Anesthesia — Foundation of Discipline

F12b Assessing and providing labour analgesia for healthy parturients with an uncomplicated pregnancy, including the management of common complications of labour analgesia

Key Features:
- This EPA may include any of the following complications: inadequate control of pain,
hypotension, bradycardia, fetal bradycardia and decelerations, respiratory
depression, unilateral block, high block and/or inadvertent subarachnoid block.
- The observation of this EPA is divided in 2 parts; assessment, provision and
management of labour analgesia; management of common complications.
- This EPA includes direct observation of procedural skills (e.g. epidurals).
- Observations of both parts may be done on the same occasion.

Form

F1: Observation

Milestones

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

• ME 1.4. Perform focused clinical assessments of a parturient during labor, acknowledge limitations of the assessment in this specific context and demonstrate strategies to overcome those limitations

• ME 2.4. Develop and implement initial management plans

• ME 3.4. Seek assistance as needed when unanticipated findings, difficulties or changing clinical circumstances are encountered

• COM 4.1. Communicate with cultural awareness and sensitivity

• COM 5.1. Document clinical encounters to adequately convey clinical reasoning and the rationale for decisions

• COL 1.1. Receive and appropriately respond to input from other health care professionals

• L 4.1. Organize work using strategies that address strengths and identify areas to improve in personal effectiveness

• P 2.2. Demonstrate a commitment to patient safety and quality improvement through adherence to institutional policies and procedures

Context Variables

• Type of observation (single-choice)
  • direct
  • case review
• Type of complications (single-choice)
  • high block
  • bradycardia
  • hypotension
  • unilateral block
  • other complication
  • respiratory depression
  • inadequate control of pain
  • inadvertent dural puncture
  • inadvertent subarachnoid block
  • fetal bradycardia and deceleration

Requirements

• Collect at least 3 observations of achievement (minimum 3)