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Anaesthesia in the Atlantic Provinces

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Anaesthesia in the Atlantic Provinces THE NOVA SCOTIA MEDICAL BULLETIN Editor-in-Ch ief Editorial Board Manaqinq Editor DR. lA~ E. PURKIS DR. c. J. w. BECKWITH Board Corresponding Members Departments D R. I. D. ~1AXWELL Secretaries of Branch Societies ~Iedico-Legal Column D R. D. A. E. SIIEPUARO DR. I. D. ~IAX WELL D R. W. E. P oLLETT Ad vertising D R .\. J. B o oR DR. D. A. E. SHEPHARO T his issue contains a Symposium on Anaesthesia based on papers presented at t he Atlantic Regional Meetin g of the Canadian Anaesthetists' Society, St . J oh n 's, Newfoundland, September 1967. Coordinating Editor: Dr. David Shephard Anaesthesia in the Atlantic Provinces c. 1:. HuoEnsox. ~ID. c:.r. CRCP(C). FACA* St. J ohn"s, Newfoundland The pre entation of this ymposium by anaes­ .\dvances in medical cience are progre sing at thetists or the Atlantic Province is in itseif signifi­ such a rapid rate that within the past twenty years can t. It points to the increasingly important role there has been an almost complete change in the ~· hi ch the specialty and its practitioners are playing practice of anae thesia and doctors practi ing in m the medical and urgieal care of patients in thi this field need constant refreshment and renewal. part of the world. The regular attendance at regional and national meetings cannot help but make one appreciate the Tht subjects co,·ered in thi ympo ium are largely nature and rapidity of these changes. For many tho t' presented at the Annual Regional ~ Ieeting of years anaesthe ia was limited to the subduing of the Canadian Anaeslhetists· ociety of the Atlantic patients for surgical inten·entions and very little, Provinces held in t. John's, Newfoundland, last if any, empba is was laid on the proper maintenance autumn. These meetings, or which this was the of phy iological normalcy in the major body systems. ~v('nt h. have been held regularly at various centres \\"ith the coming of a deeper understanding of In the Atlantic Provinces and have grown in stature various body functions and subsequently the man­ OV('r the years both in the quality or paper presented agement of malfunctions it has become necessary and t he number of doctors in attendance. The Cor the modern anaesthetist to become what has merr ber of the joint division s of the Canadian been described as the internist of the operating and .\na('sthetist's ociety in the Atlantic Pro,·inces are post-operative reco,·ery rooms. This is most ob­ happy to present to the members or The Xova 'ions when one considers the great number and co 1a :\l edical ociety this symposium and hope Yariety of surgical and diagno tic procedures now that the ubjects treated are or such a broad nature being carried out on the Yery young, the Yery old a to be of general interest to all readers. and the very ill patient. From the Department or Anaesthesia. t. John's General Hospital. St. John's, ~ewroundland. 'i'H E ~OVA COT!A MEDICAL BULLET!, 97 JU~E. 1968 Anaesthetists are constantly pre ented with a full might be of some interest to note that a recent re. spectrum of abnormal body fun ction related to the 1-iew of are idency program at the t. John' Gen. disease, the surgical procedure and the drug which era! Ro pita! (Kfld.) reveals that of thirty- c1·en they them eh·es u e to carry the patient through residents who have passed through the program the particular illness and operation. In order to ince 1955 thirty ha1·e continued on in anae the.~ia cope adequately with tbi wide nriety of problem and have been ucces ful in obtaining Certification it i essen tial that the anae thetist be very broadly or Fellowship. or are presently qualified to write trained. AIt bough techu.ical expertise is considered the e examinations. ~lost of the anaesthetist in a sine qua non of the e:-.--pcrt, the indi1·idual must the pro1•ince of Xewfoundland at this time ha1·e had resist the temptation to become a mere technician contact in some way with the training program at and must keep abreast of change in knowledge the t. John's General Hospital but others have un­ and technique and be malleable enough to apply fortunately for us migrated to distant areas where these changes so that they will help to impro1·e the economic and climatic conditions appeared to be care of patient entrusted to him. more de irable. Anaesthesia in the Atlantic Pro1·inces, we belie1·e. Another important aspect of the overall training program in this area has been the series of refresher has kept up to date and in fact certain advances cour es produced by the t;nivcrsity staff primarih· ha1·e been introduced by anaeslhetisls in the first instance. orne of the c were post-anaesthesia for part-time anaesthetists. or to e:-.--pre it mo~ reco1·ery rooms, followed more recently by intensive clearly family physician who do some anaesthesia. care units, inhalation therapy departments and re­ The e courses have been run at least annuallv bv the staff of Dalhousie t;ni1·er ity. and hal'e suscitation teams. In these area the anaesthetist a l~ra~:s has become recognized as a leader and plays a large been popular and useful. The Atlantic Regional role in the teaching of programs for the treatment of ~1eet ing of the Canadian Anaestbetists' ocietv ha en·ed as a refresher course for pecialists in th~ shock, respiratory di order~ and resuscitation to field and bas the added adl'antage of permitting the both medical and paramedical personnel. physicians in volved to meet annually, and thus get . \ rough un·ey of the health department tatistic to know one another's problem . in the Atlantic region re1•eal the urprising fact Furthermore the new medical cbool which is pro­ that approximately two hundred thousand (200.000) gres ing rapidly at the ~Iemorial University of Xcw­ anaesthetics are administered in the four Atlantic foundland will bring ad1·ance in anae the ia edu­ Prol·inces annually. or the e it is estimated that cation in this area. The formation of a full unil·er­ from fifty to sixty percent are administered by fully sity department of anaesthesia and the inception of a trained specialists. These figures would point to full training program in the specialty of anaesthesia the fact that. if we believe that e1·ery patient de­ i being acti1·ely pur-ued and will undoubtedly lead serves anaesthesia supervised and administered by to the pro1·ision of more and better trained physicians fully trained specialists we still have a lot of work for the field of anae the ia. left to be done. Ha1·ing said this, we hould hasten Recent ur1·ey by The Royal College of Physi­ to com mend those of our colleagues doing part-time cians and Surgeons of Canada rCI'eal a large de­ anaestbe ia, who are doing an excellent job. often ficiency in numbers of physicians in the field of under ad1·erse conditions. Tho e of us who for anae the ia in Canada based on a uggested ideal economic and population reasons ha1·e ample scope of one anae thesiologist per fifteen thousand popu­ to practise the specialty full time have a responsi­ lation. This opportunity then should be taken to bility at all limes to encourage part time physician pre ent a plea to those of you who may now be part­ interested in anaesthesia to obtain more training. time anaestheti t . or tudent or interne contem­ For many years in the Atlantic Pro1inces there plating a future career, to con icier coming into this were several indi1·iduals known to many of us who field, which has become a 1-itally intere ting multi· pioneered the specialty of anae the ia. but it was not disciplinary specialty, one which if practi ed at a until about twenty years ago that an organized high standard provides physicians with a most satis­ teaching program was started at Dalhou ie t;ni­ factory form of sen·ice to their patient . Yersity ~Iedical cbool. Graduates of this training In presenting this ymposium it is hoped that a program have made themseh·es felt throughout picture will form highlighting some of the aspects of the Atlantic region and many have settled in distant medical practice with which anaesthetists in the parts of Canada and in fact throughout the world. Atlantic region concern themseh·es. \\"e thank Undoubtedly, they have made their pre ence felt The Medical ociety of X ova eolia for the oppor­ in an upgrading of anaesthetic care wherever they tuu.i ty of presen ling this material and we hope that ha1·e settled. In Xew Brunswick and Xewfound­ light ha thus been cast on the 1-itally important land training programs of a less ambitious nature role played by the specialty or anaesthe ia in medi· ha1·e been going on for about fifteen year , and it cine today. o THE XOVA COTJA :\rEDICAL BvLLETIX 98 JLl\E, 1008 Problems of Iatrogenic Disease With Special Reference to Anaesth esi ::1 J. \Y. DcxnEE. :\ID. FFARC * Belfast, Northern Ireland .\<h·ances in medicine all cause their own prob­ Iatrogenic disease, as a condition affecting the lems. These may be due to the increasing demands course of anaesthesia. fir t came into prominence the\· make on nursing and medical tares. and the '\ith the introduction of the hypotensive drugs and mo~ ~-~ a\·ailable or, as in the case of the recent heart the corticosteroids.
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