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Obstetric Anesthesia Rotation Plan

Focus Of This Rotation

Providing peripartum anesthetic management for high-risk parturients including all complex cases of labour analgesia, caesarean section and other operative deliveries. This includes patient assessment, identification of contraindications, discussion of risks/benefits and consent, identification of required monitoring and execution of the management plan as well as resuscitation of the unstable parturient. Management includes parturients with complex medical conditions and medical conditions / complications of pregnancy.

 

CBD Stage For This Rotation

Core of Discipline - Anesthesia

 

EPA For This Rotation

  • COD 4 Managing patients presenting with a difficult airway, including developing plans for extubation. Target # of Entrustments (EEM): 4
  • COD 7 Providing peripartum anesthetic management for high-risk parturients. Target # of Entrustments (EEM): 6 + MSF
  • COD 8 Initiating resuscitation and providing anesthetic management for unstable parturients. Target # of Entrustments (EEM): 2
  • COD 24 Providing care for patients who have experienced a patient safety incident. Target # of Entrustments (EEM): 0 - 1

 

Key Objectives For This Rotation

By the end of the rotation, the resident should be able to:
  1. Use complete, accurate assessments and anesthetics considerations for consultations of high risk parturients with, but not limited to, hypertensive disorders of pregnancy, respiratory disease, cardiac disease, morbid obesity, endocrine disease, hematologic and coagulation disorders. Role - Medical Expert
  2. Demonstrate advanced breadth of knowledge, clinical application and appropriate procedural skills in the perioperative management of high risk parturients for the delivery of the newborn in emergent and non-emergent situations. Role - Medical Expert
  3. Demonstrate advanced critical thinking, insight, judgement and management of the unwell parturients. Role - Medical Expert
  4. Recognize and manage emergency conditions of unstable parturients resulting in prompt and appropriate treatment; diagnostic tests and therapeutic interventions are appropriate and consultative services are usually appropriately consulted. Remain calm, act in a timely manner and prioritize correctly. Role - Medical Expert / Professional
  5. Demonstrate competence in intrapartum and postpartum neonatal resuscitation. Role - Medical Expert
  6. Establish a therapeutic and effective relationship with patients and communicate well with family. Provide clear and thorough explanations of the perioperative anesthetic plan, including risk and potential complications, in a professional manner. Demonstrate empathy and sensitivity to racial, gender and cultural issues. Role - Communicaton
  7. Work effectively and respectfully with multidisciplinary teams. Convey clinical reasoning and rationale for decision-making. Role - Collaborator
  8. Demonstrate an understanding of prioritization of patients, carry out cases in a timely manner with available resources, and takes appropriate safety precautions for self and others. Role - Professional
  9. Take appropriate actions to ensure patient safety and limitation of adverse events, including appropriate management of complications when they occur, all to the highest ethical standard. Role - Health Advocate / Professional

 

Other Goals, Objectives Or Activities:

 

Physiology
  • Physiologic changes of normal pregnancy and anaesthetic implications
  • Physiologic changes that accompany the onset of labour, delivery and postpartum

 

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