Anesthesia. What should I be doing?

[phoenx]

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I'm on an anesthesia rotation this month. And I have no idea what I should be doing every day. My goal is to learn about anesthesia but I don't feel like I'm learning.

The rotation is kind of disorganized and I'm not even sure they've had students on this rotation before. Regardless, it's more likely something I'm doing or not doing.

Is there a good source to study? Tips for getting the most I can out of this?

 

[Stellar Clouds]

My med school had a small word document with the basics for a medical student. You can find it here.

There is a simple anesthesia textbook that's about 150-200 pages and hits the very basics, but I can't for the life of me remember the name of it. If I find it, I will let you know.

For a more in depth text, try Miller's Basics of Anesthesia

I know some medical students used Anesthesia Secrets, but I personally don't know much about this book.

 

[Stellar Clouds]

Honestly, the absolute best thing you can learn to do on this rotation is learn how to properly mask ventilate a patient. It's not quite as glamorous as getting to say that you intubated or placed a central venous line, but it is a simple skill that can truly save a life.

 

[IlDestriero]

Honestly, the absolute best thing you can learn to do on this rotation is learn how to properly mask ventilate a patient. It's not quite as glamorous as getting to say that you intubated or placed a central venous line, but it is a simple skill that can truly save a life.

And place an IV.

 

[phoenx]

Thanks. I'm not worried about the glamour. Just maximizing what I can learn. So focusing on bagging and IVs.-good stuff.

Is it realistic to expect not much more than bagging and IVs out of this?

 

[Stellar Clouds]

Depends on your institution/attendings, but you may get a chance to intubate, place an arterial line, or place a central line--but if they really have never had medical students before, I wouldn't bank on any of those.

 

[Winged Scapula]

I'm on an anesthesia rotation this month. And I have no idea what I should be doing every day. My goal is to learn about anesthesia but I don't feel like I'm learning.

The rotation is kind of disorganized and I'm not even sure they've had students on this rotation before. Regardless, it's more likely something I'm doing or not doing.

Is there a good source to study? Tips for getting the most I can out of this?

Show interest in doing more. If they've never had students before, perhaps they don't recall what that requires.I eavesdrop on the anesthesia student's education in my ORs and the faculty are always asking questions, judging level of interest and knowledge and teaching. They'll ask if I mind if the student intubates, starts IVs etc (not because they need my permission but because I can give some insight into patient acceptance of students as well as prior medical treatments that might impact patient care). If you are just standing around watching, not being engaged, there's something wrong - and its not necessarily with you.

 

[evilbooyaa]

Ask to do whatever you can. If you see the senior resident is going to place an IV, ask them if you can do it with their supervision. Ask residents if you can intubate. Ask if you can put in central lines, a-lines under supervision. Hell, ask them if they can walk you through whatever they see on the echo during a cardiac case.

Ask to do whatever you can (and are willing to do). Whatever level that is depends on each person. During my MS3 rotation, I asked to place every IV, intubate every patient, and would have asked to place central/a-lines if it wasn't hospital policy that MS3 students are not allowed to place them. The worst thing that happened is that the resident gave some excuse (either BS or legit [A cardiac case with the person having 5 lines coming out of them already with minimal physiologic reserve, they were not going to let me intubate]) and said no. The best thing that happened is they let me do it. Then once the intubation was done, most of them said, "go read until the next case is supposed to come back".

Make sure you introduce yourself to the patient as a med student on the anesthesia service, obviously. #1 way to get them comfortable with you poking them.

 

[MedicineMike]

I'm a 3rd yr who plans on doing an anesthesia rotation. I've done surgery and a surg selective and the anesthesia guys (and crnas) have let me intubate any time I want to. Is this not normal?

 

[VisionaryTics]

I'm on an anesthesia rotation now. In 2.5 weeks, I have intubated twice (the only two times I have masked a patient). This is despite asking every day, working hard, putting in IVs, getting stuff ready in the room, reading, knowing my ****, etc. Always some BS excuse.

Whatever. Typical medical school bull****. Can't wait to match and graduate. Tired of being treated as useless and feeling useless.

 

[Stellar Clouds]

I'm a 3rd yr who plans on doing an anesthesia rotation. I've done surgery and a surg selective and the anesthesia guys (and crnas) have let me intubate any time I want to. Is this not normal?

It's really institution/student dependent. I was allowed to intubate a lot of the time as a medical student (unless they were doing something like a fiberoptic), but as you can clearly see from VTs post right above mine, that is not always the case. If you are doing your anesthesia rotation at the same place you did your surgery rotations (where they let you intubate a lot), then I see no reason why the trend wouldn't continue.

 

[tco]

My med school had a small word document with the basics for a medical student. You can find it here.

There is a simple anesthesia textbook that's about 150-200 pages and hits the very basics, but I can't for the life of me remember the name of it. If I find it, I will let you know.

For a more in depth text, try Miller's Basics of Anesthesia

I know some medical students used Anesthesia Secrets, but I personally don't know much about this book.

I get a "Not Found" page error when I click on your Word Document link. If you could find it and upload it, I'd appreciate it. Thanks.

 

[Stellar Clouds]

I get a "Not Found" page error when I click on your Word Document link. If you could find it and upload it, I'd appreciate it. Thanks.

Try this.

 

[phoenx]

Try this.

Thank you.

Yesterday and today have been a little better. After kind of reading over things and thinking it through, I think I have a plan for the next 2.5 weeks. Let me know what you all think.

-One or two days (or half days if the nurses are over it) in the next couple of weeks, I thought I'd ask to spend on the pre-op side starting IVs and learning from the nurses.
- a day in the outpatient surgery suite.
-a day in the pain management office-one of the anesthesiologists in that office already gave me the all clear.

I hadn't considered bouncing from room to room and asking each dr/crna for hands on time. I had been mostly in one room, every day, trying to learn from that person. But a friend mentioned it and I'm considering it as it seems to be something that will help me get better at bagging and such. Especially since I don't have any one person I'm assigned to be with.

Are there any negatives to this I may not be considering?



Thank you all.

 

[evilbooyaa]

Outpatient surgery suite isn't going to be much different from inpatient. Most of the surgeries are shorter and may not require intubation. However, they will likely still need a peripheral IV (and won't have multiple central lines like some inpatients) so it might not be a bad idea. I would spend the day on outpatient looking at a surgery that really interests you that you won't routinely find in inpatient (cataracts/lumpectomy/TnAs or tympanectomies/etc. etc.)

Bouncing around from room to room was difficult at my institution as there were multiple med students and CRNAs at any given time. In terms of CRNAs, I found most of them are less willing to let you do anything than the residents, but it may vary at your institution.

 

[cabinbuilder]

I was fortunate to do anesthesia as a student with a guy who was only in open heart cases. So every case I did a central line from the jugular approach (no US in those days) and intubated the patient. The rest of the time I watched the open hearts. I also learned to mix drugs and understand the different types of anesthesia, nerve blocks, different tubes vs LMA, etc. Comes down to the person you are paired with. Keep trying.

 

[Libertas]

I would discourage anybody interested in an anesthesiology residency from trying to bounce between rooms for procedures (I know you haven't been doing that before). It looks lame to the provider doing the case and it's obviously not representative of an actual day in the life. Although, sometimes attendings will let students follow them 1 on 1 a whole day outside of rooms doing pre-ops, placing IVs, starting cases, etc, which may be helpful to see the 'attending' work flow. In the actual OR, you can try and work with the same provider a few days, and achieve increasing involvement....ask them if you can help draw or give drugs, place a 2nd IV, or mask during induction....maybe do the whole airway as they trust you more and you ask the right questions to show you're interested.

Something you can also try to do depending on what your hospital/staff situation is like is to ask to take a couple overnight call shifts with some of the staff. You could try and ask one of the attendings you've worked with before about it.

 

[blaqmamba]

Think of it as a X-week vacation and enjoy

 

[phoenx]

I spent two mornings doing IVs. Mixed results but definitely good experience. My visit to the outpatient suite was actually to hang out with a gas Dr doing pain management so acting on the other side of things.

I think my first week was so odd because it was just a weird week in the dept. At least that's what I heard from one of the attendings.

I sat down with one of the attendings yesterday and made a game plan for the coming week so I'm feeling better about it all.

 

[Siggy]

I did an anesthesiology rotation at a hospital with both a residency and a CRNA program and was placed with both the residents and SRNAs with no major difference from the students end. What I did was pre-op, present to the attending after discussing the case with the resident (XX y/o with hx of ___ going for ___. Exam findings.... anesthesiology plan (LMA vs ET tube, normal induction vs RSI, etc), help roll the patient back, set the patient up. Depending on the exam and who I was with I might intubation(both resident/SRNA and attending. The PD, for example, always wanted the interns to do the intubations for experience). Then I'd either do any other basic procedures needed (i.e. sink the OG tube) and help start up the paperwork. Near the end of the surgery I'd go and pre-op the next patient, then return to help extubate the patient and get them to PACU.

 

[alpinism]

Honestly, the absolute best thing you can learn to do on this rotation is learn how to properly mask ventilate a patient. It's not quite as glamorous as getting to say that you intubated or placed a central venous line, but it is a simple skill that can truly save a life.

👍

 

[phoenx]

The rotation is almost over. Bagging has gotten pretty decent-if the lack of correction from the attendings is any indication. I've gotten all but 1 of the last 20+ intubations and all of the LMAs and OGs. From the time the patients enter the room to the intubation (with the exception of pushing drugs), the docs have been letting me call it/do it all. So I feel so much better about the rotation and what I've learned over the last couple of weeks. It still seems like I didn't ask enough questions but I was at such a loss on many days for what to ask. Still trying to work on IV experience. Hopefully, I'll have more opportunity for IVs. Thanks for all the input.

 

[Winged Scapula]

The rotation is almost over. Bagging has gotten pretty decent-if the lack of correction from the attendings is any indication. I've gotten all but 1 of the last 20+ intubations and all of the LMAs and OGs. From the time the patients enter the room to the intubation (with the exception of pushing drugs), the docs have been letting me call it/do it all. So I feel so much better about the rotation and what I've learned over the last couple of weeks. It still seems like I didn't ask enough questions but I was at such a loss on many days for what to ask. Still trying to work on IV experience. Hopefully, I'll have more opportunity for IVs. Thanks for all the input.

Glad things improved for you. 🙂

 

[tco]

The rotation is almost over. Bagging has gotten pretty decent-if the lack of correction from the attendings is any indication. I've gotten all but 1 of the last 20+ intubations and all of the LMAs and OGs. From the time the patients enter the room to the intubation (with the exception of pushing drugs), the docs have been letting me call it/do it all. So I feel so much better about the rotation and what I've learned over the last couple of weeks. It still seems like I didn't ask enough questions but I was at such a loss on many days for what to ask. Still trying to work on IV experience. Hopefully, I'll have more opportunity for IVs. Thanks for all the input.

Awesome! Congrats.

Sent from my SCH-I535 using Tapatalk

 

[phoenx]

Thanks for the feedback to everyone! The rotation is in the bag.

 

[evilbooyaa]

The rotation is almost over. Bagging has gotten pretty decent-if the lack of correction from the attendings is any indication. I've gotten all but 1 of the last 20+ intubations and all of the LMAs and OGs. From the time the patients enter the room to the intubation (with the exception of pushing drugs), the docs have been letting me call it/do it all. So I feel so much better about the rotation and what I've learned over the last couple of weeks. It still seems like I didn't ask enough questions but I was at such a loss on many days for what to ask. Still trying to work on IV experience. Hopefully, I'll have more opportunity for IVs. Thanks for all the input.

Pretty solid turn around from what you started with. Sounds like an overall good experience.