Anesthesia — Transition to Discipline

TTD2 Monitoring adult patients undergoing non-complex surgical procedures, under general or regional anesthesia

Key Features:
- This EPA focuses on preparing for, recognizing, and initiating patterned management
for critical changes in patient status and other intraoperative events (i.e. situational
awareness).
- This EPA includes
o Preparing the operating room for non-complex surgical procedures including appropriate equipment checks, monitor selection/application and basic medication preparation
o Recording physiologic values at appropriate intervals in the anesthetic chart o Identifying vital sign/monitoring abnormalities and initiating
management/calling for help when needed
- This EPA does not require diagnosis or complete management of all situations.
Relation with other EPAs: This EPA demonstrates the structured knowledge and understanding required for progression to the Foundation EPA on «anticipating, preventing and managing common intraoperative events»

Form

F1: Observation

Milestones

• ME 1.1. Demonstrate compassion for patients

• ME 1.3. Apply the CAS Guidelines to the Practice of Anesthesia in preparing an operating room for patient care, including preparation of the required monitoring equipment

• ME 1.3. Apply knowledge of the normal and abnormal physiologic values for adult patients during general or regional anesthesia

• ME 1.5. Demonstrate awareness of limitations and seek help as needed in a timely manner

• ME 3.4. Ensure that the OR is adequately prepared and that all necessary equipment and medications are readily available for the patient and proposed procedure

• ME 3.1. Apply appropriate monitors for the planned surgical procedure

• ME 5.2. Prepare medications and label syringes in a manner that optimizes patient safety and minimizes adverse events

• ME 5.2. 8 ME 5.2

• ME 5.2. Demonstrate situational awareness

• ME 5.1. Document anesthetic care and physiologic values at appropriate intervals during the continued monitoring under general or regional anesthesia

• COL 1.1. Describe the role of respiratory therapists/anesthesia assistants in the preparation of an OR for patient care

• COL 1.2. Negotiate overlapping and shared responsibilities of preparing an operating room with respiratory therapists/anesthesia assistants/RNs/RPNs

• COL 1.3. Work with the team by communicating abnormal physiologic values that require attention

• L 4.1. Demonstrate awareness of the organization of operating room preparation such that it efficiently uses the time available in the operating room for the patient and proposed procedure

• ME 3.4. Demonstrate knowledge of appropriate setting of visual and auditory alarms in the continued monitoring of the adult ASA1 or 2 patient under general or regional anesthesia undergoing a minor elective surgical procedure

• ME 5.2. Apply the principles of universal precautions and importance of infection prevention and control in preparing an operating room for a patient and proposed procedure

• P 1.1. Prioritize the needs of patients and others to ensure the patient’s legitimate needs are met

• P 1.2. Ensure that operating rooms are always prepared appropriately before engaging in patient care

Context Variables

• Type of anesthesia (single-choice)
  • general
  • regional
• Type of surgical procedure (single-choice)
  • urology
  • gynecology
  • ophthalmology
  • other surgery
  • otolaryngology
  • general surgery
  • plastic surgery
  • orthopedic surgery

Requirements

• Collect a minimum of 3 observations (minimum 3)