Anesthesia — Foundation of Discipline

F11 Assessing pregnant patients and providing routine obstetric care or initial medical management for acute medical, surgical or obstetric conditions

Key Features:
- This EPA focuses on assessing the pregnant patient, for routine care or for an acute
problem, and proposing management plans that incorporate the wellbeing of both
baby and mom.
- This EPA includes routine prenatal assessments, initial assessments during labour,
common problems of pregnancy and acute/emergent medical, surgical or obstetric
conditions.
- Examples of acute/emergent medical surgical or obstetric conditions include:
a. Medical:pneumonia,pulmonaryembolus,diabetes,HTN,sepsis
b. Surgical:acutecholecystitis,acuteappendicitis,perforatedviscous
c. Obstetric: pre-term labor, pre-eclampsia, antepartum haemorrhage, post-partum haemorrhage, placental abruption, abnormal placentation

Form

F1: Observation

Milestones

• ME 1.3. Apply clinical and biomedical sciences to manage presentations in pregnant patients

• ME 1.4. Perform focused clinical assessments

• ME 1.4. Recognize urgent problems that may need the involvement of more
  experienced colleagues and seek their assistance immediately

• ME 2.4. Develop and implement initial management plans

• ME 2.4. Diagnose and initiate management of common obstetric emergencies such as antepartum haemorrhage, post-partum haemorrhage, placental abruption and placenta previa

• ME 2.4. Diagnose and initiate management of common medical and surgical conditions during pregnancy such as diabetes, hypertension, sepsis, appendicitis or kidney stones

• ME 2.4. Develop management plans that integrate basic fetal physiology, potential fetal effects of acute medical and obstetrical conditions, and basic principles of fetal heart rate monitoring, including intrauterine resuscitation

• ME 3.2. Describe the indications, contraindications, risks, and alternatives for fluid therapy and for transfusion of blood products in the perioperative or periobstetrical context

• COM 2.1. Conduct a patient-centred interview, gathering all relevant biomedical and psychosocial information for any clinical presentation

• ME 2.2. Synthesize the clinical information for clear and succinct presentation to supervising residents or consultants

• COL 2.2. Manage differences in opinion and conflict situations arising in the interdisciplinary team effectively and constructively

• S 3.4. Incorporate evidence-based medicine into clinical practice

• P 1.1. Demonstrate reliability and conscientiousness in comprehensive
  patient centered care

Context Variables

• Issue (single-choice)
  • acute medical
  • acute surgical
  • acute obstetric
  • routine prenatal
  • routine initial assessment during labour
• Setting (single-choice)
  • other setting
  • prenatal clinic
  • labour and delivery
• Gestational age (free-text)
• Type of condition (free-text)

Requirements

• Collect at least 3 observations of achievement (minimum 3)
• At least 1 observation of a routine assessment
• At least 1 observation of an acute medical, surgical or obstetric condition