETT size and depth for peds
• List the common sedatives, nonnarcotic analgesics, and emergency drugs commonly used in peds cases
• Explain the approach to fluid administration in peds cases
• Describe the different induction techniques and the pros / cons to each

In this episode we will discuss strategies and considerations for the preop evaluation in pediatric patients

Learning Objectives:

• Know the goals of the preop interview in pediatric anesthesia patients
• Describe the characteristics of each age groups and the preop strategy for each
• Explain the things you should ask for each system during the preop evaluation
• (Optional) Review the HY board related vignettes that you might come across when taking a history

In this episode we will discuss unique physiology considerations for the pediatric patient and review its implications on pharmacodynamics

Learning Objectives:

• Explain the components of fetal circulation and the transition to neonatal circulation
• Describe the unique aspects of pediatric physiology, particularly the respiratory, cardiovascular, renal, hepatic, GI, and hematopoietic systems
• State how pediatric physiology affects pharmacodynamics

In this episode we will discuss unique characteristics of the pediatric airway and considerations for IV access in the pediatric patient.

Learning Objectives:

• Describe the unique features of the pediatric airway (i.e. mouth, epiglottis, glottis, cricoid cartilage, trachea) and the implications of these features.
• Explain the methods for obtaining venous access in pediatric patients, and where to obtain it.

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In this episode, we will discuss general concepts for non-obstetric surgery in the pregnant patient, then we will run through anesthesia considerations for five common types of procedures.

Learning Objectives:

• Describe the goals of managing non-obstetric surgery in the pregnant patient
• Be able to explain the anesthetic plans and considerations for common procedures (i.e. hysteroscopy, D&C, LEEP procedure, robotic assisted hysterectomy, laparoscopic procedures)

In this episode we will discuss the pathophysiology, treatment, and anesthesia management of hypertensive disorders of pregnancy.

Learning Objectives:

• Describe the pathophysiology, treatment, and anesthesia management of preeclampsia
• State the signs of magnesium toxicity and name the treatment
• Describe HELLP syndrome and state the anesthetic management

In this episode, we will discuss ante and postpartum hemorrhage, what causes them, the risk factors, and most importantly, the anesthetic management of these conditions.

Learning Objectives:

• Explain the pathology, risk factors, presentation, diagnosis, anesthetic management, and choice of anesthesia for different causes of ante (i.e. placenta previa, placental abruption, abnormal placentation, uterine rupture, vasa previa) and postpartum hemorrhage (i.e. uterine atony, retained placenta, general trauma, uterine inversion)

In this episode we will go over anesthetic considerations for regional and general anesthesia for labor and delivery, as well as go over the steps for managing patients undergoing vaginal deliveries and C-sections.

Learning Objectives:

• Explain the implications of maternal physiology on delivering regional anesthesia
• Determine how general anesthesia considerations changes for labor and delivery
• Understand the steps for non-emergent labor neuraxial analgesia and C-sections

In this episode we will review drugs commonly used in OB cases. Sorry, it's a little dry, but it will be great review for the coming episodes!

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Learning Objectives:

• List the type of anesthetics that can and can NOT cross the placenta
• Describe the common drugs utilized in OB cases

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In this episode, we will kickstart our discussion of OB anesthesia by reviewing the physiologic changes that occur in pregnancy, the stages of labor, and review the pros and cons of different neuraxial methods in labor and delivery.

Learning Objectives

• Explain the physiologic changes in pregnancy (respiratory, circulatory, hematologic, GI, and central nervous system)
• Determine the implications of maternal physiology changes for general anesthesia
• Review the stages of labor and why it is important for pain management during delivery
• Other than general anesthesia, list the different options for pain control in labor and delivery

In this episode we will introduce you to the basic concepts of mechanical ventilation and discuss the basic vent modes.

Learning Objectives:

- Explain the four parameters of mechanical ventilation

- Understand how to read the ventilation monitor curves (i.e. flow, pressure, volume)

- Explain peak / plateau pressure, and discuss the pathology associated with these

- Know the difference between Volume control and Pressure control

- State the pros and cons to Assist Control and SIMV

- Explain how Pressure Support Works

- List the parameters and criteria for extubation

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In this final part of the Applying to Anesthesia Series, we will discuss things to consider during the interview season and match week. Specific topics include:

• Pre-interview season events (i.e. Open Houses, ASA Conference)
• Things program directors look for
• Letters of interest (for interviews)
• Tips on keeping track of interviews
• Discussion on how many interviews to attend
• Pre-Interview Dinners / Meet & Greets
• Equipment and set-up for Zoom interviews
• Interview Tips
• Post-Interview Communication (thank you letters, letters of intent / interest)
• Rank Order List (ROL) Discussion
• Match Week Events
• SOAP Overview

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NOTE: These are my views as an US DO medical student applying for residency in the United States.

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This is part 2 of the Applying to Anesthesia series in which we will discuss various aspects of preparing your application for residency through the Electronic Residency Application Service (ERAS). 

Specific topics discussed in this episode include:

- Snapshot of the 2020-2021 data 

- Types of anesthesia programs (categorical vs. advanced)

- Intern year only programs (preliminary and transitional year)

- General timeline for residency application

- Components of the ERAS application (e.g. CV, personal statement, etc.)

- Where to apply & how many applications to send

- Back up plans

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NOTE: These are my views as an US DO medical student applying for residency in the United States.

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Now that the 2020-2021 Match Season is finally over, I wanted to talk a little bit about applying to anesthesiology for residency. This episode is the first of three episodes on the application process, with this one focusing on things to do / consider during your preclinical years to third year. 

Specific topics discussed in this episode include: 

- Things to consider during preclinical years 

- Thoughts on 3rd year core clerkships

- Letters of recommendations 

- Applying to Audition Rotations 

- Tips for doing well on Audition Rotations 

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NOTE: These are my views as an US DO medical student applying for residency in the United States. 

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In this episode we will review respiratory physiology for anesthesia. Topics will include a review of lung volumes (specifically tidal volume and functional residual capacity), pulmonary circulation (pulmonary vasoconstriction and lung zones), gas exchange (hypoxemia and hypercarbia), and control of breathing.

In this episode we will discuss fundamentals of ultrasound including how ultrasound works, probe selection and characteristics, how different tissues appear on ultrasound, orientation, and useful tools like color doppler, pulse wave, and M-Mode. Since ultrasound is a visual technique, I highly recommend checking out the show notes to actually see what I talk about.