Anesthesia — Foundation of Discipline

F13 Providing anesthesia for patients undergoing non-complex cesarean section

Key Features:
- This EPA is focuses on providing anesthesia for non-complex obstetric patients
undergoing cesarean section, regardless whether it is scheduled or not (“urgent” cesarean section where there is no immediate threat of life of woman or fetus, but early delivery is required).
- This EPA does not include “emergent” cesarean section (e.g. “code pink”) where there is immediate threat to life of woman or fetus. These cesarean sections are part of the Core EPA on managing any parturient for cesarean section.

Form

F1: Observation

Milestones

• ME 1.1. Demonstrate compassion for patients

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

• ME 1.4. Perform focused clinical assessment

• ME 2.4. Develop and implement initial management plans

• ME 3.2. Obtain and properly document informed consent for commonly performed anesthesia procedures and therapies

• ME 3.4. Perform common procedures in a skillful, fluid, and safe manner including appropriate infection control measures and using protective equipment

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

• ME 4.1. Diagnose and initiate management of common neuraxial anesthesia complications such as inadequate anesthesia, high spinals and hypotension

• ME 5.2. Use cognitive aids such as procedural checklists, structured communication tools, or care paths, to enhance patient safety

• COM 1.2. Optimize the physical environment for patient comfort, privacy, engagement, and safety

• COM 4.1. Communicate with cultural awareness and sensitivity

• COM 5.1. Document all aspects of an anesthesia encounter in an accurate, complete, legible, timely, and accessible manner, in compliance with regulatory and legal requirements

• COL 1.1. Respect established rules of their team

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

• COM 3.2. Communicate with the receiving physicians or health care professionals during transitions in care, clarifying issues after transfer as needed

• S 1.1. Demonstrate a structured approach to monitoring progress of learning in the clinical setting

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

Context Variables

• Patient BMI (free-text)
• Patient weight (free-text)
• Type of anesthesia (single-choice)
  • GA
  • spinal
  • use of epidural previously inserted for labor analgesia
• Priority of surgery (single-choice)
  • urgent
  • scheduled

Requirements

• Collect a minimum of 5 observations of achievement (minimum 5)