Yes, I assumed you didnt do off service rotations but asked since I have heard of a couple that do. I find it weird that some IV practice and medication quizzes makes you even remotely qualified to run sedations.
What was the plan to handle emergencies?
How many people had you bag-masked prior to starting to run sedations?
How many people had you intubated prior to starting to run sedations?
Just my thoughts. People may disagree, but it boggles my mind.
All fair questions for sure. There was extensive courses we reviewed and simulated prior to doing any sedations. You aren't ever in there by yourself, they know you haven't ran sedations before and haven't done your anesthesia training. Before you can run sedations where we are, you have to take and pass ALCS, BLS, ATLS, and PALS. We don't have any experience intubating anyone on a live human for the exception of doing it on manikins in ACLS and ATLS and PALS (I am sure its quite different). During the summer the residents that had done their anesthesia training (upper levels at our program) would run the sedations and we would shadow them, they would train us on all the medications and when to give them and why, when not to give a certain medication, etc. We reviewed all emergency protocols and how to run an emergency (laryngospasm, bronchospasm, seizure, MI, etc)
When we did start having more involvement in running sedations the chief in there during the surgery will give you one attempt to get the IV started, if not - they would do it. After that they guide/help you in terms of what medications to give, when and why. This was all part of the training I mentioned prior to running any sedations that reviewed in our anesthesia course during the summer and the shadowing. There was always an attending and upper level in the room during a sedation but we followed certain protocols in place depending on the emergency.
I don't disagree with anything you have said, in fact, just the training I did this year on running sedations has opened my eyes into how scary/bad things can get so fast. I just want to be clear that us interns were never running sedations solo. After our courses, simulations, ATLS, ACLS, PALS and other trainings I felt more comfortable running sedations but I always had an attending and an upper level in the room. I will add that they were very strict and tough on us when running sedations - if we didn't have the room set up properly, had the anesthesia log filled out correctly, had the correct emergency drugs out or any drugs for that matter out, knew the MOA of each drug we gave and had on our cart then it wouldn't be good aka they'd yell or reprimand us.
With everything I've talked about, I wouldn't consider myself to be fully qualified to run a sedation by myself and completely comfortable until I complete all my anesthesia training. There are too many variables to consider and things that can go wrong that doing just what we had for training isn't enough in my opinion. I am very grateful for the training thus far and I think it was really solid training to roll me into my anesthesia rotation next year. Let me know your thoughts.
