Introduction to anesthesia

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An introduction to anesthesia for undergraduates

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Introduction to anesthesia

  1. 1. Where to go.....?Follow your heartKnow your heart…..and most importantly……..have a heart!
  2. 2. Where to go.....?If your favourite place in the world is the operating room, be asurgeon.If your favorite place in the hospital is the operating room, bean anesthesiologist.
  3. 3. TRUE OR FALSEYou are more familiar with a surgical knife [1] and catgut thanan oropharyngeal airway ….[2]You have observed breast lump excision or appendicectomy[3]better than a peripheral vein cannulation…[4]More often, learning to drive a car will prove easier and useful,than learning to fly an aeroplane!
  4. 4. ….. Anaesthesiology…….?
  5. 5. What we do…Practice clinical pharmacology and physiology!Administrators of medications to alter physiology andpathology: immediate response!
  6. 6. What we do..Analysts and rapid problem solvers!Team leaders.
  7. 7. What we do…Our working environment: complex, technical, requires multi-tasking!
  8. 8. Why anaesthesiology?Clinical and Basic Research!
  9. 9. SkillsAssessment of patient readiness for surgeryAirway management!Pharmacology!Resuscitation!Fluid replacement!Postoperative pain control!Regional anesthesia!Oxygen transport!Operative stress reduction!
  10. 10. We go to…..• Operating rooms!• • Intensive care units!• • Labor and delivery suite!• • Pain clinic!• • Radiology suite!• • Gastroenterology suite!• • Ambulatory care centers
  11. 11. Procedures.
  12. 12. ProceduresSedation outside ORLabour analgesiaCentral venous cannulationArterial cannulationIntubationPercutaneous tracheostomyLumbar punctureACLS
  13. 13. Our tools….• • Inhaled anesthetics!• • Local anesthetics!• • Induction agents!• • Muscle relaxants!• • Opioids!• • NMDA antagonists!
  14. 14. Why anaesthesia?The Objectives• Loss of awareness / Amnesia!• Analgesia!• Reduce movement in response to stimuli!• Minimize autonomic responses to surgical stimuli!• Muscle relaxation- if required!• Autonomic Regulation!
  15. 15. Youngster !Unlike many other medical specialties, anesthesiology isyoung.!• Availability of effective surgical anesthesia:~150 years.!• Greatest advances: since 1950.!
  16. 16. What a change!1950: Death rate from anesthesia 1 : 1,500!1995: Death rate from anesthesia 1 : 250,000!
  17. 17. Slide masterYour Text here
  18. 18. Big momentThis demonstration occurred at the Massachusetts GeneralHospital on October 16, 1846Dr. Warren removed a congenital vascular malformation from20-year-old Edward Gilbert Abbott’s neck. After the surgery,the patient replied, “I did not experience pain at any time,though I knew that the operation was proceeding.”
  19. 19. Slide masterYour Text here
  20. 20. SafetyPULSEOXIMETER [1990]ETCO2[1996]TRANS ESOPHGEAL ECHO[TEE]BISPECTRAL INDEX [BIS]ENTROPYFOB- INTUBATION / LAVAGEPULMONARY ARTERIAL CATHETER
  21. 21. StepsYour Text here
  22. 22. EvaluationHistoryPhysical examinationLab tests
  23. 23. OptimizationYour Text here
  24. 24. Prepare them; prepare ourselvesPreop ordersExplanationPreparing OTEquipments and drugsChoice of anaesthesiaInduction, IntubationMonitoringReversal and extubationPACU
  25. 25. Spinal and Epidural anaesthesia
  26. 26. SpecializationsCritical careCardiac AnaesthesiaPain and palliative careNeuroanaesthesiaObstetric , Pediatric Anaesthesia
  27. 27. Thoughts …….Good judgment is based on experience and experience is basedon bad judgment.Savor your successes but do so quickly and then move on—dwelling on them causes overconfidence.
  28. 28. Thoughts …….Some patients you think will get better will get worse.Some patients you think will get worse will get better.When you’re making decisions on rounds, put personalproblems aside.
  29. 29. Hello……You get to interact with the whole menagerie of medical andsurgical specialties
  30. 30. What suits one customer might not suit the next;individualize your Rx .....always
  31. 31. Support! different situations by specific tools.
  32. 32. Patient is more imporant than our ego;call for help, whenever patient is indangerYour Text here
  33. 33. Thank youvisit me @ www.thelaymedicalman.blogspot.inwww.facebook.com/groups/anaesthesiaindiaMacintosh noted: “for the surgeon the spinalends with the injection of the agent; for theanesthetist it begins with the injection of theagent.”
  34. 34. Slide masterYour Text here

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