Námsþættir – Units of Training

Í upphafi skulu allir gera 19 skylduæfingar (WPBAs) sem eru hluti af aðlögun og innleiðslu í starfi. Þeir taka á fjölmörgum þáttum er snúa almennt að vinnuumhverfi svæfinga- og gjörgæslulækna en æfingarnar eru ekki lokaþjálfun á umræddum atriðum heldur kynning á því sem í þeim felst. Þessi hluti nefnist IAC – Initial Assessment of Competence og er einnig skylduhluti fyrir sérnámslækna í bráðalækningum sem sækja námsvist á svæfingadeildum:

  • A-CEX
    • Preoperative assessment of a patient who is scheduled for a routine operating list (not urgent or emergency)
    • Manage anaesthesia for a patient who is not intubated and is breathing spontaneously
    • Administer anaesthesia for acute abdominal surgery
    • Demonstrate Rapid Sequence Induction
    • Recover a patient from anaesthesia
  • DOPS
    • Demonstrate functions of the anaesthetic machine
    • Transfer a patient onto the operating table and position them for surgery
    • Demonstrate cardio-pulmonary resuscitation on a manikin
    • Demonstrates technique of scrubbing up and donning gown and gloves
    • Core Competencies for pain management – manages PCA including prescription and adjustment of machinery
    • Demonstrates the routine for dealing with a failed intubation on a manikin
  • CBD
    • Discuss the steps taken to ensure correct identification of the patient, the operation and the side of operation
    • Discuss how the need to minimise postoperative nausea and vomiting influenced the conduct of the anaesthetic
    • Discuss how the airway was assessed and how difficult intubation can be predicted
    • Discuss how the choice of muscle relaxants and induction agents was made
    • Discuss how the trainee’s choice of post-operative analgesics was made
    • Discuss how the trainee’s choice of post-operative oxygen therapy was made
    • Discuss the problems emergency intra-abdominal surgery causes for the anaesthetist and how the trainee dealt with these
    • Discuss the routine to be followed in the case of failed intubation

Þá er sérstakur námsþáttur sem snýr að aðlögun og innleiðslu starfa á fæðingadeild – Initial assessment for competence in obstetric anaesthesia – IACOA

  • A-CEX
    • Conduct epidural analgesia for labour (sama og í Core competency)
    • Conduct regional anaesthesia for caesarean section (sama og í Core competency)
    • Conduct general anaesthesia for caesarean section (sama og í Core competency)
  • DOPS
    • Top up epidural for labour analgesia (sama og í CC)
    • Top up epidural for caesarean section (sama og í CC)
    • Perform spinal anaesthesia (sama og í CC)
  • CBD
    • Discuss how the changes in the anatomy and physiology due to pregnancy influenced the conduct of anaesthesia
    • Discuss whether pregnancy influenced the choice of drugs used during anaesthesia
    • Discuss how the conduct of general anaesthesia is affected by late pregnancy
    • Examine the case records of a patient that the trainee has anaesthetised for operative delivery in a situation where major haemorrhage might be expected. Discuss the factors that influence the likelihood of major obstetric haemorrhage, the precautions that should be taken to deal with it and the principles of its management
    • Examine the case records of a patient with pregnancy associated hypertension that the trainee has treated. Discuss how this influences anaesthetic management
    • Examine the case records of a patient for whom the trainee provided extradural analgesia for normal labour. Discuss the methods of pain relief available for normal delivery

Öðrum námsþáttum er skipt milli ára auk þátta sem skal lokið skv skiptingu sérgreina milli deildanna tveggja. Námsþættirnir eru misstórir en almenna viðmiðið er að til grundvallar samþykkis á námsþætti (Completion of Unit of Training – CUT) sé eitt WPBA af hverri tegund, samtals þrjú stykki.

  • 1. ár
    • Preoperative assessment
    • Premedication
    • Induction of general anaesthesia
    • Intra-operative care
    • Postoperative and recovery room care
    • Management of respiratory and cardiac arrest
    • Control of infection
    • Introduction to anaesthesia for emergency surgery
  • 2. ár
    • Airway management
    • Critical incidents
    • Day surgery
    • Non-theatre / transfer
    • Paediatrics
    • Pain medicine
    • Regional
    • Sedation
    • Trauma and stabilisation
  • Húsbundnar sérgreinar
    • General, urological and gynaecological surgery
    • ENT, maxillo-facial and dental surgery
    • Obstetrics
    • Orthopedic surgery