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National Curriculum for Canadian Anesthesia Residency First Edition April 2010

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National Curriculum for Canadian Anesthesia Residency First Edition April 2010 ASSOCIATION OF CANADIAN UNIVERSITY DEPARTMENTS OF ANESTHESIA National Curriculum for Canadian Anesthesia Residency First Edition April 2010 Edited by Dr. Mark Levine MD, FRCPC, Dr. Patti Murphy BScN, MD, FRCPC Original Contributors: Drs. Fred Baxter, Rob Brown, Johanne Carrier, Francois Girard, Carolyn Goyer, Melanie Jaeger, Ramona Kearney, Mark Levine, Jean-Pierre Morin, Patti Murphy, Jeremy Pridham, Mateen Raazi, Bruce Ramsey, Sal Spadafora, Joanne Todesco, Narendra Vakharia, Clinton Wong, and Linda Wynne. This is not an official document of the Royal College of Physicians and Surgeons of Canada. Please refer to the RCPSC Objectives of Training for current guidelines regarding anesthesia training in Canada. Table of Contents 1 Airway Evaluation and Management ...................................................................................................................................... 4 2 Ambulatory Anesthesia ......................................................................................................................................................... 11 3 Autonomic Nervous System .................................................................................................................................................. 14 4 Cardiovascular Anesthesia .................................................................................................................................................... 16 5 Complications of Anesthesia ................................................................................................................................................. 22 6 Critical Care .......................................................................................................................................................................... 25 7 Ear, Nose and Throat Surgery ............................................................................................................................................... 32 8 Endocrinology ....................................................................................................................................................................... 36 9 Ethics .................................................................................................................................................................................... 38 10 Geriatrics ............................................................................................................................................................................... 39 11 Hematology ........................................................................................................................................................................... 42 12 Hepatobiliary ......................................................................................................................................................................... 46 13 Immunology and Rheumatology ........................................................................................................................................... 48 14 Infectious Diseases ................................................................................................................................................................ 50 15 Monitoring and Equipment ................................................................................................................................................... 52 16 Neurology/ Neurosurgical Anesthesiology ........................................................................................................................... 56 17 Neuromuscular Junction ........................................................................................................................................................ 59 18 Obstetrical Anesthesia ........................................................................................................................................................... 61 19 Ophthalmology...................................................................................................................................................................... 67 20 Orthopedic Surgery ............................................................................................................................................................... 69 21 Pain Management .................................................................................................................................................................. 72 22 Pediatric Anesthesia .............................................................................................................................................................. 79 23 Pharmacology........................................................................................................................................................................ 83 24 Plastic Surgery ...................................................................................................................................................................... 87 25 Post-Anesthetic Care Unit (PACU) ....................................................................................................................................... 89 26 Preoperative Consultation ..................................................................................................................................................... 91 27 Regional Anesthesia .............................................................................................................................................................. 96 28 Remote Locations ............................................................................................................................................................... 100 2 This is not an official document of the Royal College of Physicians and Surgeons of Canada. Please refer to the RCPSC Objectives of Training for current guidelines regarding anesthesia training in Canada. 29 Renal / Urologic .................................................................................................................................................................. 102 30 Respiratory Physiology and Thoracic Anesthesia ............................................................................................................... 104 31 Statistics .............................................................................................................................................................................. 107 32 Thermoregulation ................................................................................................................................................................ 109 33 Transplantation.................................................................................................................................................................... 111 34 Volatile Agents ................................................................................................................................................................... 114 Note: As a convention in this document, plain text denotes skills and knowledge that apply to the specialty training at the graduate level of a non-sub specialized Anesthesiology Resident. Italicized items denote knowledge and skills that apply to specialty training of the Subspecialty Fellow. 3 This is not an official document of the Royal College of Physicians and Surgeons of Canada. Please refer to the RCPSC Objectives of Training for current guidelines regarding anesthesia training in Canada. 1 Airway Evaluation and Management See Ear, Nose and Throat 7 The competent Anesthesiologist shall demonstrate advanced knowledge and proficiency in all the objectives related to airway evaluation and management listed below. 1.1 Basic Science a) Structure and function of upper and lower airways: i. Nose, mouth, teeth, tongue ii. Nasopharynx, oropharynx, pharynx iii. Epiglottis, larynx, glottis, vocal cords, valleculae iv. Cartilages v. Sensory and motor innervation vi. Conducting and respiratory airways: trachea, bronchi, bronchioles, alveoli b) Physiology and pathophysiology of ventilation and respiration i. Control of breathing ii. Central nervous system iii. Diaphragm and accessory muscles 1.2 Airway Obstruction a) Etiologies of airway obstruction b) Complications i. Hypercarbia/acidosis ii. Hypoxia iii. Aspiration 1.3 Basic Airway Management The competent Anesthesiologist must demonstrate knowledge and expertise in basic airway management for the patient with upper airway obstruction. a) Acute Airway Obstruction The competent Anesthesiologist must demonstrate proficiency in immediate recognition and management of the patient with an acutely obstructed airway i. Basic Life Support (BLS) protocols: ii. Assessing patient responsiveness iii. Obtaining assistance iv. Patient positioning v. Recovery position vi. Chin lift, head tilt, jaw thrust vii. Indications for and use of pharmacologic agents e.g. in management of laryngospasm viii. Rescue breathing ix. Cardiopulmonary resuscitation b) Bag-Valve-Mark Ventilation 4 This is not an official document of the Royal College of Physicians and Surgeons of Canada. Please refer to the RCPSC Objectives of Training for current guidelines regarding anesthesia training in Canada. The competent Anesthesiologist must demonstrate knowledge and expertise in patient ventilation using bag-valve-mask devices, including: i. Selection of appropriately-sized
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