• Rotation Director: Peter Dendel, M.D.
• Rotation Location: Scripps Green Hospital, La Jolla, CA
• Rotation Duration: One 4-week block
• Trainees/month: One

Education Purpose and Rotation Description:

The Anesthesia rotation at Scripps Green Hospital provides fellows with hands-on experience in managing and maintaining an open airway in perioperative patients. Fellows will also gain familiarity with placing vascular lines and administering muscle relaxants, narcotics, and anxiolytic medications. Under the direct supervision of a staff anesthesiologist, fellows will be involved in all aspects of patient care.

Rotation Objectives:

• Acquire knowledge and clinical experience in the following areas:
  • Understand the effects of anesthesia on pulmonary and cardiac function.
  • Recognize indications, contraindications, side effects, and safe application of muscle relaxants, narcotics, anxiolytics, and anesthetic agents.
  • Demonstrate techniques for establishing and maintaining an open airway.
  • Maintain normal cardiac physiology parameters in patients with surgical pathology or under sedation or general anesthesia.
  • Apply appropriate treatment for hemodynamic instability, including the use of intravenous pressors and antihypertensives.
  • Utilize ventilatory support, weaning, and respiratory care techniques.
  • Master intravenous and arterial access techniques.
• Acquire knowledge of and competence in performing the following procedures, including indications, contraindications, complications, and limitations:
  • Manage the airway in non-intubated, unconscious, or paralyzed patients.
  • Perform procedures related to intravenous access, arterial line placement, and hemodynamic monitoring.
  • Use reservoir masks and other adjuncts for supplemental oxygen delivery.
• Acquire knowledge and clinical experience in Interpretation of diagnostic studies and data pertaining to hemodynamic monitoring.
• Gain additional knowledge, skills, attitudes, and education experience in the core competency areas of patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and systems-based practice by:
  • Actively participating in multidisciplinary conferences.
  • Effectively communicating with physicians from other services to ensure optimal patient care.
  • Obtaining informed consent for all invasive procedures.
  • Ensuring adequate sedation/pain control for all procedures and treatments.
  • Communicating patient orders to healthcare personnel in a professional manner and following hospital guidelines.
  • Understanding and implementing hospital and national regulations regarding patient privacy (HIPAA).

Rotation Schedule:

• Monday: full day at rotation.
• Tuesday: full day at rotation.
• Wednesday: Half day at rotation in the morning and academics in the afternoon.
• Thursday: Half day at rotation in the morning and clinic in the afternoon.
• Friday: A full day at rotation.

Learning Venues and Teaching Methods:

Conferences:

• Please refer to the schedule.

Direct Patient Care:

• Scripps Green Hospital Department of Anesthesia, Main OR, PACU
• Pulmonary Clinic

Suggested Reading:

1. Ripple’s Intensive Care Medicine.
2. Walls’ Manual of Emergency Airway Management.

Evaluation:

Trainees will receive a written evaluation upon completion of their rotation. This evaluation will assess their cognitive, patient management, procedural, and humanistic skills. The evaluation, including suggested areas for improvement, will be discussed personally with the trainee at the end of the rotation and then shared with the Fellowship Director to be included in the trainee’s permanent file.