erasmus31

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I'm about to take my first Anesthesia elective and I was wondering what is the best way to do well. More specifically:

1.) What is a good, quick read for a 4 week elective? (I think Baby Miller was previously suggested)

2.) What are some common "Pimping" questions?

3.) What are some basic facts that were obvious after your first elective, but not before? (ie. ASA Classification,etc.-stuff every resident should know PRIOR to his/her first day of CA-1)

4.) How do I impress during my audition elective?

I'm sure there are others who are wondering the same, since elective time is just around the corner. Thanks in advance for the help!
 

Ipassgass

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Here's what I can advise based on what I can remember from my elective 8 months ago...

1) Read Baby Miller, pay special attention to all of the pharmacology. I would also have a handbook of some sort to flip through while you're in the OR; I used the Handbook of Anesthesiology from Current Clinical Strategies.

2) From what I can recall, most of the pimping questions where based on pharmacology and issues regarding the case you're invloved with (like explaining the oculocardiac reflex in an opthalmology case).

3) I can't think of anything for this one off hand, except maybe the importance of positioning prior to the start of the case for prevention of pt bumps and bruises as well as access issues....

4) Work. Be sure to demonstrate that you're not (and hopefully this is so) one of those entering this field for the potential lifestyle. Read about your patient(s) the night before the case(s). Think of what type of anesthetic plan you would use. Come in before the resident and set up the room as best as you can.

Hope this helps....
 

jc237

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I'm also taking my anes sub-I very soon. I'm a little worried about that b/c I'm a third year student and I heard that taking pulmonary, cardiology, SICU electives before doing subI is a good idea. Needless to say, I haven't done any of the three.... my anes attendings next week are gonna think I'm a ******* :scared:
 

IV Doc

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1.) What is a good, quick read for a 4 week elective? (I think Baby Miller was previously suggested)

Baby miller is the way to go. Before the elective read the first part of the book that deals with the common drugs. This is by far the most important section.

2.) What are some common "Pimping" questions?
The things that they will ask is why do I give this medication. For example why do we give the following induction agents. Fentanyl, lidocaine, propofol, muscle relaxant.

Fentanyl/lidocaine - Intubating a pt is very stimulating from an autonomic nervous system point of view so these agent numb the nerve receptors in the throat so that while you are intubating a patient the pt BP doesn't become 200/120.

Propofol - Causes the pt to become unconcious

Muscle relaxant - Allows easier intubation and helpful for many sugeries.

The point is you don't need to know everything about every drug initially but instead try to focus on the major concepts. For example focus on the drugs classes initially so know depolarizing muscle relaxants and non-depolarizing muscle relaxants and why we use each. Don't worry about knowing the differences between roc and vec initially.


3.) What are some basic facts that were obvious after your first elective, but not before? (ie. ASA Classification,etc.-stuff every resident should know PRIOR to his/her first day of CA-1)

The following things I would know prior to the elective
Overall drug classes and the uses for each
ASA class
Airway class
Read how to intubate - it is easier if you have read and seen the pictures before trying to do it

4.) How do I impress during my audition elective?

Show interest (obviously)
Try to be helpful
Draw up meds (if they will let you)
Set up the IV bag
Help set up the room for the next case
Ask if you can help pre-op the patients for the next day
Get things for the resident from the prep room
Realize that you are probobly going to be an annoyance to the resident so try and find all the things they don't want to do and help out. I know this sounds like scut but the more you help the resident the more they will try and allow you to do.

When I finished my rotations I had done far more epidurals, spinals, A-lines etc than many of my peers. The I think this is, is because the residents saw that I was trying to make their life easier so they tried to throw me a bone once and awhile.

Also there is another issue whether you should try and stay in one room or hop around rooms and starting cases. The advantage of hoping around is you get to do more intubations but I think it is bad in the long run. The reason for this is you don't get a good experience with the other issues of anesthesia. Over time intubations become less of a big deal and you realize there is so much more to anesthesia. Second I have found that the best interactions I have with attendings is when they come into the room in the middle of the case to relieve the resident for a break. Ask to stay around because it allows you to have 1 on 1 time with the attending. This is a great oppurtunity to learn and impress the attending at the same time. If you hop from room to room you will lose this oppurtunity.
 

IV Doc

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jc237 said:
I'm also taking my anes sub-I very soon. I'm a little worried about that b/c I'm a third year student and I heard that taking pulmonary, cardiology, SICU electives before doing subI is a good idea. Needless to say, I haven't done any of the three.... my anes attendings next week are gonna think I'm a ******* :scared:
Those rotations are helpful if you are a resident but almost no one has taken them prior to doing the anesthia subI. The reason for this is you want to do your sub i in July, Aug. Personally I think all of those rotations are helpful and impressive but do them after you sub I. The reason that they are helpful is they show you interest in areas of medicine that are related to anesthesia.
 

IV Doc

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did i mention it is wonderful being a fourth year with nothing to do but read this board. My day consisted of a 45 minute lecture at the hospital. I think july will be a shock when I have to work again.
 

apma77

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what most students do is just show up in the OR to intubate and run away..that is really not appreciated and will not make you many friends who are residents. I personally wont let a med student intubate my patient unless he/ she know something about the patient and their airway.
some medstudents have the audacity to walk into the OR and know nothing about the patient and want to do the fiberoptic intubation and run away as soon as the tube is in!

If you are willing to intubate the patient then you should be willing to babysit the patient for the rest of the case with me and discuss patient management.
medstudents who are not willing to be a part of the team are frowned upon.
 

chicamedica

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mygassmellsfine said:
i love 4th yr so how rich are we going to be???? ;)

Um, aren't you an undergrad? If you're going into gas only for the money you'll be miserable and i feel quite sorry for you.