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Transcript
Anesthesiology
Lifeline to Modern Medicine
Anesthesiology: The Early Years
1799
1840s
1905
British chemist Humphry
Davy discovers anesthetic
qualities of nitrous oxide
Harvard professor Charles
Jackson suggests ether
has anesthetic properties
The American Society of
Anesthesiologists (ASA) is
founded
October 1846
Dentist William Thomas Green Morton successfully
demonstrates ether anesthesia in public
November 1846
Word spreads as the first article appears in The
Boston Medical and Surgical Journal
2
Anesthesiologists Make Modern
Medicine Possible
Anesthesiologists are the leaders in
patient safety and each day save
countless lives.
– They are highly specialized physicians whose
work transcends the operating room, including
taking the lead in intensive care and pain
medicine.
– These specialists make modern medicine
possible by maintaining a patient’s Vital Health
when he/she is most vulnerable.
3
Anesthesiologists and Vital Health
By definition, Vital Health is how effectively a person
maintains a healthy lifestyle and how that impacts wellness
and medical outcomes.
– Vital Health measures include body mass index, cholesterol levels
and blood pressure.
– By ensuring that vital signs are optimized when patients are often at
their most vulnerable, anesthesiologists are the keepers of Vital Health.
– As such, they’ve created the Vital Health Tool, an interactive survey to
assess patients’ Vital Health located at www.knowyourvitalhealth.com.
4
Training and Education
Requirements
Anesthesiologists must fulfill extensive training and
education requirements, through which they become eligible
for board certification by the American Board of
Anesthesiology. These requirements include:
– Earning an undergraduate degree and fulfilling pre-med requirements
(four years)
– Graduating from medical school (four years)
– Specializing in anesthesiology during a one-year internship and threeyear residency program
– Receiving subspecialty fellowship training that can last several additional
years (optional)
5
Role on the Anesthesia Care Team
– With at least eight years of postundergraduate training,
anesthesiologists are equipped to
lead Anesthesia Care Teams.
– In this role, they supervise and
delegate tasks to non-physician
anesthesia providers such as nurse
anesthetists (NAs) and
anesthesiologist assistants (AAs).
– But anesthesiologists assume
overall responsibility for the safety
and well-being of patients before,
during and after medical
procedures.
6
Anesthesiologist
Anesthesiologist
Nurse
Assistant (AA) Anesthetist (NA)
7
What Anesthesiologists Do Before
Medical Procedures
– Review their patients’
general medical history,
including:
•
•
•
•
•
8
Medical conditions and
diseases
Medications (supplements,
herbals, OTCs, habits)
Allergies
Relevant family histories
Experiences with
anesthesia
What Anesthesiologists Do Before
Medical Procedures
– Conduct focused physical
examinations
– Order, review and interpret lab
tests and diagnostic studies
– Order preoperative medications
– Develop comprehensive
anesthesia plans
– Obtain informed consent from
their patients to undergo
anesthesia
9
What Anesthesiologists Do During
Medical Procedures
– Administer and maintain appropriate levels
of anesthesia
– Monitor and support vital functions such as:
•
•
•
•
•
•
Brain function
Heart function
Breathing
Blood pressure
Body temperature
Body fluid balance
– Diagnose and treat medical conditions
– Manage fluid therapy and blood
transfusions
10
What Anesthesiologists Do After
Medical Procedures
–
–
–
–
–
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Help safely transfer patients to the Post-Anesthesia Care Unit (PACU)
Provide necessary pain relief
Manage respiratory care
Provide immediate postoperative care
Evaluate patients for discharge
Beyond the Operating Room
– As medical technology has advanced, so has the need for
anesthesiologists to participate in procedures that occur outside the
traditional operating suite. These procedures often include:
•
•
•
Radiological imaging
Gastrointestinal endoscopy
Placement and testing of cardiac pacemakers and defibrillators
– Beyond the operating room, anesthesiologists also frequently practice
in settings such as:
•
•
•
12
Intensive care units (ICUs)
Labor and delivery suites
Pain medicine offices
The ICU
– Because of their extensive training in clinical
physiology/pharmacology and resuscitation,
anesthesiologists are uniquely qualified to
coordinate the medical care of patients in the
ICU. Responsibilities include:
•
•
•
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Medical assessment and diagnosis
Respiratory and cardiovascular support
Infection control
The ICU
– Anesthesiologists also
possess the medical
knowledge and technical
expertise to deal with many
emergency and trauma
situations. They often provide:
•
•
•
•
Airway management
Cardiac and pulmonary
resuscitation
Advanced life support
Pain control
– Anesthesiologists play an
active role in stabilizing and
preparing patients for
emergency surgery, as well.
14
Labor and Delivery
– Anesthesiologists protect the safety and well-being of expectant mothers and
babies, and also provide pain relief during labor and delivery.
– Working with obstetricians, anesthesiologists offer expectant mothers pain
relief options such as:
•
•
•
•
15
Breathing exercises and relaxation techniques
Pain medications
Local blocks
Regional techniques
Labor and Delivery
– Regional anesthetic techniques
(spinal, epidural and combined
spinal-epidural) are often used
during labor and delivery
because they:
•
•
•
Provide better pain relief
Allow patients to participate in
the birthing process
Don’t make babies sleepy after
delivery
– During emergency Caesarean
sections, anesthesiologists
provide surgical anesthesia while
managing the life functions of
mothers and babies.
16
Pain Medicine
– Whether the result of injury, illness or a chronic condition, 70 million
Americans experience pain annually.
– Anesthesiologists are pain medicine specialists with extensive experience
diagnosing and treating both acute and chronic pain conditions such as
arthritis, back and neck pain, cancer pain, nerve pain, migraine headaches,
shingles and pain caused by AIDS.
– As pain medicine specialists, they develop appropriate treatment plans after
thoroughly researching and evaluating patients’ conditions. This involves:
•
•
•
•
•
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Working closely with primary care physicians
Reviewing medical records and X-rays
Asking patients for detailed information such as the onset and location of pain
Performing physical examinations
Possibly ordering additional tests
Pediatric Anesthesia
– As physicians, anesthesiologists know how children react to hospitals and
surgery. They therefore work with other doctors to make hospital visits as
pleasant as possible for children.
– Anesthesiologists are specially trained to maintain the safety and comfort of
children before, during and after medical procedures. Responsibilities include:
•
•
•
•
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Ensuring parents and children are well prepared for procedures
Monitoring and supporting vital functions such as heart rate, breathing and blood
pressure during procedures
Providing pain relief and consultation in the pediatric ICU after procedures
Providing consultation even when children do not undergo operations
Pediatric Anesthesia
– The ASA has developed
a set of tips located at
www.lifelinetomodern
medicine.com to help
parents prepare their
children for surgery.
19
Geriatric Anesthesia
– More than 12 percent of the total U.S.
population is over age 65 and, of that
segment, more than half will undergo at
least one surgical procedure as senior
citizens.
– Anesthesiologists inform and care for
senior patients before, during and after
medical procedures.
20
Geriatric Anesthesia
– A person’s age can impact his/her anesthesia experience with:
• Cardiovascular, respiratory, kidney and mental functions
• Body temperature regulation
• Medication effects
– The ASA has developed a set of tips located at
www.lifelinetomodernmedicine.com to help prepare senior citizens and
their caregivers for surgery.
21