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Anaesthesia 101

Anaesthesia 101. What the JMO Needs to Know And….The Anaesthetic Career Path. Libby Freihaut Staff Specialist Anaesthetist HNEH 2011. A Brief Bio. *Newcastle education *5yrs undifferentiated doctor *Anaesthetic training *FANZCA 2006 *Darwin, Newcastle, Gosford, Hobart, Public, Private

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Anaesthesia 101

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  1. Anaesthesia 101 What the JMO Needs to Know And….The Anaesthetic Career Path Libby Freihaut Staff Specialist Anaesthetist HNEH 2011

  2. A Brief Bio *Newcastle education *5yrs undifferentiated doctor *Anaesthetic training *FANZCA 2006 *Darwin, Newcastle, Gosford, Hobart, Public, Private *Fiji, Timor Leste, Indonesia *80% Staff Specialist in Anaesthesia. 20% Private Practice.

  3. Today’s Menu • What is Anaesthesia? The many ways to skin a cat. • What the JMO/RMO needs to know *Booking surgical pts *Post –op care / pain management *Anaesthetic complications • Anaesthetic experience and/or training

  4. 16th October 1846?

  5. “Gentlemen, this is no Humbug”

  6. First Public Demonstration of Surgery under Anaesthesia • MGH Boston • William Morton- Dentist • John Warren-MD • Gilbert Abott- Patient • Vascular Tumour of the Jaw • Ether

  7. A Short Film • Tunnel vision • Effective communication • What do your colleagues need to know to do their job?

  8. The Triad Of Anaesthesia Unconsciousness Relaxation Analgesia

  9. SLEEP • Induction • Maintenance • IV • Volatiles • Other routes

  10. RELAXATION • Paralysis • Enough of the sleepy medicine • Motor Block using LA

  11. ANALGESIA • Multimodal • Simple- Paracetamol, NSAIDs • Opiates • Gasses- N20, Ether • Local Anaesthetic- nerve blocks • Ketamine, Clonidine • Antineuropathics…Amitriptyline, Calproate

  12. Choosing the right mix • Balanced Anaesthesia • Patient Factors • Surgical Factors • Anaesthetic Factors

  13. Eyelid tumour….oh and that thing in the neck

  14. but you weren’t expecting this!

  15. Choosing the right mix • Balanced Anaesthesia • Patient Factors • Surgical Factors • Anaesthetic Factors

  16. Booking A Patient for OT • What does the anaesthetist want to know?

  17. Booking A patient for OT Comorbidities Relevant Ix / Ex / Correspondences Fasting Consent Post-op plans • Who ? • Where? • What is the surgery and why? • Urgency • Surgeon and availavbility

  18. Post-Op Care/ Pain Mx/Complications • Pain Relief • Fluid Management • Nerve Blocks • Epidurals • Oversedation • Airway problems • Dental / awareness/ confusion / pain/ paralysis

  19. Post-op Care / Pain Mx/ complications • What have you observed? • Who do I ask? • I never really understood the point of…. • I just can’t get my head around…..

  20. Career Path • Get good, well rounded experience first • Don’t Rush • Do What you Love doing • Do what you are suited for • Talk to the old /wise / experienced • You are more than a doctor

  21. Anaesthetic Training • Resident terms • SRMO- Critical Care Year • Registrar appointments • The Exams • BTY1, BTY2, ATY1, ATY2, ATY3 (Fellowship)

  22. Anaesthetics leads into… • Subspecialities • Paeds • Obs • Cardiothoracics • Acute and Chronic Pain • ICU • Retrieval • Teaching

  23. Anaesthesia Allows you to • Be Flexible • Change Track • Travel • Work O.S. • Be Public • Be Private

  24. Now some unsolicited advice • Don’t be rushed • Do what you enjoy, and what you believe in • Look after the physical, mental and spiritual health of yourself and your family • You are more than a doctor • Insure you greatest asset- “income protection”

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