Dr. Essam Manaa e_manaa@yahoo pager # 2017

1. Dr. EssamManaae_manaa@yahoo.compager # 2017 045 Course Outline

2. Lecture Objectives.. • The format of the course • Knowlede and skills that can be gained • Course program • Materials - text books - clinical anesthesia

3. Attendence Requirement Assessment Final exam Contact information Dr. Manaa ………. bleep 2017 or tel. 92005 Dr. Waleed ……….bleep 2032 or tel. 92356 Mr. Waleed ……… tel. 92356

4. LECTURES

5. Role of anaesthetist in the preoperative care The student will learn pre-anesthetic patient evaluation and risk stratification • Obtain a full history and physical examination including allergies, current medications, past anesthetic history, family anesthetic history • Understand how patient co-morbidities can affect the anesthetic plan • Able to plan an anesthetic for a basic surgical procedure • Understand risk stratification of a patient undergoing anesthesia

6. General objectives of the emergency room management • Recognize and be aware of the basic management of common BLS and ACLS protocols • Gain experience in the evaluation and management of patients presenting to the ER for acute care • Developing proficiency with emergency procedures • Expanding the knowledge in acute care medicine to include , Acute Chest pain, Trauma ,and shock management

7. General anaesthesia technique • Definition of general Anaesthesia • Steps of general anaesthesia • Learn about several agents used on induction & maintenance of general anaesthesia • Complications commonly encountered during general anaesthesia

8. Airway Management and equipment • Basic airway anatomy • Conduct a preoperative airway assessment • Identify a potentially difficult airway • Understand the issues around aspiration and its prevention • The management of airway obstruction • Become familiar with airway equipment • Practice airway management skills • Learn about controlled ventilation • Know the different ways of monitoring (oxygenation and ventilation)

9. Regional Anaesthesia Techniques • What are the risks and benefits of regional (epidural/spinal) anesthesia? • What are the contraindications to regional anesthesia? • How do you prevent hypotension following epidural/spinal anesthesia?

10. Intravenous Fluid Resuscitation and Blood Transfusion • What perioperative factors affect the patient’s fluid requirements? • How do you estimate maintenance fluid requirements? • List the potential physical and laboratory findings seen in a patient with a volume deficit • How do you calculate the patient’s perioperative fluid deficits? • Know information about blood products • Identify the risk and complications of blood transfusion

11. Monitoring During anaesthesia • Standard Monitors : • Non-invasive blood pressure • ECG • Pulse oximetry • Capnography (CO2 monitor) • Temperature • ***Peripheral nerve stimulator • Specialized monitors : • Arterial line (invasive blood pressure) • Central venous line (cvp monitoring) • Pulmonary artery flotation catheter ( monitors function of right and left side of the heart) • BIS monitor (depth of anesthesia) • TOF

12. Vascular Access • Anatomical considerations • Prepare and set-up an IV infusion set • What are the different sites suitable for central venous catheter placement? • Discuss precautions • Indications and complications of central venous access

13. Management of postoperativecomplications • Study post-operative respiratory and hemodynamic problems • Learn about PONV • Post-operative agitation and delirium • Learn about the causes of delayed emergence and know how to deal with this problem • Postoperative shivering

14. Pharmacokinetics and Pharmacokinetics a) Types of Anesthetics b) Adjuvants c) Reaction in different situations d) Interaction e) Fate

15. Postoperative pain management a) Learn types of pain b) Complications results from pain c) Stepladder way for pain management d) How to deal with adult and pediatrics e) Multimodal use of drugs

16. Practical Activities

17. Enabling Objectives in the operative room General Anesthesia • Anesthetic Machine • Airway management • Intravenous access Regional Anesthesia Indications and contraindications USG nerve block Local anesthetics

18. Enabling Objectives in the Emergency room • Resuscitation • Assessment of the patient • Anaphylactic reaction • Management of Trauma patients • Management of shock

19. Case Scienario with Simulation • Case • Possibility • Way of discussion • Management • Human application

20. Post-operative Care Unit Orientations PACU HDU SICU

21. Books recommended • Anesthesia for medical students (Bryce Smith) • Literature & Manual (Dept. of Anesthesia) • - Anesthesia (Carl Gwinnutt) • Equipments and Practice in Anesthesia For Medical Students • Pain Pocket Guide

22. Written examination OSCE examination

24. Key Success Factors • Attendance • Realistic Expectations • Maintains communication with the faculty member • Good organizational skills • Expect to work beyond the classroom • Stay on track/understand commitment required • Ask questions