Inpatient US Clinical Experience in Anesthesiology in Houston

Information about this clinical experience:

This is an inpatient experience during which you will be under the supervision of a  board certified anesthesiologist with many years of practice. In addition to delivering high quality patient care, the physician is committed to educating future physicians. The attending is on staff at DeTar Healthcare System and at Citizen's Memorial Hospital.

Rotators will learn about the role of the anesthesiologist in patient care in the preoperative, intraoperative, and postoperative periods. Prior to surgery, learners will understand how an experienced anesthesiologist can form a connection with a new patient, address concerns, and reassure anxious patients. Relieving preoperative anxiety requires excellent communication skills to build trust and educate patients. Working with this preceptor will provide an excellent opportunity to learn how to achieve this important goal. 

Students will also learn how to assess patients undergoing anesthesia, recognize comorbidities that can impact anesthetic care, examine the airway, and develop a basic anesthetic plan. The emphasis here will be on appropriate history-taking and examination so that you anticipate the challenges that may be encountered based on the patient's history and exam, coexisting diseases, past difficulties with anesthesia, etc. 

Rotators will observe how the operating room is set up for anesthesia. A useful mnemonic to know for set up is MSMAIDS which stands for machine, suction, monitors, airway, IV, drugs, and special. The following article goes through the details of this process:

Setting Up The Operating Room For Anesthesia

The induction phase of anesthesia is a particularly crucial time and you will be able to appreciate all the steps involved in the process including preoxygenation, administration of the intravenous anesthetic and neuromuscular blocking agent, ventilation, and induction. In the operating room, at all times, the emphasis will be on careful monitoring of the patient while providing anesthesia. A variety of pharmacologic agents will be used to support and manage these patients, allowing the student to deepen their knowledge of pharmacology. As the case proceeds, students will have the opportunity to see how the attending recognizes intraoperative events (e.g., hypotension, hypertension), evaluates the event, and then responds accordingly.

In the postoperative period, time will be spent in the post-anesthesia recovery unit (PACU). During this time, the student will become familiar with the evaluation and management of common postoperative events, including nausea, vomiting, pain, hypoxia, hypertension, and hypotension. Rotators will also recognize when it is safe for a patient to be discharged from the PACU based on standard criteria.

To maximize learning during this clinical experience, we recommend that you read pages 23-50 of the following handbook:

Anesthesiology Advanced Clinical Rotation Handbook

During your experience, you will learn the following U.S. medical practices under the preceptor’s supervision:

• Taking patient histories (preoperative).

• Performing physical exams under the physician's supervision.

• Presenting patients.

• Being present in the operating room.

• Accessing the EMR to review the patient chart (Meditech Expanse)

• Have opportunities to research the literature to answer clinical questions at the point of care.

• Being involved in patient education.

• Spending time with other healthcare professionals to understand their roles and responsibilities.