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Anesthesiology elective
- Thread starter ssg
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Ssg, my advice is to show up everyday wanting to learn anestheisa. This will shine through. They know those that just want to ventilate and intubate are either posers or trying to pick up the skills for wards (which is admirable). I was told time and again that I was one of the best students they've had because I was truely interested. If you are worried about the grade, I would say it's important but I can also tell you that no interviewers asked me what it was (it was still being processed). However they did pay very close attention to the letter that you must get out of it. Don't try to prefect procedures, you will have more than enough time in residency to do that. See if you can sit through a 90 minute IV sedation case where at times you have to support the airway manually and still love anesthesia. As far as what's expected of you, your physical presence alone I suppose would suffice for at least a passing grade.
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If you can, I'd recommend taking a cardiac anesthesia elective alone or in addition to a general anesthesia elective..
That stuff kicks it! You get to do things (in addition to intubating, also a-lines, central lines, IV's) and learn lots of practical physiology to boot.
Look at the know-how and skills needed for the types of cases:
anesthesia management in the face of major sympathetic stimulation (i.e., cracking the chest and so forth)
restarting the heart after bypass,
managing arrhythmias,
managing heart failure,
managing hemodynamics in the face of valvular disease (multiple valves sometimes),
managing labile hemodynamics,
analyzing swan-ganz parameters on a second to second basis,
managing MAJOR fluid shifts & acid-base issues after coming off clamp in thoraco-abdominal-aortic aneurysm repairs,
stopping ALL circulation ("circ-arrest") in ascending arch repairs (i.e. NO bypass),
diangosing/correcting acid-base & electolyte imbalances,
learning how to read trans-esophageal echocardiography in the different modes and functions (at least an intro into this),
how to use the setting of pacemakers, aortic ballon pumps,
when / how to give various blood products, aprotinin, amicar, heparin reversal, different autonomic meds, etc.
and much more!
That stuff kicks it! You get to do things (in addition to intubating, also a-lines, central lines, IV's) and learn lots of practical physiology to boot.
Look at the know-how and skills needed for the types of cases:
anesthesia management in the face of major sympathetic stimulation (i.e., cracking the chest and so forth)
restarting the heart after bypass,
managing arrhythmias,
managing heart failure,
managing hemodynamics in the face of valvular disease (multiple valves sometimes),
managing labile hemodynamics,
analyzing swan-ganz parameters on a second to second basis,
managing MAJOR fluid shifts & acid-base issues after coming off clamp in thoraco-abdominal-aortic aneurysm repairs,
stopping ALL circulation ("circ-arrest") in ascending arch repairs (i.e. NO bypass),
diangosing/correcting acid-base & electolyte imbalances,
learning how to read trans-esophageal echocardiography in the different modes and functions (at least an intro into this),
how to use the setting of pacemakers, aortic ballon pumps,
when / how to give various blood products, aprotinin, amicar, heparin reversal, different autonomic meds, etc.
and much more!
