Canadian Anesthesiologists’ Society

WHAT’S INSIDE ANESTHESIANEWS 1 President’s Message 3 2014 Annual Meeting: Have you registered for St John’s? PRESIDENT’S MESSAGE 4 2014 Recipients Announced for Research Program and Operating Grants 5 In Memoriam: Dr Mary-Ellen (Maria) F Morris Dear Colleagues: 5 Royal College Renews CAS Thank you! Accredited CPD Provider Status Two years ago when I assumed the role of CAS 6 CARF President, I was honoured by the privilege, and 7 CAS Newly Certified excited about building on the work of others Anesthesiologists while moving the Society’s priorities forward. Two years later, I reflect on our collective efforts. 8 Dr Davy Cheng Receives 2014 CSPE I believe they are impressive. Excellence in Medical Leadership Award uring my presidency, I have had the pleasure of meeting many CAS 8 2014 Earl Wynands Lecture Now members from across Canada and know first-hand that a large part of Online Dour accomplishments is due to the commitment of many individuals. The dedication is apparent in various activities—from those who lead and 8 What Would I Want for my Surgery? serve on the CAS Board of Directors, committees and Sections, to others who 9 Australian Society of Anaesthetists willingly step forward to help represent the Society’s interests externally and also those who work quietly but effectively “behind the scenes”. I salute all 10 Letter of Appreciation: Oximeters who, in some way, have given generously of their time and energy. Well-received in Nepal The Executive Committee has been an important source of sage advice 10 CAS Provides Feedback for Lancet and support to me: Dr Rick Chisholm (Past President), Dr Susan O’Leary (Vice President), Dr Salvatore Spadafora (Secretary) and Dr Douglas Commission Report on Global DuVal (Treasurer). Surgery The Society’s success is capably supported by the hard-working CAS team, 11 Report from the Allied Health led by Mr Stanley Mandarich, and I also wish to acknowledge the team’s Professions Committee assistance and guidance to me in my role as President. 12 Donors May 2013 – April 2014 I am sincerely appreciative of the combined efforts of many in enabling the 13 The Self Assessment Program from Society to represent and advocate for Canada’s anesthesiologists. the Canadian Journal of Anesthesia – Next stop: St John’s CPD Online As you read this newsletter, we are only a few days from gathering for the 14 The Personal 2014 CAS Annual Meeting. 15 American Society of Anesthesiologists I extend my personal invitation to all CAS members to join us in St John’s from June 13 – 16. The Annual Meeting Committee chaired by Dr Daniel Bainbridge and the Local Arrangements Committee chaired by Dr Angela Ridi have developed an excellent program—and more—for us. Don’t miss it. Dr Patricia Houston, FRCPC VOLUME 29 www.cas.ca President NUMBER 2 Innovative leadership and JUNE excellence in anesthesia, perioperative care, and 2014 patient safety CAS LOOKS FORWARD TO WELCOMING YOU TO ST JOHN’S! PHOTO CREDITS: FOR INFORMATION ABOUT THE MEETING, VISIT: © NEWFOUNDLAND AND LABRADOR TOURISM; © BARRETT & MACKAY www.cas.ca/AM2014

2013/2014 BOARD OF DIRECTORS MEMBERS Quebec CJA Editor-in-Chief President Dr François Gobeil, Boucherville Dr Hilary Grocott, Winnipeg Dr Patricia L Houston, Toronto New Brunswick RCPSC Representative Past President Dr Andrew Nice, Quispamsis Dr Michael Sullivan, Aurora Dr Richard Chisholm, Fredericton Newfoundland and Labrador You may contact members, Vice-President Dr Michael Bautista, St John’s representatives and invited guests Dr Susan O’Leary, Outer Cove of the Board of Directors through Nova Scotia the CAS central office. Secretary Dr George Kanellakos, Halifax Dr Salvatore Spadafora, Toronto Editor-in-Chief Prince Edward Island Dr Salvatore Spadafora Treasurer Dr Timothy Fitzpatrick, Charlottetown Dr Douglas DuVal, Edmonton Managing Editor Resident Representative Andrea Szametz DIVISIONAL REPRESENTATIVES Dr Elizabeth Miller, Ottawa British Columbia Design and Production Dr Jean Gelinas, Campbell River Ex-officio ACUDA President Fusion Design Group Dr Davy Cheng, London Alberta Dr Michael Cassidy, Calgary Executive Director Stanley Mandarich Saskatchewan Dr Joelle McBain, White City INVITED GUESTS CARF Chair Manitoba Dr Doreen Yee, Toronto Canadian Anesthesiologists’ Society Dr Jay Ross, Winnipeg CAS IEF Chair Ontario Dr Francesco Carli, Montreal www.cas.ca Dr David Neilipovitz, Ottawa

VOLUME 29, NUMBER 2 – JUNE 2014 2 2014 ANNUAL MEETING: HAVE YOU REGISTERED FOR ST JOHN’S?

The countdown to St John’s is on and the Local Arrangements Committee is working hard to ensure an exceptional educational program, networking opportunities and a fun-filled social program to showcase Newfoundland & Labrador’s warm hospitality. We highly recommend making your plans as soon as possible to avoid disappointment….

TAKE A BREAK… the North Atlantic, the oldest surviving The Johnson GEO Centre shows If you can spare a few days, consider lighthouse in Newfoundland and a the amazing life-story of our planet going in advance of or staying after Second World War coastal defence through the remarkable geology of the Annual Meeting to explore St John’s battery are yours to explore. Newfoundland & Labrador. One of or other parts of Newfoundland & the most distinctive buildings in the Labrador. There is plenty to see and do Colonial Building opened in the province, the GEO Centre is located and, at the very least, consider some 1850s, almost two decades after within a beautiful 18 acre site on world- leisure time in St John’s. Here’s a Newfoundland obtained self- renowned Signal Hill. sampling of what you can explore: government in 1832. Much of Newfoundland’s most important Known as the Newfoundland Bannerman Park is a Victoria-style political history occurred in and T’Railway Provincial Park, the rail urban park located in historic around this building. bed route extends for 883 kilometres downtown St John’s where there is linking urban, rural and wilderness a public swimming pool, playground Fort Amherst is the first lighthouse areas and providing travellers with and many large open grassy areas. in Newfoundland built by the British first-hand experience of the province’s Military Garrison in 1810 and is located varied flora and fauna. Blackhead Chapel Museum is a at the entrance to St John’s Harbour tiny wooden chapel constructed as Narrows. a one-room school in 1879. The Grand Concourse is an integrated Botanical Garden at Memorial walkway system for the cities of St John’s, University is located near the heart Mount Pearl and the Town of Paradise, VISIT of St John’s and is unusual in its dual and its 120 kilometres of walkways TOURISM NEWFOUNDLAND purposes of botanical garden and link every major park, river, pond and TO FIND OUT MORE! natural reserve. Wander through the green space in the three municipalities. flower gardens and explore the five nature trails that meander through a The James J O’Mara Pharmacy 110 acre managed natural reserve. Museum is a heritage drug store circa 1895, complete with antique store Cape Spear National Historic Site fixtures, a display of pharmaceutical is just 17 kilometres from downtown implements and more… St John’s, situated at the most easterly point in North America. Overlooking

LIMITED NUMBER OF RENTAL CARS: BOOK EARLY Avoid disappointment: A limited number of cars is available for rent in Newfoundland from June 11 – 18, 2014. Visit the CAS website for information and a special offer to delegates.

VOLUME 29, NUMBER 2 – JUNE 2014 3 2014 RECIPIENTS ANNOUNCED FOR RESEARCH PROGRAM AND OPERATING GRANTS

RESIDENTS’ RESEARCH AWARD

ONTARIO’S ANESTHESIOLOGISTS – CAS RESIDENTS’ RESEARCH GRANT $10,000 Dr Neil Goldenberg University of Toronto – Anesthesia Toronto, ON The Role of the Calcium Channel TRPV4 in Hypoxic Pulmonary Vasoconstriction

NEW INVESTIGATOR AWARDS

ABBVIE NEW INVESTIGATOR CANADIAN ANESTHESIOLOGISTS’ AWARD IN ANESTHESIA $20,000 SOCIETY RESEARCH AWARD $30,000 Dr Harsha Shanthanna Dr Gerard Curley McMaster University – Anesthesiology University of Toronto and St Michael’s Hamilton, ON Hospital – Anesthesia Toronto, ON Most Effective Opioid Analgesia in Ambulatory Surgeries: A Randomized Pre-activated Mesenchymal Stem Cell Control, Investigator Blinded, Parallel Therapy for Bacterial Pneumonia Group with Superiority Design Study of Morphine versus Hydromorphone

SUBSPECIALTY AWARDS

CAS RESEARCH AWARD IN DR EARL WYNANDS NEUROANESTHESIA in memory RESEARCH AWARD $30,000 of Adrienne Cheng $10,000 Dr Michael Zaugg Dr Alana Flexman University of Alberta – University of British Columbia – Anesthesiology Anesthesiology and Pain Medicine Pharmacology & Therapeutics Edmonton, AB Vancouver, BC Anti-inflammatory and Infarct Size Effect of an Alveolar Recruitment Maneuver Reducing Actions of Fat Emulsions on Subdural Pressure, Brain Swelling and in Hearts: An In Vivo MicroPET/CT Cerebral Perfusion Pressure in Patients Analysis in Rats Undergoing Supratentorial Tumour Resection

OPEN AWARDS

THE CANADIAN JOURNAL OF ANESTHESIA DR R A GORDON RESEARCH AWARD RESEARCH AWARD $30,000 $40,000 Dr David Ansley Dr Ban Tsui University of British Columbia – University of Alberta – Anesthesiology Anesthesiology, Pharmacology & Therapeutics and Pain Medicine Vancouver, BC Edmonton, AB Propofol Mediated Cardioprotective Local Anesthetic Reversal for Signal Transduction: Role of Caveolin Peripheral Nerve Blocks

VOLUME 29, NUMBER 2 – JUNE 2014 4 IN MEMORIAM: DR MARY-ELLEN (MARIA) F MORRIS JANUARY 2, 1932 – MARCH 16, 2014

BY: DR BEVERLEY A ORSER, FRCPC Professor of Anesthesia & Physiology, University of Toronto Canada Research Chair in Anesthesia Fellow of the Canadian Academy of Health Sciences

Dr Mary Morris was one of Canada’s first anesthesiologist-scientists and, at the time, one of only a few female ROYAL COLLEGE anesthesiologists. RENEWS CAS ACCREDITED CPD fter completing high school, Mary enrolled into Queen’s University Medical School (MD, 1955). During anesthesia residence PROVIDER STATUS A training at McGill University, Mary developed a strong interest The Royal College of Physicians and in neurophysiology. As a result, she embarked on research training, Surgeons of Canada recently granted initially under the supervision of Dr Ronnie Millar, an Edinburgh-trained CAS an accreditation period of five anesthesiologist, then later under the tutelage of Dr Kresimir Krnjevic in years, effective June 1, 2014 and the Anesthesia Research Department at McGill University. ending June 1, 2019. Members will note that the reviewers were “very impressed In the 1960s, Mary demonstrated that respiratory acidosis activated with the comprehensive work that has sympathetic neurons. To further satisfy her interest in neurophysiology, been been achieved within the Society’s she completed a PhD thesis on the effects of carbon dioxide on synaptic CPD program”. transmission in primary afferent pathway in the medulla (PhD, 1971). She subsequently undertook studies under the supervision of Dr Krnjevic who showed that GABA was the main inhibitory neurotransmitter in the brain and that inhaled anesthetics increased intracellular calcium, which in turn acted on potassium channels to modify neuronal excitability. Mary used sophisticated in vivo animal models to identify an important and interesting finding—that anesthetics potentiate neurotransmission. She subsequently used state-of-the-art methods, including the manufacturing of ion-selective microelectrodes, to measure changes in extracellular potassium and May 23, 2014 calcium ions caused by anesthesia and pathological factors such as hypoxia. Mary was the first to demonstrate that even a brief episode of hypoxia Dr. Peter McDougall CPD Chair, Canadian Anesthesiologists' Society 1 Eglinton Avenue East, Suite 208 generates a sizable increase in extracellular concentration of potassium ions Toronto, ON in the cortex. Additional studies systematically identified the anions that M4P 3A1 Dear Dr. McDougall, generate inhibitory synaptic potentials. She first reported that bicarbonate (CAS) for submitting an the Canadian Anesthesiologists’ Society We would like to thank application to renew its status as a Royal College Accredited CPD ions are a significant permeant ion of inhibitory receptors. She also showed ellent accreditation in the last exc as demonstrated Provider. The reviewers were very impressed with the comprehensive work that has been achieved within the Society’s CPD program that Substance P is a slow excitatory neuromodulator in primary afferent on review. Congratulations! accreditati June This accreditation period is effective synapses in the spinal cord and medulla, rather than a principal transmitter. We are pleased to inform you that the CPD Accreditation edCommittee a more detailed has granted report the an accreditation period of 5 years.Please find enclos An interim report Society June 1, 2019. . - and will end deemed partially 1, 2014 for each accreditation3 -standardc which was The impact of her fundamental discoveries is evident today in studies of outlining the levels of adherence Society will be required to address standard from the ng adherent. description and supporti brain ischemia, anesthesia-induced neurodepression and pain. partially-adherent This report should provide a addressed the • Interim Report: documentation outlining how the Society has . This report should be forwarded to our office no later than standard 3-c For many years, Mary directed a federally-funded research program, December 31, 2017. ached report to all members of

mentored young clinician-investigators and worked as a Professor at We would encourage you to forward this letter and the att s. The intent of our report is to provide a framework to guide your Education Committee ce the further development of your CPD program. the University of Toronto, then at the University of Ottawa. In 2001, the you will be invited to participate in a teleconferen this final Accreditation Report. As part of the accreditation process questions or issues concerning al Canadian Anesthesiologists’ Society honoured this work with the 2001 to discuss any (CAS) for working with the Roy Canadian Anesthesiologists’ Societyits commitment to innovation and We thank the the CAS to continue Research Recognition Award. After closing her laboratory, Mary worked with College and we encourage -quality CME/CPD programs. n developing high Health Canada in the Medical Devices Bureau. She remained an energetic excellence i investigator well into her 80s. Several weeks before her passing, she wrote in an enthusiastic email, “still working – hanging in!” Determined, gracious, and quietly unstoppable, Dr Mary Morris made a memorable contribution to the science and clinical specialty of anesthesiology.

VOLUME 29, NUMBER 2 – JUNE 2014 5

CONGRATULATIONS FÉLICITATIONS 2013 NEWLY CERTIFIED ANESTHESIOLOGISTS ANESTHÉSIOLOGISTES NOUVELLEMENT ACCRÉDITÉS

Etedal, Aamri Sarah Farsi Marie-Eve Laurence Christine Pickering Sonia Ah-Kye Karine Fillion Ronit Lavi Lisa Pillo Igor Andonov Julie Fournier Elisabeth Leclerc Christelle Poulin-Harnois Maya Atallah Kristen Gadbois Sang Lee Fiona Punter Sinziana Avramescu Pierre-Olivier Gagnon Steven Lee Laura Puopolo Remus Barbos Ryan Gamez Edith Lepire Adam Puzio Raveen Bhalla Rebecca Gerlach Justin Letourneau Émilie Richer-Seguin Manpreet Bhangu Angineh Gharapetian Billy Levasseur Andrew Roberts Darcy Bishop Brian Grant Lisa Li Nandini Sachdeva Diana Blackburn Justin Greenberg Peter Liu Amanda Schwartz James Bohn Felix Gregoire-Bertrand Kimberly Macala Riley Senft Nicolas Boisvert Roman Gusztak Daniel Macdonald Colleen Shamji Valérie Boucher Christina Hardcastle Ryan Mahaffey Oskar Singer Riley Boyle Ahmed Hegazy Marie-Pier Mandeep Singh Malenfant-Rancourt Mark Burbridge Edwin Ho Praveena Sivananthan Greg Manning Jean-Francois Canuel Adnan Jalal Teresa Skelton Azad Mashari Mairi Chadwick Geneviève Virginie Janelle Ryan Smith Jonathan Mcmann Anton Chau Christopher Jenkins David Sommerfreund Ann Merah Peter Coady Jennifer Joo Marc Stalder Paul Mercereau Peter Collins Gregory Klar Patrick St-Pierre Martin Michaud Nicolas Côte Ian Kluk Louise Sun Aaron Mocon Tracy Cupido Tracy Kok Gerard Teichler Stephen Morrison Christiane Dawe Justina Koshinsky Barry Thorneloe Wayne Nates Amélie De Varennes Thomas Kosick Melanie Toman Craig Needham Minal Desai Gregory Kostandoff Tony Trinh Ulyana Nemish Philippe Desjardins Richelle Kruisselbrink Adam Van Der Merwe Angela Neufeld Olivier Desjardins-St-Jean Pavan Kumar Cornel Van West Diana Noseworthy Joanna Dion Peter Kuszewski Claudia Viens Alagarsamy Pandian Marc Dore Alim Ladha Marcin Wasowicz Sanjay Patel Geneviève Dupuis Geneviève Lalumière Amanda Whippey Marie-Pierre Pellerin Christopher Durkin Mandy Lam Clara Wong Yvonne Peng Reuben Eng Sophia Lamghabbar Qian Wu Christopher Perkes Martin Esken Matthew Langdon Murray Yazer Raissa Petriw Michael Fader Marie-Laure Jordan Zacny Laskine-Holland Vitali Petrounevitch Muryum Farooq

Canadian Anesthesiologists’ Society Société canadienne des anesthésiologistes www.cas.ca 2014 CSPE EXCELLENCE IN MEDICAL LEADERSHIPNEWS AWARD (Chris Carruthers Award)

Dr Davy Cheng Distinguished Professor and Chair/Chief, Anesthesia & Perioperative Medicine,Dr. Davy Cheng London Health Sciences Centre and St Joseph’sDistinguished Health Professor Care and Professor, Chair/Chief, Anesthesia & Perioperative Medicine, London Critical Care Medicine,Health Sciences Western Centre University and St. Joseph’s Health Care, London 2014 EARL WYNANDS DR DAVY CHENG RECEIVESProfessor, 2014 Critical CareCSPE Medicine, Western LECTURE NOW ONLINE University EXCELLENCE IN MEDICAL LEADERSHIP The 2014 Earl Wynands Lecture given AWARD by Dr John Freedman at the Society ongratulations to Dr Davy Cheng on receiving the Canadian of Cardiovascular Anesthesiologists

Dr. Cheng graduated fromSociety the University of Physician of Toronto’s faculty Executives’ of agement, (CSPE) minimally 2014 invasiveCSPE and Excellence robotic cardiac surgery, and periop- (SCA) Foundation’s meeting in New medicine in 1983 and completedin Medical an internship Leadership in internal medicine Award erative (also evidence-based known as medicine. the HeChris established the Evidence-Based Orleans earlier this year is available and a residencyC in anesthesia in 1987. A fellowship in cardiovascular Perioperative Clinical Outcomes Research Group (EPiCOR) and the Carruthers Award). This annual award is presented to an individual for viewing online. The Lecture is anesthesia took him to the University of Iowa Hospitals and Clinics in Medical Evidence, Decision Integrity, Clinical Impact (MEDICI) Centre Iowa City. who has made an outstanding contributionat Western and to London the developmentteaching hospitals and is also responsible for supported through a gift from the and mentorship of medical leaders ina number the fieldof pivotal publicationsof health that services direct evidence-based clinical CAS Cardiovascular and Thoracic Before his currentleadership appointment, and Dr. Chengmanagement. was professor and and surgical practice. deputy chief of anesthesiology at Toronto General Hospital, (CVT) Section’s Earl Wynands Fund. and medicalSince director, Cardiovascular2001, Dr ChengSurgery Program, has Universityled and transformedDr. Cheng is a recognized the Departmenthealth care leader at the forefront of Health Network, Toronto. research, practice, and policy. As principal investigator and co-investi- of Anesthesia & Perioperative Medicinegator, he in has London been awarded into over $4.7 one million of in peer-reviewed grants Click here to view Dr Freedman’s Since 2001, theDr. Cheng top has academic led and transformed anesthesia the Department departments of and over $1.7in the million world, in non-peer including reviewed grants. He has published presentation – Transfusion Medicine: Anesthesia &doubling Perioperative Medicinethe faculty in London to into 80 one consultants, of the top over 47 140 residents, peer-reviewed and scientific 12 papers fellows. in high-impact journals and academic anesthesia departments in the world. He doubled the facul- 45 books or chapters. He has led international multicentre clinical tri- Time for a Shift ty to 80 consultants, 47 residents, and 12 fellows, and the department als and consensus conferences in practice guideline development. Dr. is fully committedDr Cheng to the strategic is recognizedplans of the university as and a hospital world Chengexpert has been in invited perioperative to be a visiting professor at over 80 Canadian in terms of clinical,outcomes educational, and and research resource deliverables. utilization andin internationalthe areas universities of cardiac and cardiac centres. surgery, blood management, minimally invasive and robotic Dr. Cheng is recognized as a world expert in perioperative outcomes Dr. Cheng has been married for over 35 years to his wife Winnie. They and resourcecardiac utilization insurgery, the areas of andcardiac perioperative surgery, blood man- evidence-basedhave one son, Andrew, who medicine. is currently living in Toronto. He established the Evidence-Based Perioperative Clinical Outcomes Research Group (EPiCOR) and the Medical

Dr. Cheng isEvidence, a leader in his field. Decision However, my Integrity, reason for nominating Clinical ImpactDr. Cheng received (MEDICI) his CCPE inCentre 2013. He has identified leaders within him [for thisat award] Western is his demonstrated and Londonleadership ability teaching and com- hospitals,the department andand supported is also their leadership development through mitment to responsiblethe development of otherfor physiciana number leaders. of pivotal publicationsleadership courses and that strategic direct leadership opportunities. He has also nurtured young leaders in the department, supporting their involvement Dr. Cheng wasevidence-based recruited as the academic clinicalchair at Western and University surgical in thepractice. Professional Staff Organization by managing their clinical com- and the hospital chief for both London Health Sciences Centre and mitments. He is an exceptional leader in developing himself and others. St. Joseph’s Health Care London. At the time of his recruitment there were three very distinct anesthesia business groups. Through his per- Gillian Kernaghan, MD, CCFP, FCFP sistent leadership and vision, London now has a cohesive anesthesia President and CEO department.WHAT Dr. Cheng set theWOULD standards, both clinically I WANT and behav- FORSt. Joseph’s MYHealth Care SURGERY? iourly, and heldBY: department ANDREW members SIU, accountable. ENGAGEMENT &London, CAMPAIGN Ontario SPECIALIST, BC PATIENT SAFETY AND QUALITY COUNCIL Teamwork. Communication. Transparency. These ideals seem to be common sense in what a patient is expecting from a surgical team. However,CCPL FINALfinding PROGRAM 2014methods 9 to standardize “good” working culture has proven challenging. The implementation of the surgical safety checklist is intended to create these standards by framing how an operating team communicates; this in turn minimizes avoidable risks that endanger patients. Seems to make sense, but a recent study was released concluding there was no correlation between the surgical checklist and patient mortality. Nonetheless, does this mean that there is no value in its application?

n British Columbia, a variety of stakeholders from the Since there is very little education on this for health surgical community have responded to this study with professionals, this group suggests that hospitals invest Ihopes of highlighting the value of good team work and resources and expertise to provide teams coaching and communication in the operating room. There is more value training to “get it right”. Ultimately, we know that all health to the checklist beyond its statistical significance. It ensures care professionals would like to have a high functioning team that common objectives are being effectively communicated. performing their own surgery in the event that they were a It is a tool that empowers all health professionals to speak patient. We hope this paper offers some constructive ideas up if they notice a potential error. It gives patients a voice on how we can move forward as we aim to improve care in determining their own care. for patients. You can view our full response here.

VOLUME 29, NUMBER 2 – JUNE 2014 8 Gold CoaSt 4 - 7 october 2014

Practice, precision and professionalism

Join us on the Gold Coast for the NSC 2014!

The packed programme will appeal to a wide audience, exploring the theme of ‘Practice, precision and professionalism’ within the specialty. In addition, a fantastic social programme has been scheduled to truly make the most of Gold Coast location, with events at Movie World and Jupiter’s Casino.

Invited Speakers include:

dr Michael Barrington St Vincent’s Hospital, Melbourne

dr david Bogod Nottingham University Hospital, UK

dr alan William Harrop-Griffiths Imperial College, UK

www.asa2014.com.au Australian Society of Anaesthetists LETTER OF APPRECIATION: CAS PROVIDES FEEDBACK FOR OXIMETERS WELL-RECEIVED LANCET COMMISSION REPORT IN NEPAL ON GLOBAL SURGERY Following the successful 2011 – 2012 CAS he Lancet is a well-known medical journal published IEF appeal to raise funds to purchase and in the UK. Over the next year, a Commission will be working on making the case for investing in distribute Lifebox pulse oximetry kits, a T surgery and anesthesia as part of health care in lower and letter of appreciation from the Government middle income countries (LMIC) and would like to hear as of Nepal’s Ministry of Health & Population many views as possible to feed into the final publication. attests to the importance of this initiative. The Commission recognizes that anesthesia faces many challenges, including creating an adequate workforce, training, facilities, infrastructure, equipment and drug supply. he author of the letter, Dr Tara Nath Pokhrel, is the Director, Logistic Management Division and, on At a recent World Federation of Societies of Anesthesiologists T behalf of both the Government of Nepal and the (WFSA) Executive Committee meeting, there was discussion health organizations that have received Lifebox oximeters about the Commission and the need to engage with its work. through CAS IEF, has expressed gratitude for the generosity, To that end, the WFSA will consider all views on any aspect particularly for the facilities in the more remote areas of the of anesthesia services and their development as well as country. Despite some challenges in the initial distribution contribute an overall view of the situation to the Commission. process, the efforts in facilitating the “handing over” of For its part, the CAS provided the following comments oximeters to health workers who have received training and recommendations to WFSA: have resulted in the institutions with oximeters using them “regularly”. • Partnership models between institutions in high-income countries and those in low and middle-income countries be developed to support educational programs (post-graduate

Tel: 4261463

Government of Nepal medical, clinical officer and nursing), build capacity and

Ministry of Health & Population support the development of safe systems of care. DEPARTMENT OF HEALTH SERVICES Pachali, Teku • Safe mother and infant care should be a priority. The SAFE Logistics Management Division Kathmandu, Nepal project is one model that might be emulated. It has been

Date: July 21, 2013 and is a major sustainable educational effort involving three Ref No. medical specialties: surgery, anesthesia, and obstetrics

and nursing.

Dear Mr President, Society of Anaesthesiologist, of Nepal • Implementation of a trauma registry and organization of

trauma teams where surgery and anesthesia have a strong presence is desirable in many jurisdictions. The burden of - On the behalf of Logistic Management Division DOHS ,Nepal it is my trauma is very high and a trauma registry is not available pleasure to thank and inform Society of Anaesthesiologist of Nepal for co ordination with Life box UK to donate Pulse oxymeter to Nepal. in many sub-Sahara countries.

we are also providing those equipment following practical demonstration for using appropriately by our Biomedical Engineers with high .LMD appreciation has received from • Collect data on surgical mortality; this should be supported very positive response with the pulse oxymeter by the WHO. Surgery and anesthesia need to be part of the Health institutions that have received already and are usingoxymeter regularly. at a timeWe express apology for not being able to distribute all Pulse- “What comes after 2015?” National governments need to because of lack of enough resources to send directly by our means of be made aware of the public health aspects of surgical care. transportation .we are handing over to the health workers of the concerned health institute directly after practical demonstration and registering their detail address for follow up and helping them in case of any difficulty while • None of the initiatives to improve world health will succeed operating. without the full commitment of the local government as the We highly appreciate your contribution for supporting the Health Facilities of Nepal. We have supplied those pulse oxymeter to various Health institution who is primarily and ultimately responsible for institutions of Nepal located at very remote areas as per the list provided by society of Anaesthesiologist of Nepal. health delivery of that country. Health care must be a priority —GDP contribution to health care should be an average of

Lists of equipment supplied to date is attached below. 10% in all countries.

operation in future Expecting similar co- To provide additional feedback, answer a

Dr Tara Nath Pokhrel short questionnaire put together by the

Director, Logistic Management Division Commission, mainly aimed at anesthesiologists who work regularly in LMIC, here.

For more information, go to: www.gscommission.com

VOLUME 29, NUMBER 2 – JUNE 2014 10 REPORT FROM THE ALLIED HEALTH PROFESSIONS COMMITTEE

BY: DR HOMER YANG, FRCPC The Allied Health Professions Committee is charged with the mandate of liaising and overseeing “health professionals who participate in the delivery of anesthesia services and care”, and making recommendations to the CAS Board of Directors. publication and, finally, posting it to ith a number of changes on the CAS website. In brief, from the the training and deployment Chiefs’ survey, clear guidelines emerged Wof Anesthesia Assistants about the roles and duties of AAs (26% across Canada in recent years, the Allied identified as the top priority and 62% Health Professions Committee worked as top three) and standardized training collaboratively with the CSRT (Canadian (24% and 49%, respectively). Rounding Society of Respiratory Therapy), NAPANc out the top five priorities are building (National Association of Peri-Anesthesia an anesthesia care team model (34% Nurses Canada), and the CNA (Canadian identified as top three), developing a Nurses Association) to develop the certification program for AAs (30%) “Foundation Knowledge for Anesthesia and defining a funding model: number Assistants”, with endorsement from of AAs per OR (27%). those organizations in 2009. Since then, various college and university programs From the AAs’ survey, the top priorities training anesthesia assistants (AAs) are standardized training (24% identified have aligned their training programs to as the top priority and 48% as top three) comply with the document. and compensation (19% and 48%, respectively). Rounding out the top five In 2013, a survey was conducted priorities are establishing an organizing respectively on the Chiefs of body for the profession (43%), clear Anesthesia and the AAs across the guidelines about the roles and duties country, sponsored by the CAS. The of AA (34%) and building an anesthesia Committee would like to sincerely care team model (30%). express its appreciation to all those There does seem to be significant who participated in the survey. The results are slowly being analyzed but convergence from the Chiefs and from it is clear that having the “voice” of the the AAs in terms of the top priorities. CAS membership heard is an essential The CAS Allied Health Professions step in the Committee’s work. Committee will be working through these survey reports over the next The report is being slowly released little while to delineate our next in stages—from publication in this strategic steps and to make those newsletter and the 2014 Annual Report recommendations to the CAS Board to presenting it to the CAS Board of of Directors. Directors, submitting it to a journal Anyone who has any questions or comments should feel free to contact us at [email protected]

VOLUME 29, NUMBER 2 – JUNE 2014 11 Canadian Anesthesiologists’ Society DONORS International Education Foundation From May 2013 to April 2014

Patrons Michael Cassidy Aviva Stewart Robin Cox Andrew Klahsen Thomas Pimblett ($1,000+) Richard Chisholm Jennifer Szerb Douglas Craig Charles Knapp Marie Plamondon Anthony Boulton Jan Davies Jamie Taylor Brigitte Crepeau Mark Kostash Jeremy Pridham Francesco Carli Kathryn DeKoven William A Tweed Michele Danelice Marelise Kruger Mateen Raazi Thomas Coonan Gordon Edwards Paul Westacott Dalhousie University, Murugesan Samir Rafla Angela Enright Henry Ekwueme Julie Williams Department of Kulandaivelu Bruce Ramsey Anesthesia Christine Goossen Faye Evans Anne Katling Wong Edward Lazar Nikhil Rastogi Ama Degraft-Johnson Brent Kennedy David Fermor Gordon Wood Kenneth LeDez Desigen Reddy Hélène Deslippe Patricia Livingston Allen Finley Trevor Lee Dennis Reid Friends Claire Dionne OMA Section on Pierre Fiset Serge Lenis John Riendl (Up to $249) Ian Dobson Anesthesiology Jocelyn Foran Martin Lessard Edwin Roberts William Abbott François Donati Saifudin Rashiq Alison Froese Mark Levine David Rosen Scott Drysdale Robert Blake David Hook Neethia Mark Elizabeth Ling Guylaine Seguin Richardson Arsiradam Jean-Yves Dubois Patricia Houston Brenda Lougheed Gordon Sellery Paul Slavchenko E John Ashworth Douglas DuVal David Hughes Simon Lucy Shervin Shahabi- Sharon Wiens Hans Babst Janet Farrell Thomas Johnson Charles MacAdams Gharib Eric Jagdeo Mark Farrell Alison Macarthur Shane Sheppard Leaders Halina Kieraszewicz Balkissoon Alayne Farries Peter MacEwen Romesh Shukla ($500 – $999) Brian Knight Sukhjeewan K Nigel Findlay-Shirras Pirjo Manninen Alexander J Shysh Ian Beauprie Pradeep R Kulkarni (Cindy) Basran Barry Finegan Indrani Lakheeram Michael Bautista Christine Manning Christopher Sims Gordon Finlayson Elaine Forestell Robert MacNeil John Beaver John Mansfield Peter Slinger Brendan T Finucane Joanne Fortier Doug Maguire Philippe Bechard Daniel Martin Kari Smedstad Foothills Medical Jennifer Froelich Centre, Department Roger Maltby James Beckstead Andrew Maykut Peter Solomon Francois Fugere of Anesthesia Renwick Mann Claire Bernard David McCaughry- Sarah Stevens Koto Furue Cardigos Lynn Hansen Robert Martinek Jeffrey George Jean Taillefer Sylvain Gagné David McKnight Alayne Kealey Thomas McBride Betcher Alexander Tang Micheal Gallagher Elizabeth McLeod Patrick J Kelly Robert McBurney Harald Bettger William Taylor Sugantha Ganapathy Richard Merchant Phillip Lalande William McKay Sally Bird Sean (John) Thomas Nosakhare Gbinigie Lise Morin Teddy Lim Robert McLean Jean Bissonnette Roger H Tiede Adrian Gelb David Morison Carolyne Montgomery Donald Miller Jan Piotr Blachut Hamed Umedaly Marianne Graham Donald Morrison Beverly Morningstar Gillian Moll Sylvie Bois Kristine Urmson Ronald Gregg Jorge Antonio Barbara Pask Maureen Murray Gregory Bosey Christina Mahesh Rocha Mota Van Der Merwe Martine Pirlet Thomas Mutter Joseph Bremang Guntamukkala John Murdoch F L Van Eenennaam John Scovil Eding Mvilongo Russell Brown Hang Chu Ha Patti Murphy Janet Van Vlymen Robert Seal May Ngan Jessica Burjorjee Linda Hadley Yvonne Murray Estela Violago C Brian Warriner Susan O’Leary Robert Byrick Margaret Haig Janice Mustard Marcin Wasowicz H Clifford Yanover Catherine Paquet Fiona Campbell John Anthony Vinod Nair John Wetherby Steve Patterson David Cannell Allan Hakes Supporters David Neilipovitz Rajalaxmi Wong Anahi Perlas-Fontana Douglas Carrie David Halpenny ($250 – $499) Kevin Nolan Carine Wood Desiree A Persaud Jan Carstoniu Christopher Harle Gregory Allen Robert Nunn Isabel Woodhouse Sreevisara Ravinuthala Chi-Keung Chan Raymond Hasel John Ascah Thomas O’Leary Desmond Writer Mark Rosati Mark Cheesman Trevor Herrmann Laura Baker Elizabeth Oliver Doreen Yee Zdzislaw Sadowski John Chisholm Donald Hickey Malone Colin Bands Masaru Yukawa Geeta Shetty John Clark Patricia Johnson Ian Ozard David Boyle Jorge Zamora Martin Shine David Cohen Ismail Kaloul Michael Page David Bracco Naeem Zubair Greg Silverman Marcus Coneys Ramona Kearney James Paterson Eric Brown M Heather Smith Richard Cooper Ian Keith Lindsey Patterson D Norman Buckley Sylvain Cote

VOLUME 29, NUMBER 2 – JUNE 2014 12 THE SELF ASSESSMENT PROGRAM FROM THE CANADIAN JOURNAL OF ANESTHESIA – CPD ONLINE

CPD MODULE: Cesarean delivery under general anesthesia May 2014 ALSO AVAILABLE • Impact of anesthesia for cancer surgery December 2013 • Perioperative considerations for neurosurgical procedures in the gravid patient November 2013 • Airway management and oxygenation in obese patients September 2013 • Residual paralysis: a real problem or did we invent a new disease? July 2013 • Ultrasound-guided regional anesthesia for upper limb surgery March 2013 • Massive transfusion in the trauma patient December 2012 • Competency-based professionalism in anesthesiology September 2012 HOW TO ACCESS THE MODULES Instructions can be found on the Canadian Anesthesiologists’ Society website at: cas.ca/members/cpd-online Successful completion of each module of the self-assessment program will entitle readers to claim four hours of continuing professional development (CPD) under section 3 of CPD options, for a total of 12 maintenance of certification credits. Section 3 hours are not limited to a maximum number of credits per five-year period. Publication of these modules is made possible through unrestricted education grants from the following industry partners: Coverage that fits your unique needs

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OCTOBER 11-15, 2014 OCTOBER 24-28, 2015 OCTOBER 22-26, 2016 NEW ORLEANS, LA SAN DIEGO, CA CHICAGO, IL

OCTOBER 21-25, 2017 OCTOBER 13-17, 2018 OCTOBER 19-23, 2019 BOSTON, MA SAN FRANCISCO, CA ORLANDO, FL

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Anesthesia News is published by the Canadian Anesthesiologists’ Society (CAS). CAS welcomes comments and suggestions from readers. Materials published in Anesthesia News may be reprinted without permission if credit is given. Publisher: Email: [email protected] Canadian Anesthesiologists’ Society Fax: 416-480-0320 1 Eglinton Avenue East, Suite 208 Phone: 416-480-0602 Toronto, ON, Canada M4P 3A1 WWW.CAS.CA