ANZCA Final Exam Resources

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Content

Learning Outcomes

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Learning Outcomes

Learning Outcomes

Importance

Code

Learning Outcome

Notes Status

Flash Card Status

Notes

SAQ?

Category

Code

Learning Outcome

Research Status

Notes

SAQ?

AR_ME 1.1

Demonstrate a commitment to high-quality patient care

AR_ME 1.2

Integrate the roles of collaborator, communicator, health advocate, leader and manager, medical expert, professional, and scholar into practice as an anaesthetist

AR_ME 1.3

Apply knowledge of the clinical and biomedical sciences relevant to anaesthesia

AR_ME 1.5

Carry out professional duties in the face of multiple, competing demands

AR_ME 2.1

Elicit a relevant history and perform a focused examination (may include cardiovascular, respiratory, neurological, abdominal, musculoskeletal, and airway)

AR_ME 2.2

Adapt history taking and examination and order further investigations where clinically indicated, for example, to determine severity and to clarify diagnosis

AR_ME 2.5

Correctly interpret and discuss the implications of results of investigations

AR_ME 3.2

Demonstrate knowledge and understanding of the procedure, including indications, contraindications, anatomy, technique, side-effects and complications

AR_LM 1.1

Define the characteristics underpinning the provision of quality anaesthetic services, that is, safe, effective, efficient, timely and patient-centred

AR_LM 1.2

Discuss the processes of quality assurance and quality improvement, and their application to anaesthesia practice including:

Principles of quality assurance

Quality improvement cycle

Risk management

Nature of error

Relationship between adverse events

Incident monitoring

Root cause analysis

(Refer to College professional document: PS58: Guidelines on Quality Assurance in Anaesthesia)

AR_LM 1.3

Outline strategies to identify and manage adverse events and near misses and analyse these to improve future patient care

AR_LM 2.6

Discuss how evidence-based medicine and management processes can be used to optimise cost-appropriate care for patients with significant co-morbidities

AR_LM 2.7

Discuss the standardisation of equipment between different areas of care

AR_LM 3.2

Outline the relative costs of drugs and equipment in anaesthesia

AR_LM 3.3

Balance safety, effectiveness, efficiency and equitable allocation of resources in:

Choosing anaesthetic techniques

Making complex anaesthetic equipment and drugs available in multiple locations

Providing anaesthetic services in the broader healthcare environment

AR_LM 4.1

Discuss the dynamic nature of healthcare and the necessity of change, including the drivers and barriers to change

AR_LM 4.2

Describe the principles of change management

AR_LM 4.5

Outline the rules for formal meetings

AR_LM 4.7

Understand the financial, administrative and human resource requirements needed to manage a practice or hospital department, including but not limited to:

Planning health care delivery (for example, staff rosters/rotas/schedules)

Factors affecting anaesthesia expenditure

Adherence to local guidelines concerning anaesthesia practice and equipment

Quality improvement activities

Processes by which new drugs are approved for research and clinical use in Australia and New Zealand

Regulations regarding the contracting or pricing of personal anaesthesia services

AR_HA 1.12

Describe the ethical and professional issues inherent in health advocacy including altruism, social justice, autonomy, integrity and idealism

AR_HA 1.13

Discuss how access to appropriate anaesthetic services is limited and describe strategies to address this issue

AR_HA 1.14

Describe the role of anaesthetists in advocating collectively for patient health and safety (Refer to College professional document PS59 Statement on Roles in Anaesthesia and Perioperative Care)

AR_HA 1.15

Discuss the principles of health policy and their implications for patients, the health-care system, and the community

AR_HA 2.1

Develop an understanding of the determinants of health in the populations they provide care for including:

The social and economic environment

The physical environment

Health-care system factors

Individual patient’s characteristics and behaviours

Availability and barriers to access healthcare resources

AR_HA 2.2

Describe ways anaesthetists can act individually or collectively to improve health in the populations they serve

AR_HA 2.5

Outline measures to reduce the impact of anaesthesia care on environmental pollution in the workplace and globally (refer to College Professional Document “PS64 Statement on environmental sustainability in anaesthesia and pain medicine practice”)

AR_SC 1.1

Describe the principles and processes involved in the maintenance of competence and life-long learning

AR_SC 2.1

Describe the basic concepts of evidence-based medicine, including levels of evidence, meta-analysis and systematic review

AR_SC 2.2

Describe the limitations of evidence-based medicine

AR_SC 2.5

Integrate evidence into decision-making in clinical practice

AR_SC 3.1

Describe the principles and processes of research and scientific enquiry including:

Research ethics

Asking a research question

Conducting a systematic search for evidence

Selecting and developing appropriate methods to address a research question

Applying appropriate statistical analysis

Formatting and processing for research papers for publication

AR_SC 4.1

Describe the principles of adult learning relevant to medical education, including the challenges and opportunities presented by learning in clinical settings, and strategies to enhance learning

AR_PF 1.3

Outline the principles of medical ethics described by the following terms:

Autonomy

Beneficence

Non-maleficence

Fidelity

Justice

Utility

AR_PF 1.8

Discuss the principles and limits of patient confidentiality and privacy as defined by professional practice standards and the law

AR_PF 1.9

Discuss commonly encountered ethical issues including:

Relief of pain and suffering and end of life decisions

Involvement in procedures to which there may be moral, ethical or clinical objections, for example, termination of pregnancy

Prevention of futile medical care

Organ donation and transplantation

Consent

Choices between maternal and foetal wellbeing

Off label use of drugs

AR_PF 1.11

Discuss the unique vulnerability of anaesthetised or sedated patients

AR_PF 1.14

Discuss the tension between an anaesthetist’s role as advocate for an individual patient and the need to manage scarce resources

AR_PF 1.16

Explain the potential abuses of social media and other technology-enabled communication, and their relation to professionalism

AR_PF 1.17

Use technology-enabled communication, including social media, in a professional, ethical, and respectful manner and in accordance with the ANZCA Social Media policy

AR_PF 1.18

Intervene when aware of breaches of professionalism involving technology-enabled communication and social media

AR_PF 1.19

Follow relevant policies regarding the ethical use of electronic medical records

AR_PF 2.2

Describe how the history, culture and socioeconomic status of various Indigenous populations impacts upon their current health status, education and communication

AR_PF 2.3

Describe the elements of indigenous cultures that may impact upon interactions between indigenous people and health services (for example, negative perceptions of hospitals in relation to death and cultural respect, strong family and community ties)

AR_PF 2.6

Describe the principles underpinning culturally competent care and apply these to their practices (refer to Professional document PS62 Statement on Cultural competence)

AR_PF 3.1

Describe the elements necessary for informed consent

AR_PF 3.4

Describe how informed consent may be affected by the context in which it is obtained including:

Emergency and resuscitation situations

Pain

Concurrent medication

Cultural context

Age and competence of the patient

AR_PF 3.6

Discuss the role of advanced care directives in anaesthetic practice

AR_PF 3.10

Outline and apply to practice the standards of ethical and professional conduct of a medical practitioner

AR_PF 3.11

Practise in a way that gives due consideration to the standards of anaesthetic practice outlined in ‘Supporting Anaesthetists' Professionalism and Performance: A guide for clinicians’, the ANZCA ‘Code of Professional Conduct’ and ANZCA professional documents

AR_PF 3.13

Describe how to respond to, cope with, and constructively learn from a complaint or legal action

AR_PF 3.14

Outline the rationale for accreditation and the role of self accreditation in the provision of sub-specialty anaesthetic services (for example, cardiac or neonatal anaesthesia) for both anaesthetists and institutions (Refer to College professional document: PS 02 Statement on Credentialling and defining the Scope of Clinical Practice in Anaesthesia)

AR_PF 3.15

Outline the professional obligations and intervention necessary to protect patients when a colleague is impaired or practicing beyond the limits of their capabilities

AR_PF 3.16

Identify situations where senior assistance or supervision is required for junior surgeons and/or medical staff, and encourage, support or facilitate this as necessary

AR_PF 4.2

Outline how access to drugs for anaesthesia and sedation may lead to dependency and describe the signs of possible drug dependency in colleagues

AR_PF 4.3

Discuss possible reasons for the increased suicide risk for anaesthetists and ways in which risk can be alleviated

AR_PF 4.4

Outline the professional responsibilities of anaesthetists who may be carriers of a communicable disease

AR_PF 4.5

Discuss the features indicating that another professional may be in need, particularly in relation to drug dependency and situations that may increase suicide risk (refer to resource documents RD3 Depression and Anxiety, RD13 Impairment in a Colleague and RD20 Substance Abuse)

AR_PF 4.6

Describe avenues of assistance available to colleagues in need and help them to seek this out

AR_PF 4.9

Describe the methods that may be used to mitigate stress related to clinical practice

AR_PF 4.10

Identify particularly stressful times in clinical practice and take measures to mitigate that stress for self and colleagues

IT_AM 1.2

Discuss the important features of history and examination that may identify a potentially difficult airway

IT_AM 1.3

Outline preoperative fasting requirements and the common measures employed to decrease the risk of pulmonary aspiration

IT_AM 1.4

Describe an appropriate airway strategy for anaesthesia taking account of patient and procedural factors in patients with a normal airway, including indications for rapid sequence induction

IT_AM 1.5

Describe the indications for manual in-line stabilisation of the neck and the implications for airway management

IT_AM 1.7

Describe the optimal patient position for intubation

IT_AM 1.8

Describe the common complications of intubation

IT_AM 1.10

Outline an appropriate ventilation strategy suitable for routine elective and emergency patients

IT_AM 1.11

Outline potential management plans to ensure oxygenation of the patient with an unexpected difficult airway

IT_AM 1.12

Outline the clinical features, possible causes, physiological consequences and management of perioperative upper airway obstruction

IT_AM 1.13

Describe a ‘can’t intubate, can’t oxygenate’ drill, including the technique for performing an emergency surgical airway

IT_AM 1.14

Describe and classify the view obtained at direct laryngoscopy according to a common grading scale (Cormack-Lehane)

IT_AM 1.15

Describe the features of oesophageal and endobronchial intubation and outline appropriate management

IT_AM 1.16

Describe the clinical features and outline a management plan for a patient with aspiration of gastric contents

IT_AM 1.17

Describe the clinical features that indicate a patient can be extubated safely

IT_AM 1.18

Describe potential complications at extubation

IT_AM 1.19

Describe optimisation of the patient for extubation

IT_AM 1.20

Outline the important airway considerations in determining the suitability of a patient for discharge to recovery

BT_AM 1.5

Describe the potential impact of trauma to the upper or lower airway on ventilation and airway management

BT_AM 1.6

Describe the clinical features of patients with critical airway obstruction

BT_AM 1.7

Outline the clinical situations where airway anatomy may be distorted and ventilation impaired

BT_AM 1.8

Describe the commonly performed airway assessment methods and the findings that would suggest potential airway management difficulties

BT_AM 1.9

Discuss the indications and contraindications for nasal intubation

BT_AM 1.10

Outline a strategy for the safe use of throat packs

BT_AM 1.11

Outline different extubation strategies for ‘high risk’ extubation situations

BT_AM 1.12

Describe the situations where awake intubation or spontaneous breathing induction (gaseous or intravenous) of anaesthesia may be appropriate

BT_AM 1.13

Describe the full range of equipment used in airway management including the rationale and indications for its use, as outlined in College professional document PS56 - Guidelines on Equipment to Manage a Difficult Airway During Anaesthesia

BT_AM 1.14

Outline the relative merits and limitations of alternative laryngoscopy blades used for endotracheal intubation

BT_AM 1.15

Outline the various supraglottic airway devices available

BT_AM 1.16

Describe equipment used for manual ventilation

BT_AM 1.17

Outline indications for and the limitations and possible complications of supraglottic airway devices

BT_AM 1.18

Describe methods for providing local anaesthesia to the airway

BT_AM 1.20

Discuss the clinical features, possible causes and management of perioperative upper airway obstruction including laryngospasm

BT_AM 1.21

Discuss the issues involved when access to the airway is shared with surgeons or proceduralists

AT_AM 1.1

Discuss the reliability of the various airway assessment tools

AT_AM 1.2

Discuss airway strategies for patients with a difficult airway and outline a management plan appropriate to the clinical situation

AT_AM 1.3

Outline the various supraglottic airway devices available and their relative merits

AT_AM 1.4

Discuss airway strategies and outline a management plan for patients with critical airway obstruction, for example epiglottitis or laryngeal trauma

AT_AM 1.5

Discuss strategies for the safe extubation of patients with difficult airways

AT_AM 1.6

Discuss the characteristics and appropriate usage of specialised tracheal tubes

AT_AM 1.7

Discuss airway management for patients with a tracheostomy

AT_AM 1.8

Discuss ventilation strategies for complex scenarios such as ARDS, bronchospasm, pulmonary hypertension, and select appropriate ventilator parameters for patients with these conditions

AT_AM 2.1

Interpret relevant airway investigations, for example, nasendoscopy, CT, MRI and flow volume loops

IT_GS 1.6

Calculate intravenous fluid requirements and choose intravenous fluid therapy appropriate to the clinical situation for low-risk patients having low-risk surgery

IT_GS 1.7

Describe the clinical situations when anxiolytic or sedative premedication may be indicated or contraindicated

IT_GS 1.10

Outline a strategy for the management of postoperative nausea and vomiting. (Refer to the endorsed Society for Ambulatory Anesthesia Guidelines for Surgical Patients with Postoperative Nausea and Vomiting)

IT_GS 1.11

Describe the clinical features that indicate a patient can be extubated safely (also refer to the Airway management clinical fundamental)

IT_GS 1.12

Outline a strategy for the management of failure to wake from anaesthesia

IT_GS 1.13

Outline a strategy for the management of postoperative delirium

IT_GS 1.14

Outline a strategy for the management of post operative analgesia for patients in their care (also refer to the Pain medicine clinical fundamental) (refer to College professional document: PS45 Statement on Patients' Rights to Pain Management and Associated Responsibilities)

BT_GS 1.45

Define and describe the features that distinguish between conscious sedation, deeper levels of sedation, and general anaesthesia

BT_GS 1.45a

Outline the requirements for safe practice of procedural sedation contained in ANZCA professional document PS9 - Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures and the ANZCA safe procedural sedation competencies

BT_GS 1.45b

Discuss the indications for conscious sedation

BT_GS 1.45c

Describe the concepts of ‘therapeutic index’ and ‘margin of safety’ with reference to the provision of procedural sedation

BT_GS 1.45d

Outline the rationale for titration of agents in procedural sedation

BT_GS 1.45e

Discuss the potential advantages and adverse consequences of the use of combinations of drugs for procedural sedation

BT_GS 1.58

Outline the clinical signs and appropriate management of intra-arterial injection of a harmful substance

BT_GS 1.63

Discuss the management of failure to wake from anaesthesia

BT_GS 1.64

Discuss the management of postoperative delirium

BT_GS 1.71

Outline measures to increase the rate of successful intravenous cannulation and to minimise patient discomfort during this procedure

BT_GS 1.73

Describe central venous cannulation by the jugular, subclavian and femoral routes, including:

Indications and contraindications

Possible complications, including measures to reduce these

Steps involved

Documentation required

BT_GS 1.75

Describe arterial cannulation, including:

BT_GS 1.76

Outline factors determining perioperative fluid requirements and choice of fluids

BT_GS 1.77

Discuss the appropriate choice of monitoring devices to guide fluid management in the perioperative period (also refer to monitors and monitoring standards, which are covered in the Safety and quality in anaesthetic practice clinical fundamental)

BT_GS 1.79

Discuss the indications for and complications of invasive blood pressure monitoring and the interpretation of the data (also refer to monitors and monitoring standards, which is covered in the Safety and quality in anaesthetic practice clinical fundamental)

AT_GS 1.1

Evaluate the place of premedication and the utility of the available agents, particularly with reference to their safety in high risk patients

AT_GS 1.1a

Discuss the relative merits of sedation and general anaesthesia for high-risk patients undergoing investigations or procedures

AT_GS 1.1b

Describe the physiological and pharmacological basis for dose titration in procedural sedation, and the application in high-risk patients

AT_GS 1.2

Evaluate the merits of intravenous and inhalational induction

AT_GS 1.3

Evaluate the use of TIVA and TCI in comparison with inhalational anaesthesia

AT_GS 1.4

Discuss the clinical situations where incomplete reversal of neuromuscular blockade is likely and evaluate measures taken to avoid it

AT_GS 1.5

Describe the concept of ‘response surface models’ and the contribution these models make to the understanding of the process of using combinations of drugs to achieve optimal sedation and anaesthesia

AT_GS 1.6

Evaluate the prophylaxis and treatment of nausea and vomiting

AT_GS 1.7

Evaluate the methods available for monitoring depth of anaesthesia and sedation, including the role of electronic monitoring of depth of sedation and anaesthesia

AT_GS 1.7a

Discuss the aetiology of and measures to prevent intraoperative awareness under general anaesthesia

AT_GS 1.7b

Discuss your management of a patient who complains of intra-operative awareness under general anaesthesia

AT_GS 1.8

Discuss the potential causes and management of failure to wake from anaesthesia

AT_GS 1.9

Discuss the potential causes and the prevention and management of perioperative neurocognitive disorders (postoperative delirium, delayed neurocognitive recovery, and postoperative neurocognitive disorder)

AT_GS 1.10

Outline the pathophysiology of chronic drug use and discuss its interaction with perioperative anaesthetic management

AT_GS 1.11

Describe the insertion of PICC lines

AT_GS 1.12

Discuss the advantages and disadvantages of PICC v CVC

AT_GS 1.13

Evaluate the place of ultrasound in vascular access

AT_GS 1.14

Discuss the advantages and disadvantages of the internal/external jugular, subclavian and femoral routes for central venous access (Refer to endorsed guideline from ANZICS: Central Line Insertion and Maintenance Guideline 2012)

AT_GS 1.15

Discuss factors determining perioperative fluid requirements and choice of fluids

AT_GS 1.16

Discuss goal directed fluid therapy for complex surgical procedures

AT_GS 1.17

Critically evaluate the strategies to minimise blood loss and blood transfusion requirements

AT_GS 1.18

Evaluate the place of CVP measurement in perioperative fluid management

AT_GS 1.19

Describe the technique of insertion of a pulmonary artery catheter

AT_GS 1.20

Evaluate the role of the pulmonary artery catheter in perioperative management

AT_GS 1.21

Evaluate the role of continuous cardiac output monitoring devices (for example, pulse contour cardiac output monitoring) in the perioperative period

AT_GS 1.22

Evaluate methods of manipulating body temperature during anaesthesia and sedation, including active warming and cooling of patients

AT_GS 1.23

Discuss the role of echocardiography in perioperative haemodynamic management

IT_PM 1.1

Define pain, acute pain and chronic pain

IT_PM 1.2

Outline the elements of a basic pain history

IT_PM 1.6

Outline the principles of acute pain management and the assessment of analgesic efficacy and adverse effects as contained in the College professional document PS41 - Guidelines on Acute Pain Management

IT_PM 1.7

Outline a protocol for the management of pain in recovery

IT_PM 1.8

Outline a pain management plan for patients having day surgery procedures

IT_PM 1.9

Outline the risks associated with and the monitoring requirements for patients receiving patient-controlled analgesia (PCA), opioid infusions or continuous regional analgesia for acute pain management

IT_PM 1.10

Outline the problems in managing acute pain for patients with chronic prior exposure to opioids

IT_PM 1.11

Describe the assessment and adjustment of continuous regional techniques for acute pain control

IT_PM 1.12

Describe the advantages and disadvantages of patient-controlled analgesia (PCA), continuous infusion and intermittent prescription of opioids for acute pain management

IT_PM 1.13

Outline the management of hypotension associated with a central neuraxial block

IT_PM 1.14

Outline the management of ‘high spinal’ block (also refer to the Regional and local anaesthesia and Resuscitation, trauma and crisis management clinical fundamentals)

IT_PM 1.15

Outline a plan to transition patients with acute pain from parenteral to oral analgesic therapies (in low complexity cases)

IT_PM 1.16

Outline the contribution of psychosocial factors to the patient’s experience of pain

BT_PM 1.29

Describe the principles of the assessment of acute pain including the relevance of functional assessment

BT_PM 1.30

Discuss the importance of psychological and social factors in the presentation and management of acute pain

BT_PM 1.31

Outline the pathophysiology of chronic opioid use and abuse and outline management strategies for opioid tolerant patients with acute pain

BT_PM 1.32

Formulate a plan for acute pain management, which shows integrated knowledge of the interaction of analgesic agents, patient factors and the aetiology of pain (refer to College professional document: PS41 Guidelines on Acute Pain Management

BT_PM 1.33

Describe the association between acute and chronic pain and the risk of progression from one to the other

BT_PM 1.34

List the predictive factors for chronic postsurgical pain and outline measures to prevent or minimise its occurrence

BT_PM 1.35

Outline clinical situations where regional infusion techniques may be of benefit for the management of acute pain (also refer to the Regional and local anaesthesia clinical fundamental)

BT_PM 1.36

Describe the principles of neuraxial analgesia including efficacy, drugs used, adverse effects, program parameters, equipment, patient selection and safe administration

BT_PM 1.37

Discuss the risks associated with and the monitoring requirements for patients receiving patient controlled anaesthesia (PCA), opioid infusions, neuraxial and continuous regional analgesia for acute pain management

AT_PM 1.1

Outline the principles of the assessment and management of chronic pain in a multi-disciplinary team context in inpatient and outpatient settings

AT_PM 1.2

Discuss the importance of psychological and social factors in the presentation and management of pain including:

Anxiety

Depression

Placebo effect

Active and passive coping strategies

Illness behaviour

Compensation and third-party issues

AT_PM 1.3

Discuss the management of acute pain for patients with addiction disorder or opioid tolerance

AT_PM 1.4

Discuss the clinical use and mechanisms of action of complementary and alternative medicines used in pain medicine

AT_PM 1.5

Evaluate the role of acute pain management in rehabilitation and ‘fast-track’ surgery

AT_PM 1.6

Discuss the interaction between pain management techniques and postoperative delirium

AT_PM 1.7

Discuss the relative merits of systemic and neuraxial opioid agents

AT_PM 1.8

Describe the place of neurolytic blocks in the management of chronic pain

AT_PM 1.9

Formulate a pain management plan for patients with complex pain problems demonstrating integrated knowledge of the interaction of analgesic agents, patient factors and the aetiology of pain (refer to College professional document: PS45 Statement on Patients' Rights to Pain Management and Associated Responsibilities)

AT_PM 1.10

Outline the diagnosis and management of acute neuropathic pain including diagnostic criteria, features of specific pain syndromes and indications for referral to a pain medicine specialist

AT_PM 1.11

Discuss the management of acute pain in patients with preexisting chronic pain

AT_PM 1.12

Describe the management of acute back and musculoskeletal pain

AT_PM 1.13

Discuss the management of acute pain following trauma, including chest and orthopaedic trauma

AT_PM 1.14

Outline the issues involved in the management of acute pain during pregnancy (also refer to the Obstetric anaesthesia and analgesia specialised study unit)

AT_PM 1.15

Discuss issues relevant to the management of pain in the elderly

AT_PM 1.16

Outline the management of pain associated with medical conditions, for example, headache, abdominal pain, herpes zoster-associated pain and pain associated with haematological disorders and cancer

AT_PM 1.17

Outline pain management strategies for patients requiring palliative care (refer to College professional document: PS38 Statement Relating to the Relief of Pain and Suffering and End of Life Decisions)

IT_PO 1.1

Outline the ASA physical status classification system and the implications for anaesthesia

IT_PO 1.2

Outline the functional assessment of patients based on exercise capacity and performance of activities of daily living

IT_PO 1.3

Outline how functional assessment is used in perioperative risk assessment

IT_PO 1.4

Outline the implications for anaesthetic management and perioperative risk of a range of medical conditions including but not limited to:

Cardiovascular

Coronary artery disease

Valvular heart disease

Cardiac conduction abnormalities/pacemakers

Left heart failure (CCF)

Hypertension

Cerebrovascular disease (embolic and haemorrhagic)

Peripheral vascular disease

Respiratory

Chronic obstructive pulmonary disease

Asthma

Respiratory tract infection

Obstructive sleep apnoea

Chronic tobacco use

Metabolic/Endocrine

Obesity (including morbid obesity)

Diabetes

Electrolyte and acid base disorders

Steroid dependence

Haematological/Immunological

Anaemia

Thrombocytopenia

Thromboembolic disease (DVT/PE)

Coagulopathy/anticoagulant use

Immunocompromised patient

Gastrointestinal/Renal

Renal impairment (acute and chronic)

Gastro-oesophageal reflux

GIT haemorrhage

IT_PO 1.5

Outline the indications for common perioperative investigations

IT_PO 1.6

Discuss the information (i.e. material risks) that must be provided to patients as part of the informed consent process (also refer to the ANZCA Roles in Practice, Medical Expert and Professionalism)

IT_PO 1.7

Describe the treatment of life threatening arrhythmias (also refer to the Resuscitation, trauma and crisis management clinical fundamental)

IT_PO 1.8

Outline an anaesthetic and postoperative management plan for healthy patients undergoing day surgery procedures or similar (also refer to the Pain medicine and General anaesthesia and sedation clinical fundamentals for pain management and fluid management respectively)

IT_PO 1.9

Outline the management of common problems in the Post-Anaesthesia Care Unit (PACU) including:

hypotension

hypertension

tachycardia

postoperative nausea and vomiting

severe pain

IT_PO 2.2

Take a targeted history and perform a focused examination (may include cardiovascular, respiratory, neurological, abdominal and musculoskeletal) to identify features that will affect perioperative anaesthetic management

IT_PO 2.3

Interpret common perioperative investigations (CXR, ECG, haematology, biochemistry, spirometry, arterial blood gases) and identify when abnormalities will affect perioperative management

IT_PO 2.7

Assess severity and stability of common medical conditions and perioperative risk, and initiate perioperative management in low severity and stable cases

BT_PO 1.1

Discuss how abnormalities of common perioperative investigations (CXR, ECG, haematology, biochemistry, spirometry, arterial blood gases) will affect perioperative management

BT_PO 1.4

Discuss the role of antibiotic prophylaxis in preventing infection and the identification of patients requiring it

BT_PO 1.5

Describe the implications for anaesthetic management and perioperative risk of a range of medical conditions, including but not limited to:

Cardiovascular

Cardiomyopathy

Right heart failure

Respiratory

Restrictive lung disease

Neurological/Muscular

Epilepsy

Parkinson’s disease

Multiple sclerosis

Cerebral Palsy

Myasthenia gravis and myaesthenic syndrome

Muscular dystrophies, myopathies and myotonias

Spinal cord injury

Metabolic/Endocrine

Porpyria

Thyroid disease

Carcinoid syndrome/disease

Calcium disorders

Phaeochromocytoma/adrenal disease

Pseudocholinesterase deficiency

Haematological/Immunological

Haematological malignancies

Immunocompromised patient

Post-transplant patient

Investigation of drug allergies

Gastrointestinal/Renal

End stage renal failure and dialysis

Liver disease (acute and chronic)

Gallbladder disease

Bowel disease (including obstruction)

Pancreatitis

Pyloric stenosis (in neonates)

Oesophageal/gastric obstruction

Infectious diseases

Modes of transmission (contact/droplet/airborne) and precautions

Blood-borne viral disease

Tuberculosis

Psychiatric/Behavioural

Anorexia nervosa

Anxiety and depression

Psychosis/schizophrenia

Alcohol abuse

Illicit drug dependence/intoxication

Multisystem diseases/states

Frailty (age and disease related)

Rheumatoid arthritis

Scleroderma

Ankylosing spondylitis

Pulmonary hypertension

Porphyria

Carcinoid disease and syndrome

Disorders of calcium metabolism

Phaeochromocytoma

Parkinson’s disease

Myasthenia gravis and myasthenic syndrome

Muscular dystrophies, myopathies and myotonias

Multiple sclerosis

Cerebral palsy

Haematological malignancies

Immunocompromised patient

Post-transplant patient

Scleroderma

BT_PO 1.5a

Describe the perioperative care pathways in primary and secondary care and their effect on patient outcomes

BT_PO 1.5b

Describe the effect of ethnicity on physiology and disease

BT_PO 1.5c

Discuss the health disparities experienced by indigenous populations and implications for perioperative care (also refer to cultural awareness and sensitivity within the ANZCA Roles in Practice, Professionalism)

BT_PO 1.5d

Discuss the principles and role of goal-directed therapy

BT_PO 1.5e

Recognise and initiate management of issues in the PostAnaesthesia Care Unit (PACU) or postoperative ward including but not limited to:

Airway compromise

Hypoxia

Shock

Altered mental state

Oliguria

Also refer to the Airway Management, Pain medicine and Resuscitation, trauma and crisis management clinical fundamentals

AT_PO 1.1

Evaluate the available classifications of physical status and their use in preoperative assessment

AT_PO 1.2

Evaluate measures to alleviate the risk of the following complications in the perioperative period:

Aspiration

Venous thromboembolism

Surgical infection

AT_PO 1.3

Discuss the reasons for and potential implications of withholding or continuing regular medications in the perioperative period

AT_PO 1.4

Discuss the role of prehabilitation

AT_PO 1.4a

Describe the impact of nutritional status on patient outcomes

AT_PO 1.5

Discuss the role and indications for high-carbohydrate preoperative drinks, enteral feeding, and parenteral nutrition

AT_PO 1.6

Discuss the concepts of the Perioperative Surgical Home (POSH) and Enhanced Recovery After Surgery (ERAS)

AT_PO 1.7

Discuss the principles of Choosing Wisely. Apply the ANZCA Choosing Wisely recommendations in the peri-operative period

AT_PO 1.8

Describe the legal and ethical considerations of determining mental capacity (also refer to ethical issues such as prevention of futile medical care and legal issues such as persons responsible for decision making within ANZCA Roles in Practice Professionalism)

AT_PO 1.9

Explain how patients requiring emergency surgery may differ from those presenting for elective surgery in terms of physiology, psychology, and preparation

AT_PO 2.1

Use a targeted patient history, focused examination and relevant investigations to inform a tailored anaesthetic management plan

AT_PO 2.12

Describe the methods used to investigate a suspected anaphylactic reaction including blood, intradermal, and skin prick testing and recommendations around the appropriate timing for those investigations

AT_PO 2.13

Discuss postoperative outcome measures including:

30-day mortality

Disability

Hospital readmission rate

Length of stay

Quality of life

IT_RA 1.1

Describe the principles for the safe conduct of major regional anaesthesia as outlined in College professional document PS03 Guidelines for the Management of Major Regional Analgesia

IT_RA 1.2

Outline the pre-operative assessment of the patient necessary before performing any regional technique

IT_RA 1.3

Describe the sterile technique necessary for the performance of regional anaesthesia

IT_RA 1.4

Outline the skills required for the safe performance of regional blockade, including:

Confirming and marking site of surgery and site of regional technique

Positioning of patient

Identification of anatomical landmarks

Use of aseptic technique

Selection of appropriate needle

Selecting, checking, drawing up, diluting and labelling of drugs for injection

Checking for inadvertent intravenous and intraneural administration

IT_RA 1.5

Outline the clinical features and management of local anaesthetic toxicity (also refer to the Resuscitation, trauma and crisis management clinical fundamental and the endorsed AAGBI Safety Guideline Management of Severe Local Anaesthetic Toxicity )

IT_RA 1.6

Outline the management of hypotension associated with a central neuraxial block

IT_RA 1.7

Outline the management of ‘high spinal’ block

IT_RA 1.8

Describe the absolute and relative contraindications of a central neuraxial block

IT_RA 1.9

Describe how to assess the adequacy of a regional technique

IT_RA 1.10

Describe the measures to be taken when a regional technique is not working completely

IT_RA 1.11

Outline the complications of a central neuraxial block

BT_RA 1.10

List the absolute and relative contraindications to a central neuraxial block

BT_RA 1.11

List the minor and major complications of a central neuraxial block

BT_RA 1.12

Discuss clinical situations where a central neuraxial block may have specific benefits

BT_RA 1.13

Describe clinical situations in which epidural blockade or combined spinal/epidural may be indicated in preference to spinal anaesthesia alone

BT_RA 1.18

Describe the prevention and management of nausea, hypotension and bradycardia associated with a central neuraxial block

BT_RA 1.19

Describe how to assess the adequacy of a central neuraxial block for surgery

BT_RA 1.20

Outline a plan of management for a ‘total spinal’ or excessively high block (also refer to the Resuscitation, trauma and crisis management clinical fundamental)

BT_RA 1.21

Discuss measures to reduce the incidence and severity of post-dural puncture headache

BT_RA 1.22

Outline the symptoms and signs of possible post-dural puncture headache and outline a management plan for treatment

BT_RA 1.23

Outline the possible complications of low CSF pressure

BT_RA 1.24

Discuss the management of common complications of a central neuraxial block such as nausea, hypotension and bradycardia

AT_RA 1.1

For the blocks listed below, describe:

The relevant anatomy

The indications and contraindications

The appropriate patient positioning identification of anatomical landmarks and the performance of the block

Central neuraxial blocks

Spinal blocks

Lumbar epidural blocks

Thoracic epidural blocks

Caudal blocks

Major nerve/plexus blocks

Brachial plexus – interscalene, supraclavicular, infraclavicular, axillary approaches.

Lumbar plexus block – femoral, 3in1, fascia iliaca approaches

Sciatic nerve block

Paravertebral block – thoracic and lumbar

Minor nerve blocks

Supra-orbital, infraorbital, mental and occipital nerve blocks

Superficial and deep cervical plexus blocks

Intercostal nerve block

Inguinal block

Transversus abdominus plane block

Penile block

Peripheral blocks of the upper limb including wrist and digital blocks

Peripheral blocks of the lower limb including ankle block

IVRA (Bier's block)

AT_RA 1.2

Evaluate the effectiveness of local anaesthesia infusion administered via surgically placed catheters

AT_RA 1.3

Discuss when extending the use of continuous infusion techniques into the postoperative period may be appropriate

AT_RA 1.4

Discuss the appropriate use of anxiolytics, sedatives and analgesics to supplement regional anaesthesia

AT_RA 1.5

Describe post-anaesthesia instructions for patients who have undergone regional anaesthesia

AT_RA 1.6

Discuss the management of local anaesthetic toxicity (refer to the endorsed AAGBI Safety Guideline Management of Severe Local Anaesthetic Toxicity)

AT_RA 1.7

Describe the use of a nerve stimulator to identify appropriate needle location

AT_RA 1.8

Describe the selection and performance of regional techniques, taking account of patient factors, co-morbidities and surgical procedure

AT_RA 1.9

Discuss the investigation and management of patients who have developed complications as a result of the use of regional techniques

IT_RT 1.1

Outline a systematic approach to identifying the cause and describe the initial management of the following, when occurring in association with anaesthesia or sedation:

Dyspnoea

Hypoxia

Hypocapnoea/hypocarbia

Hypercapnoea/hypercarbia

Tachycardia

Bradycardia

Hypotension

Hypertension

High airway pressures

Oliguria/anuria

Failure to wake from anaesthesia (also refer to the General anaesthesia and sedation clinical fundamental)

IT_RT 1.2

Outline the clinical features and describe the initial management of patients with the following life threatening conditions:

Cardiac arrest

Respiratory arrest

Shock

Hypovolaemic

Distributive

Cardiogenic

Obstructive

Cardiac tamponade

Acute myocardial ischaemia

Acute pulmonary oedema

Aortic dissection

Arrhythmias causing haemodynamic compromise

Aspiration of gastric contents

Severe bronchospasm

Tension pneumothorax

Massive haemoptysis

Coma

Raised intra-cranial pressure

Prolonged seizures

Local anaesthetic toxicity (also refer to the Regional and local anaesthesia clinical fundamental and the endorsed AAGBI Safety Guideline Management of Severe Local Anaesthetic Toxicity)

Anaphylaxis

Malignant hyperthermia

Pulmonary embolism

Gas embolism

Coagulopathy in association with surgery or trauma

Hyper/hypokalemia

IT_RT 1.3

Outline the personnel, equipment and drugs available for crisis management in anaesthetising locations

IT_RT 1.4

Describe the primary survey of the trauma patient

IT_RT 1.5

Describe techniques for the immobilisation of patients with spinal injuries during transport and transfer

BT_RT 1.24

Outline the clinical signs that may differentiate the causes of shock

BT_RT 1.25

Outline initial investigations of the shocked patient

BT_RT 1.26

Outline the likely changes in blood gas analysis in the shocked patient

BT_RT 1.27

Outline the use of indicators of tissue oxygenation (base deficit, lactate, mixed venous oxygen saturation) in resuscitation

BT_RT 1.28

Correlate clinical signs of hypovolaemic shock with estimates of volume loss

BT_RT 1.29

Outline how the clinical signs of hypovolaemic shock may be altered by anaesthesia, sedation and current medication

BT_RT 1.30

Outline how the clinical signs of shock may be altered by age

BT_RT 1.31

Outline an approach to volume replacement in shock due to:

Haemorrhage

Loss of fluid and electrolytes

BT_RT 1.32

Outline the indications for the use of vasopressors and/or inotropes in the management of shock

BT_RT 1.33

Outline strategies to prevent and manage complications of massive transfusion

BT_RT 1.34

Outline the diagnosis and management of major transfusion reactions

BT_RT 1.35

Outline an approach to obtaining vascular access in the shocked patient

BT_RT 1.36

Describe drainage of the pericardial space

BT_RT 1.37

Describe how to program an external pacemaker

BT_RT 1.40

Outline methods to treat life threatening hypoxaemia

BT_RT 1.41

Describe the management of severe asthma

BT_RT 1.42

Describe the diagnosis and management of pneumothorax

BT_RT 1.43

Describe the technique of emergency drainage of tension pneumothorax

BT_RT 1.44

Describe insertion of an intercostal catheter

BT_RT 1.45

Outline the causes of coma and an approach to the initial assessment and management of the comatose patient

BT_RT 1.46

Describe the Glasgow Coma Scale

BT_RT 1.47

Describe the management of prolonged seizures and status epilepticus

BT_RT 1.48

Outline the causes of acute spinal cord dysfunction and an approach to the initial assessment and management of the patient with acute spinal cord dysfunction

BT_RT 1.49

Describe clinical situations likely to result in and outline the initial management of:

Hyper/hypokalemia

Hyponatremia and hypo-osmolality

Hypernatremia

Hyper/hypoglycemia

Hyper/hypocalcemia

Hyper/hypomagnesemia

Metabolic acidosis

BT_RT 1.50

Outline the steps to take in the event of:

An operating room fire

Electrical power failure in the operating suite

BT_RT 1.51

Describe the likely presentation of and steps to take in the event of:

Failure of pipeline gas supply

Anaesthesia machine and ventilator malfunction

Breathing circuit malfunctions such as stuck valves and massive leaks

BT_RT 1.52

Outline appropriate preparation of equipment and personnel prior to the arrival of the trauma patient in the hospital

BT_RT 1.53

Outline features of the patient’s history that are indicative of injury severity

BT_RT 1.54

Identify contraindications to urinary catheters and nasogastric tubes during trauma resuscitation

BT_RT 1.55

Describe indications for a definitive airway in the trauma patient

BT_RT 1.56

Describe strategies to prevent hypothermia in the trauma patient

BT_RT 1.57

Describe infection control techniques in the trauma setting

BT_RT 1.58

Outline the initial steps in local disaster management protocols for their institution

AT_RT 1.1

Where the following problems occur in association with anaesthesia and sedation, the trainee will be able to:

Discuss potential causes and their relative frequency

Evaluate severity, potential consequences and the need for treatment

Select treatment appropriate to the severity of the condition

Describe the clinical evaluation and both the initial and definitive management

Problems:

Dyspnoea

Hypoxia

Hypocapnoea/hypocarbia

Hypercapnoea/hypercarbia

Tachycardia

Bradycardia

Hypotension

Hypertension

High airway pressures

Oliguria/anuria

Failure to wake from anaesthesia (also refer to the General anaesthesia and sedation clinical fundamental)

Tension pneumothorax

Massive haemoptysis

Local anaesthetic toxicity (also refer to the Regional and local anaesthesia clinical fundamental and the endorsed AAGBI Safety Guideline Management of Severe Local Anaesthetic Toxicity)

Malignant hyperthermia

Gas embolism

Fat embolism

Raised intracranial pressure

Coagulopathy in association with surgery or trauma

AT_RT 1.2

Describe the clinical features and resuscitative management of patients with:

Ischaemic and haemorrhagic stroke

Prolonged seizures

Rhabdomyolysis

Pulmonary embolism

Haematemesis and melaena

Thyroid storm

Addisonian crisis

Diabetic ketoacidosis

Hyperosmolar, hyperglycaemic state

Hypo-osmolar states

Severe electrolyte disturbances

Severe acid base disturbance

Acute drug intoxication

AT_RT 1.3

Discuss the effects of age, body mass index (BMI) and concurrent medication on the presentation and management of patients with severe multi-trauma

AT_RT 1.4

Discuss the differential diagnosis of shock in the trauma patient

AT_RT 1.5

Discuss pain management in the multi-trauma patient

AT_RT 1.6

Describe the role of diagnostic ultrasound in the initial assessment of the trauma patient

AT_RT 1.7

Discuss the diagnosis and management of life-threatening haemorrhage in the multi-trauma patient and in particular haemorrhage due to:

Chest trauma

Abdominal trauma

Pelvic trauma

Major vascular injury

AT_RT 1.8

Outline the indications for emergency resuscitative thoracotomy

AT_RT 1.9

Discuss the diagnosis and management of cardiac tamponade in the trauma patient

AT_RT 1.10

Discuss the differential diagnosis of hypoxia in the trauma patient

AT_RT 1.11

Discuss the initial diagnosis and management of:

Pneumothorax

Flail chest

Pulmonary contusion

Traumatic aortic disruption

Tracheobronchial injury

AT_RT 1.12

Discuss the initial assessment and management of:

Acute traumatic brain injury

Unstable spinal injury including clearing the cervical spine

Acute spinal cord injury and ‘neurogenic’ shock

AT_RT 1.13

Describe the rationale for and methods of immobilisation of:

Pelvic fractures

Long bone fractures

AT_RT 1.14

Describe problems associated with crush injury

AT_RT 1.15

Describe the clinical features and outline the management of compartment syndrome

AT_RT 1.16

Describe the initial assessment and management of the patient with severe burn injury including:

Fluid management

Pain management

Inhalational injury (also refer to the Airway management clinical fundamental)

Carbon monoxide poisoning

AT_RT 1.17

Describe the initial assessment and management of the patient who has experienced:

Electrocution

Drowning and near drowning

Envenomation

Severe hypothermia

AT_RT 1.18

Outline the process for arranging a patient transfer

AT_RT 1.19

Discuss requirements for the safe transfer of critically ill patients (also refer to the Safety and quality in anaesthetic practice clinical fundamental and professional document PS52: Guidelines for Transport of Critically Ill Patients)

AT_RT 1.20

Contrast the challenges, difficulties and limitations of transferring patients by road or air

AT_RT 2.3

Interpret imaging relevant to the primary survey

IT_SQ 1.1

Outline and apply the College guidelines and recommendations for standards of safe practice:

Ensure appropriate standards are met in terms of equipment, monitoring and staffing when providing anaesthesia and sedation. Refer to College professional document PS55 Recommendations on Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and Other Anaesthetising Locations

Perform a level 2 and 3 check of the anaesthetic machine and related equipment. Refer to College professional document PS31: Recommendations on Checking Anaesthesia Delivery Systems

Apply appropriate monitoring for each case. Refer to College professional document PS18: Guidelines on Monitoring During Anaesthesia (PILOT)

Safely draw up, label and store drugs. Refer to College professional document PS51: Guidelines for the Safe Administration of Injectable Drugs in Anaesthesia

Demonstrate safe handover of care during and after anaesthesia. Refer to College professional document PS53 Statement on the Handover Responsibilities of the Anaesthetist

Outline the planning staffing and equipment required for the safe intra-hospital transfer of patients. Refer to College professional document PS52: Guidelines for Transport of Critically ill Patients

Outline and apply the surgical safety checklist (including time-out procedure). Refer to endorsed guideline WHO surgical safety checklist Australian and New Zealand edition

Outline the requirement for, and competencies of, an assistant for the anaesthetist when undertaking anaesthesia, analagesia or sedation procedures: Refer to College professional document PS08: Statement on the Assistant for the Anaesthetist (PILOT)

IT_SQ 1.2

Describe safe transfusion practices including:

Safe storage and handling of blood and blood products

Protocols for checking prior to transfusing

IT_SQ 1.3

Outline measures to minimise the risk of injury or complications resulting from the use of a tourniquet

IT_SQ 1.4

Outline the recommended vaccinations for healthcare workers. Refer to College professional document PS28 Guidelines on Infection Control in Anaesthesia

IT_SQ 1.6

Outline the risk of peripheral nerve injury and measures to minimise this risk during procedures

IT_SQ 1.7

Outline steps to minimise the risk of eye injury during perioperative care

IT_SQ 1.8

Outline measures to minimise the risk of injury or complications resulting from the following patient positions

Supine

Trendelenberg and reverse trendelenberg

Lateral

Lithotomy

Prone

BT_SQ 1.1

Define the characteristics of quality healthcare provision as applied to anaesthesia (safe, effective, efficient, timely, patient-centred) and outline how this might be delivered

BT_SQ 1.2

Outline the general principles related to staffing and facilities for recovery room care. Refer to College professional document PS4: Recommendations for the Post-Anaesthesia Recovery Room

BT_SQ 1.3a

Outline the safe perioperative care of patients presenting for day care procedures. Refer to College professional document: PS 15 Recommendations for the Perioperative Care of Patients Selected for Day Care Surgery

BT_SQ 1.3b

Outline criteria for safe discharge of patients from the recovery room

AT_SQ 1.1

Define the characteristics of quality provision of anaesthesia services (safe, effective, efficient, timely, patient-centred) and discuss the processes of quality assurance and quality improvement (refer to College professional document: PS58 Guidelines on Quality Assurance in Anaesthesia) and their application to anaesthesia practice and College professional document: PS08 Statement on the Assistant for the Anaesthetist (PILOT)

AT_SQ 1.2

Outline the process for responding to patient complaints in their own institution

AT_SQ 1.3

Discuss how patient complaints provide an opportunity to improve the quality of anaesthesia care

AT_SQ 1.4

Discuss the non-technical skills required for safe anaesthesia practice

AT_SQ 1.5

Evaluate the College guidelines and recommendations for standards of safe anaesthetic practice contained in the following professional documents and evaluate their application in clinical situations appropriate for their practice.

PS55 Recommendations on Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and Other Anaesthetising Locations

PS54 Statement on the Minimum Safety Requirements for Anaesthetic Machines and Workstations for Clinical Practice

PS58 Guidelines on Quality Assurance in Anaesthesia

PS8 Guidelines on the Assistant for the Anaesthetist

PS15 Recommendations for the Perioperative Care of Patients Selected for Day Care Surgery

PS51 Guidelines for the Safe Administration of Injectable Drugs in Anaesthesia

PS52: Guidelines for Transport of Critically Ill Patients

Endorsed guideline: WHO Surgical Safety Checklist Australian and New Zealand edition

PS28 Guidelines on Infection Control in Anaesthesia

PS60 Guidelines on the Perioperative Management of Patients with Suspected or Proven Hypersensitivity to Chlorhexidine

AT_SQ 1.5a

Discuss criteria for safe discharge of patients from the recovery room

AT_SQ 1.6

Discuss the safety of methods used to manipulate the body temperature of patients during anaesthesia and sedation, including active warming and cooling

AT_SQ 1.7

Use tourniquets safely and discuss the hazards associated with their use

AT_SQ 1.8

Evaluate measures to minimise the risk of injury or complications (including pressure injury) resulting from the following patient positions:

Supine

Trendelenberg and reverse trendelenberg

Lateral

Lithotomy

Prone

Beach chair

Sitting

AT_SQ 1.9

Describe the management of injuries sustained during anaesthetic care, for example, peripheral nerve injury, eye injury

AT_SQ 1.10

Discuss the safety precautions and equipment requirements necessary for providing anaesthesia and sedation in the MRI suite

AT_SQ 1.11

Describe the stages in the design of a clinical trial including:

Research question and hypothesis

Literature review

Statistical advice

Ideal study protocol to minimise the risk of bias and to achieve optimum power of the study

Ethical issues and informed consent

Data collection and processing

AT_SQ 1.12

Explain the following concepts in statistics:

Distribution of data

Frequency distributions

Measures of central tendency

Dispersion of data

Selection and application of non-parametric and parametric tests in statistical inference

AT_SQ 1.13

Explain the principles of errors of statistical inference and describe techniques to minimise such errors through study design

AT_SQ 1.14

Explain sources of bias and confounding in medical research and methods available to reduce such bias

AT_SQ 1.15

Describe the various statistical methods used to estimate risk

AT_SQ 1.16

Describe the features of evidence-based medicine including levels of evidence, meta-analysis and systematic review

AT_SQ 1.17

Describe the role of ethics committees and outline the process involved in obtaining ethics committee approval for a research project

SS_NS 1.1

Describe the basic anatomy of the skull, brain, ventricular system, meninges, spinal cord and vertebral column of relevance to anaesthesia

SS_NS 1.2

Describe the blood supply of the brain and spinal cord

SS_NS 1.3

Describe the anatomy relevant to providing local anaesthesia for awake craniotomy

SS_NS 1.4

Outline the changes to cerebral blood flow control and cerebral perfusion pressure in patients with intracranial pathology

SS_NS 1.5

Explain the effect of fluid and electrolyte disturbances on brain function

SS_NS 1.6

Outline the grading of subarachnoid haemorrhage severity

SS_NS 1.7

Outline the radiological features of common acute neurosurgical conditions

SS_NS 1.8

Discuss pharmacologic and non-pharmacologic methods to manipulate intracranial pressure

SS_NS 1.9

Outline methods to reduce secondary injury and limit disability in traumatic brain injury and intracranial haemorrhage

SS_NS 1.10

Describe the anaesthetic implications of spinal cord trauma

SS_NS 1.11

Discuss the pathophysiology of pituitary tumours, including the implications of endocrine disorders such as acromegaly, Cushings syndrome, pan-hypopituitarism

SS_NS 1.12

Describe the mechanism and management of disorders of sodium control detected after neurosurgery

SS_NS 1.13

Outline the criteria for the diagnosis of brain stem death

SS_NS 1.14

Evaluate the effects of anaesthetic agents on brain and spinal cord physiology including metabolism, blood flow, intracranial and intraspinal pressure

SS_NS 1.15

Discuss the possible complications of sedative/hypnotic and analgesic agents in neurosurgical patients

SS_NS 1.16

Describe the pharmacology and clinical utility of antiepileptic and prophylactic therapy in neurosurgical patients

SS_NS 1.17

Describe the pharmacology and clinical utility of corticosteroids in neurosurgical patients

SS_NS 1.18

Discuss the pharmacology and clinical utility of pharmacological agents for prophylaxis and treatment of cerebral vasospasm associated with subarachnoid haemorrhage

SS_NS 1.19

Discuss methods to monitor cerebral blood flow including transcranial Doppler

SS_NS 1.20

Describe methods of intracranial pressure monitoring

SS_NS 1.21

Outline the principles of electrophysiological monitoring (electroencephalogram/sensory and motor evoked potentials) and the implication of neuromuscular blockade

SS_NS 1.22

Discuss the implications for anaesthesia of the positions used for neurosurgery

SS_NS 1.23

Discuss the risks associated with patient positioning for neurosurgical procedures and the methods of risk minimisation

SS_NS 1.24

Describe the typical presentation and natural history of the different types of intracranial haemorrhage

SS_NS 1.25

Discuss the acute resuscitation and management of patients with intracranial/subarachnoid haemorrhage (also refer to the Resuscitation, trauma and crisis management clinical fundamental and the intensive care specialised study unit)

SS_NS 1.26

Discuss the anaesthetic management of patients requiring the following neurosurgical procedures:

Clot retrieval for stroke

Craniotomy for intracranial tumour

Craniotomy for intracranial aneurysm or haemorrhage (acute and chronic)

Insertion of intracranial pressure monitors

Interventional neuroradiology for acute intracranial bleed

Interventional neuroradiology for stable intracranial vascular pathology

Spinal surgery (cervical, thoracic, lumbar)

Spinal fluid shunt procedures

SS_NS 1.27

Discuss the anaesthetic management of patients requiring intervention for the following:

Non-neurosurgical trauma in patients with concurrent traumatic brain injury

Traumatic brain injury

Intracranial vascular malformations

Vestibular schwannoma

Trigeminal neuralgia

Pituitary tumours

Epilepsy and movement disorders (including awake craniotomy and deep brain stimulation)

Meningomyelocoele

Cranial vault pathology

SS_NS 1.28

Discuss the complications of neurosurgical procedures including:

Air embolism

Rapid, life threatening bleeding

Cerebral ischaemia

(Also refer to the Resuscitation, trauma and crisis management and perioperative medicine clinical fundamentals)

SS_NS 2.2

Perform a basic neurological examination for assessment of neurological deficits

SS_CS 1.1

Discuss the physiology of hypothermia and deep hypothermic cardiac arrest

SS_CS 1.2

Evaluate means of estimating cardiac output

SS_CS 1.3

Describe pharmacological and non-pharmacological strategies to relieve anxiety in patients presenting for cardiac surgery

SS_CS 1.3a

Describe the anatomy of the heart and great vessels, particularly in relationship to the use of ultrasound imaging

SS_CS 1.4

Discuss the perioperative assessment of:

Myocardial ischaemia

Cardiac rhythm

Filling status

Left ventricular systolic and diastolic function

Right ventricular function and pulmonary artery pressure

Valve pathology

Shunts

SS_CS 1.5

Outline the basic surgical steps involved in the following cardiac procedures:

Coronary artery bypass both on and off pump

Aortic and mitral valve replacement

Repair of aortic dissection

SS_CS 1.6

Describe the initial medical management of acute thoracic aortic dissection (also refer to the Resuscitation, trauma and crisis management clinical fundamental) and outline the principles of providing anaesthesia for surgical repair

SS_CS 1.7

Describe an appropriate anaesthetic technique for the following cardiac surgical procedures including haemodynamic goals:

Coronary artery bypass

Aortic and mitral valve replacement

SS_CS 1.8

List indications for application of external defibrillation/pacing pads prior to surgery

SS_CS 1.9

Describe the use of internal defibrillation

SS_CS 1.10

Describe the types of cardiac pacing including transvenous, external and epicardial pacing

SS_CS 1.11

Outline principles of programming cardiac pacemakers

SS_CS 1.12

Outline pacing modes and the terminology and abbreviations commonly used

SS_CS 1.13

Describe the method of insertion of a pulmonary artery catheter, describe the waveforms obtained (also refer to the Intensive Care Medicine specialised study unit)

SS_CS 1.14

Discuss the interpretation of the data obtained from PAC and other cardiac output measurement devices

SS_CS 1.15

Outline the specific issues associated with ‘re-do’ cardiac surgery

SS_CS 1.16

Outline the indications for cardiopulmonary bypass and ECMO in non-cardiac surgery procedures

SS_CS 1.17

Outline the issues related to the care of patients undergoing cardiopulmonary bypass, including:

Maintenance of anaesthesia during this period

Intraoperative myocardial protection

Potential neurocognitive effects and cerebral protection

Implications of aortic disease for aortic cannulation

Anticoagulation during cardiopulmonary bypass and point-of-care and laboratory methods of monitoring anticoagulation

Use of antifibrinolytics

Management of protamine reactions

Reperfusion injury and ischaemic preconditioning

Haematological and inflammatory effects of cardiopulmonary bypass

Steps to take to safely initiate and wean from bypass

SS_CS 1.18

Describe an approach to the patient with heparin resistance, heparin induced thrombocytopenia and thrombosis (HITTS) and heparin induced thrombocytopaenia (HITS)

SS_CS 1.19

Outline strategies for the management of the patient who is difficult to wean from bypass

SS_CS 1.20

Discuss factors influencing duration of postoperative ventilation following cardiac surgery

SS_CS 1.21

Discuss the role of ‘fast-track’ cardiac surgery and principles of anaesthesia and intensive care unit management for ‘fast track’ surgery

SS_CS 1.22

Outline the routine and emergent postoperative management of cardiosurgical patients in the intensive care unit

SS_CS 1.23

Outline the common complications presenting in the early postoperative period in cardiac surgical patients and their management

SS_CS 1.24

Outline a basic haemodynamic assessment using TOE or TTE

SS_CS 1.25

Discuss the role of echocardiography in assessing the haemodynamically unstable patient

SS_CS 1.26

Describe the initial medical management of the patient with acute myocardial infarction and cardiogenic shock and outline the principles of providing anaesthesia for acute revascularisation (also refer to the Resuscitation, trauma and crisis management clinical fundamental)

SS_CS 1.27

Outline the major complications associated with interventional cardiology procedures, their presenting features and initial management

SS_CS 1.28

Outline principles of intra-aortic balloon counterpulsation

SS_GG 1.1

For the following discuss the key clinical features which influence anaesthetic management. (Also refer to the Perioperative medicine clinical fundamental):

Bowel disease

Disease of the oesophagus

Disease of the stomach

Gallbladder disease

Liver disease

Disease of the spleen

Renal and urinary tract disease

Pancreatic disease

Adrenal disease

Gynaecological disorders

Breast disease

SS_GG 1.2

Discuss the physiological changes associated with pneumoperitoneum and management of those changes

SS_GG 1.3

Outline the differential diagnosis of the acute abdomen and the implications for anaesthetic management of the different causes

SS_GG 1.4

Outline the consequences of prolonged vomiting, bowel obstruction and malabsorption syndromes

SS_GG 1.5

Outline the anatomical modification that results from common gastrointestinal operations and the potential pathophysiological consequences

SS_GG 1.6

Discuss the surgical requirements and implications for anaesthetic management of patients undergoing the following elective general surgery, urological, gynaecological and endoscopic procedures:

Major open abdominal surgery

Major open urological surgery

Major gynaecological operations

Minor general, urological and gynaecological surgery

Breast surgery

Laparoscopic surgery

Endoscopic procedures

Lithotripsy

Treatment for infertility

SS_GG 1.7

Discuss perioperative analgesia and fluid therapy options for elective general surgery, urological, gynaecological and endoscopic procedures, including strategies for ‘fast track’ recovery programs for major abdominal surgery

SS_GG 1.8

Discuss the surgical requirements and implications for anaesthetic management of patients undergoing the following emergency general surgery, urological, gynaecological and endoscopic procedures:

Minor general, urological and gynaecological procedures

Major laparotomy and laparoscopy

Diagnostic laparoscopy

Gastroscopy

Ureteroscopy

SS_GG 1.9

For patients undergoing the following complex operations, discuss the specific anaesthetic management, including options for perioperative analgesia and perioperative fluid therapy:

Renal transplant

Partial hepatectomy

Surgery for major liver trauma

Oesophagectomy

Pancreatectomy

Adrenalectomy, including phaeochromocytoma

Resection of carcinoid tumour

Bariatric surgery

Breast reconstruction (also refer to the Plastics, reconstructive and burns surgery specialised study unit)

Surgery for gynaecological and urological malignancy

Major bowel resection, pelvic exenteration etc

SS_GG 1.10

Discuss the diagnosis and management of the possible complications of surgical procedures including (also refer to the Resuscitation, trauma and crisis management specialised study unit):

Venous air embolus

Rapid, life-threatening bleeding, including management of severe coagulopathy

Aspiration

Cardiovascular responses to insufflation of the peritoneal cavity

Sepsis

Hypo-osmolar syndromes

Reperfusion of ischaemic organs

Acid base imbalance, temperature control, positioning injuries

SS_GG 1.11

Describe the provision of anaesthetic care for organ procurement in a donor declared brain dead

SS_HN 1.1

Describe the anatomy and innervation of the face, external ear, neck, nasal passages, pharynx and larynx with reference to the performance of regional or topical anaesthesia for head, neck or ear nose and throat procedures.

SS_HN 1.2

Describe the indications for and features of special tracheal tubes used in ear nose and throat surgery, for example those used for:

Microlaryngeal surgery

Laser surgery

Laryngectomy

SS_HN 1.3

Describe the equipment used for emergency and elective jet ventilation

SS_HN 1.4

Describe the nature and biological effects of lasers commonly used in ear nose and throat

SS_HN 1.5

Describe the common co-morbid disease and patient factors encountered in patients having head, neck and ear nose and throat procedures

SS_HN 1.6

Describe the effects of previous surgery or radiation on the airway (also refer to the Airway management clinical fundamental)

SS_HN 1.7

Discuss the surgical requirements and the anaesthetic management of patients requiring common elective ear nose and throat procedures including:

Septo-rhinoplasty

Functional endoscopic sinus surgery (FESS)

Tonsillectomy and/or adenoidectomy

Microlaryngoscopy

Panendoscopy

Insertion of grommets

Myringoplasty or other middle ear surgery

Mastoidectomy

Laryngectomy or pharyngo-laryngectomy

Parotidectomy

Neck dissection

Tracheostomy

SS_HN 1.8

Discuss the surgical requirements and the anaesthetic management of patients requiring emergency ear nose and throat procedures including:

Reduction of fractured nose

Removal of inhaled foreign body

Removal of foreign body from the oesophagus or pharynx

Surgical management for obstructing laryngeal lesions (also refer to the Airway management clinical fundamental)

Drainage of oro-pharyngeal cysts or abscess, including quinsy

SS_HN 1.9

Outline the principles of anaesthetic management for awake tracheostomy

SS_HN 1.10

Discuss the precautions, possible complications and implications for anaesthetic management associated with the use of lasers in ear nose and throat surgery

SS_HN 1.11

Evaluate the use of jet ventilation as a technique for managing the airway and ventilation in patients having ear nose and throat procedures

SS_HN 1.12

Discuss the anaesthetic management of patients requiring thyroid or parathyroid surgery. In particular:

Use, effects and complications of thyroid hormones or anti-thyroid drugs used to stabilise patients perioperatively (also refer to the Perioperative medicine clinical fundamental)

The effects and management of hyper and hypo- calcaemia

Potential airway management issues and their assessment including in the patient with a retrosternal goitre (also refer to the Airway management clinical fundamental)

Surgical positioning and the implications for patient protection and access

Airway, surgical and endocrine complications in the perioperative period and their management

SS_HN 1.13

Discuss the implications of use of local anaesthetics and vasoconstrictive agents in head and neck surgery

SS_HN 1.14

Evaluate the use, safety and methods of providing induced hypotension to minimise blood loss and improve surgical operating conditions during ear nose and throat, head and neck surgery (also refer to the Plastic, Reconstructive and burns surgery specialised study unit)

SS_HN 1.15

Evaluate methods for the smooth emergence and/or extubation of patients to minimise bleeding following ear nose and throat and head and neck procedures

SS_HN 1.16

Discuss the indications, method and implications for anaesthetic management of monitoring facial nerve function intraoperatively

SS_HN 1.17

Discuss the clinical features and management of postoperative haemorrhage following head and neck and ear nose and throat surgery, particularly post tonsillectomy haemorrhage (also refer to the Airway management and Resuscitation, trauma and crisis management clinical fundamentals and the Paediatric anaesthesia specialised study unit)

SS_HN 1.18

Describe the risks and management of airway fire

SS_HN 1.19

Describe the innervation of the teeth and regional blocks used for dental procedures

SS_HN 1.20

Outline the types of facial, maxillary and mandibular fractures and their surgical management

SS_HN 1.21

Discuss the anaesthetic management of patients requiring surgical fixation of facial, maxillary and mandibular fractures

SS_HN 1.22

Discuss the anaesthetic management of patients requiring maxillary and mandibular osteotomies

SS_HN 1.23

Describe the indications for and method of managing the airway during maxillo-facial surgery with a nasal endotracheal tube

SS_HN 1.24

Discuss the anaesthetic management of patients requiring dental procedures including those with:

Intellectual impairment

Disorders of haemostasis

SS_HN 1.25

Describe the assessment and potential progression of dental sepsis and evaluate the anaesthetic management of patients with dental abscesses and Ludwig’s angina (also refer to the Airway management clinical fundamental)

SS_HN 1.26

Describe the evidence supporting the use of electro-convulsive therapy for managing depression

SS_HN 1.27

Describe the physiological response to electro-convulsive therapy

106

SS_IC 1.1

Discuss the importance of setting therapeutic goals for admission to intensive care

SS_IC 1.2

Outline estimation of nutritional requirements and prescribe nutritional support

SS_IC 1.3

Outline the complications associated with enteral and parenteral nutritional support

SS_IC 1.4

Discuss the provision of analgesia and sedation for critically ill patients

SS_IC 1.5

Describe the effect of critical illness on the pharmacokinetics and pharmacodynamics of sedative and analgesic agents

SS_IC 1.6

Describe weaning protocols of sedative and analgesic agents and strategies to prevent withdrawal phenomena

SS_IC 1.7

Evaluate the use of muscle relaxants in the critically ill patient

SS_IC 1.8

Outline the reasons why critically ill patients are particularly at risk of acquiring nosocomial infections

SS_IC 1.9

Describe standard precautions as applied to critically ill patients

SS_IC 1.10

Outline a scoring system to assess severity of illness and discuss the utility of such scoring systems

SS_IC 1.11

Outline the long-term complications of prolonged intensive care admission

SS_IC 1.12

Describe the features of patients who may be suitable organ donors

SS_IC 1.13

Outline the management of the brain-dead patient awaiting organ donation

SS_IC 1.14

Describe the principles of safe intra and inter-hospital transfer of critically ill patients professional document: PS52: Guidelines for Transport of Critically Ill Patients (also refer to the Safety and quality in anaesthetic practice clinical fundamental)

SS_IC 1.15

Define sepsis, severe sepsis and systemic inflammatory response syndrome (SIRS)

SS_IC 1.16

Outline the pathophysiology of SIRS and sepsis and severe sepsis

SS_IC 1.17

Describe the mechanisms of organ dysfunction in severe sepsis

SS_IC 1.18

Outline the investigation and management of the patient with severe sepsis

SS_IC 1.19

Discuss goal directed therapy of sepsis (also refer to the Perioperative medicine clinical fundamental)

SS_IC 1.20

Broadly classify antimicrobial agents according to their mode of action and spectrum of activity

SS_IC 1.21

Describe the adverse effects of antimicrobial agents in the intensive care patient

SS_IC 1.22

Discuss the role of prophylaxis in preventing infection in the intensive care patient

SS_IC 1.23

Describe a rational approach to prescribing antimicrobial treatment in severe sepsis

SS_IC 1.24

Describe the clinical features of the shocked patient and the clinical features differentiating the causes of shock

SS_IC 1.25

Describe the pathophysiological consequences of shock

SS_IC 1.26

Outline the clinical use of indicators of tissue oxygenation

SS_IC 1.27

Interpret blood gas analysis in the shocked patient

SS_IC 1.28

Discuss methods of monitoring cardiac output and optimisation of fluid therapy in the intensive care patient

SS_IC 1.29

Discuss the treatment of shock according to its cause and the role of goal directed therapy

SS_IC 1.30

Discuss the role of fluid therapy in the shocked patient

SS_IC 1.31

Describe the investigation and management of the patient with acute myocardial infarction and cardiogenic shock

SS_IC 1.32

Discuss the investigation and management of myocardial contusion

SS_IC 1.33

Outline the intensive care management of traumatic aortic injury

SS_IC 1.34

Describe the diagnosis and medical management of acute thoracic aortic dissection (also refer to the Resuscitation, trauma and crisis management clinical fundamental and the Cardiac surgery and interventional cardiology specialised study unit)

SS_IC 1.35

Outline the management of heart failure in the intensive care setting

SS_IC 1.36

Discuss the use of vasopressors, inotropic and lusitropic agents in the intensive care setting

SS_IC 1.37

Outline the management of cardiac arrhythmias in the intensive care patient

SS_IC 1.38

Outline the pathophysiology of and describe the investigations and management of pulmonary embolic disorders

SS_IC 1.39

Outline the indications for and principles of use of intra aortic balloon pumps and ventricular assist devices in the intensive care setting

SS_IC 1.40

Critically evaluate the resuscitative management of patients in cardiac arrest (also refer to the Resuscitation, trauma and crisis management clinical fundamental)

SS_IC 1.41

Define respiratory failure and differentiate between types of respiratory failure

SS_IC 1.42

Discuss the differences between acute and chronic respiratory failure and the implications for management

SS_IC 1.43

Interpret blood gas analysis, CXR and pulmonary function tests in respiratory failure

SS_IC 1.44

Describe the pathophysiology of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) and outline the intensive care management of these

SS_IC 1.45

Describe the pathophysiology and management of pulmonary oedema

SS_IC 1.46

Discuss the intensive care management of chest trauma including pulmonary contusions, chest wall injuries and haemorrhage

SS_IC 1.47

Describe the pathophysiology and management of fat embolism syndrome

SS_IC 1.48

Describe the pathophysiology and management of acute severe asthma

SS_IC 1.49

Describe the management of acute exacerbations of COPD

SS_IC 1.50

Outline the management of pneumonia in the intensive care setting

SS_IC 1.51

Describe the prevention and management of ventilator associated pneumonia

SS_IC 1.52

Discuss the investigation and management of postoperative respiratory failure

SS_IC 1.53

Describe methods of and indications for providing ventilatory assistance in respiratory failure including the place of noninvasive ventilation

SS_IC 1.54

Evaluate ventilation strategies and non-ventilator therapies to optimise oxygenation and ventilation and minimise lung injury

SS_IC 1.55

Discuss the complications of ventilation and the strategies to minimise ventilator-induced lung injury including the ventilation of patients with ARDS

SS_IC 1.56

Discuss the interpretation of blood gas analysis and the use of this to guide respiratory support

SS_IC 1.57

Discuss the assessment and management of extubation in patients who have been intubated for airway obstruction, for example, epiglottitis, angioneurotic oedema, Ludwig’s angina

SS_IC 1.58

Describe the indications for, timing and subsequent management of tracheotomies, including common complications, in the critically ill patient

SS_IC 1.59

Describe the procedure, contraindications and possible complications of percutaneous dilatation tracheotomy

SS_IC 1.60

Discuss the issues associated with the long-term ventilation of patients with chronic neuromuscular disorders and outline the factors important in making the decision to initiate assisted ventilation in these patients

SS_IC 1.61

Discuss the available strategies for weaning patients from ventilatory support and discuss the timing and particular issues with different patient groups

SS_IC 1.62

Outline the indications for the use of ECMO in respiratory failure and outline the principles of delivery of ECMO

SS_IC 1.63

Outline the indications for hyperbaric oxygen therapy in the critically ill patient and the problems associated with providing this treatment

SS_IC 1.64

Critically evaluate the resuscitative management of patients in respiratory arrest

SS_IC 1.65

Discuss the initiation of ventilation and management of patients on ventilators in the intensive care setting

SS_IC 1.66

Discuss the initiation of non-invasive ventilation and management of patients receiving non-invasive ventilation in the intensive care setting

SS_IC 1.67

Describe the pathophysiology, investigation and management of acute renal failure

SS_IC 1.68

Discuss strategies to prevent acute renal failure in the critically ill patient

SS_IC 1.69

Describe the clinical situations where rhabdomyolysis is likely to occur and discuss the diagnosis and management of acute rhabdomyolysis

SS_IC 1.70

Describe methods of providing renal replacement therapy in the patient with acute renal failure

SS_IC 1.71

Discuss the aetiology, diagnosis and management of fluid and electrolyte disturbances in the critically ill patient (also refer to the Resuscitation, trauma and crisis management clinical fundamental)

SS_IC 1.72

Discuss the clinical management of acid-base disturbances in critically ill patients

SS_IC 1.73

Outline the principles of postoperative care of the renal transplant recipient

SS_IC 1.74

Describe the metabolic response to trauma and critical illness

SS_IC 1.75

Outline the intensive care management of severe hypothermia

SS_IC 1.76

Discuss the intensive care management of malignant hyperthermia and neuroleptic malignant syndrome

SS_IC 1.77

Discuss the management of endocrine emergencies, including thyroid storm, adrenocortical insufficiency, diabetic ketoacidosis and hyperglycaemic non-ketotic coma

SS_IC 1.78

Outline the diagnosis and management of persistent vegetative state

SS_IC 1.79

Discuss the clinical diagnosis of brain death and the confirmatory investigations involved

SS_IC 1.80

Discuss the determinants and control of:

Intracranial and intraspinal pressure

Cerebral blood flow

Spinal cord perfusion

SS_IC 1.81

Discuss the principles of intracranial pressure monitoring

SS_IC 1.82

Outline the pathophysiology, investigation and management of delirium in the intensive care patient

SS_IC 1.83

Discuss the management of the patient with neurological deterioration due to ischaemic and haemorrhagic stroke and subarachnoid haemorrhage

SS_IC 1.84

Discuss the management of cerebral vasospasm

SS_IC 1.85

Outline the investigation and management of encephalitis and meningitis

SS_IC 1.86

Discuss the intensive care management of:

Raised intracranial pressure

Acute traumatic brain injury

Prolonged seizures

Acute spinal cord injury

SS_IC 1.87

Outline the principles of management of:

Hemiplegia, paraplegia, quadriplegia.

Postoperative neurosurgical patients

Diabetes insipidus

Cerebral salt wasting

SS_IC 1.88

Outline the pathophysiology and indications for intensive care management for patients with:

Tetanus

Botulism

Guillain-Barre syndrome

Myasthenia gravis

Myotonias and muscular dystrophies

SS_IC 1.89

Discuss the investigation and management of the critical care patient who wakes with neurological impairment

SS_IC 1.90

Discuss the management of life-threatening GIT haemorrhage

SS_IC 1.91

Outline the diagnosis and management of oesophageal perforation

SS_IC 1.92

Outline the management of acute and acute on chronic liver failure including the indications for transplantation

SS_IC 1.93

Outline the diagnosis and management of acute pancreatitis

SS_IC 1.94

Outline the intensive care unit management of the patient with life-threatening abdominal conditions including:

Abdominal sepsis

Ischemic, perforated or obstructed gut

Major abdominal trauma

SS_IC 1.95

Discuss the intensive care management of patients who have undergone major abdominal surgery

SS_IC 1.96

Outline the management of oncology emergencies:

Due to primary disease, for example vena cava obstruction, acute cord compression, pericardial effusion

Secondary to treatment, for example, graft versus host disease, immune suppression

SS_IC 1.97

Outline an approach to the management of the intensive care patient with coagulopathy including disseminated intravascular coagulation

SS_IC 1.98

Outline the appropriate use of anticoagulants in patients in the intensive care setting including prevention and management of venous and arterial thrombosis and thromboembolism

SS_IC 1.99

Outline the investigation and management of anaemia and thrombocytopaenia in intensive care

SS_IC 1.100

Discuss the rational use of blood products in the intensive care setting

SS_IC 1.101

Discuss the investigation and management of transfusion reactions

SS_IC 1.102

Outline the intensive care management of:

Electrocution

Burns

Near drowning

Envenomation

Drug overdose

Corrosive ingestion

Altitude sickness

Decompression syndromes

SS_IC 1.103

Outline the specific requirements of managing the obstetric patient in intensive care, including maintenance of foetal viability, for example, in the patient with cardiovascular failure, respiratory failure, or intracranial haemorrhage

SS_IC 1.104

Explain the differences in basic and advanced life support in the pregnant patient (also refer to the Obstetric anaesthesia and analgesia specialised study unit)

SS_IC 1.105

Discuss the intensive care management of severe preeclampsia and eclampsia

SS_IC 1.106

Discuss the intensive care management of post-partum haemorrhage and amniotic fluid embolism

SS_OB 1.16

Describe the pre-anaesthetic assessment of a pregnant woman

SS_OB 1.17

Describe the role of aspiration prophylaxis in pregnant women undergoing surgery

SS_OB 1.18

Outline the indications for referral of the high-risk pregnant woman to more specialised centres of obstetric care

SS_OB 1.19

Describe the anaesthetic management of early pregnancy conditions such as molar pregnancy, termination, ectopic pregnancy, miscarriage and septic abortion (also refer to the General anaesthesia and sedation clinical fundamental)

SS_OB 1.20

Describe the mechanisms and progress of normal labour

SS_OB 1.21

Describe the clinical methods used for foetal monitoring in labour

SS_OB 1.22

Evaluate the analgesic options for labour and delivery

SS_OB 1.23

Describe the selection of agents and route of administration in providing neuraxial analgesia for labour and delivery

SS_OB 1.24

Discuss the role of combined spinal epidural analgesia in labour

SS_OB 1.25

Describe the urgency of emergency delivery with regard to the threat to maternal or foetal wellbeing, in accordance with established guidelines, for example, RANZCOG College Statement C-Obs 14 Categorisation of urgency for caesarean section

SS_OB 1.26

Evaluate the role of epidural, spinal, and combined spinal epidural techniques for caesarean birth

SS_OB 1.27

Evaluate methods to treat hypotension associated with neuraxial blockade for caesarean birth

SS_OB 1.28

Discuss the management of significant complications of neuraxial analgesia and anaesthesia in childbirth, for example:

Post-dural puncture headache

Total spinal

SS_OB 1.29

Discuss the management of suboptimal block including conversion to general anaesthesia for caesarean birth

SS_OB 1.30

Evaluate the role of, options for and particular problems with providing general anaesthesia for elective and emergency caesarean birth

SS_OB 1.31

Describe the prevention of venous thromboembolism in the pregnant woman

SS_OB 1.32

Discuss measures to minimise the risk of injury from positioning the pregnant patient during anaesthesia

SS_OB 1.33

Evaluate methods for providing postoperative analgesia after caesarean birth

SS_OB 1.34

Discuss the anaesthetic management of problems that may arise with labour and delivery, including the following situations:

Vaginal birth after caesarean (VBAC)

Uterine rupture

Multiple gestation

Breech

Assisted vaginal birth

Premature labour

Cord prolapse

Abnormal placental implantation

Antepartum haemorrhage

Post partum haemorrhage

Shoulder dystocia

Foetal death in utero

SS_OB 1.35

Discuss the pathophysiology and anaesthetic management of the following medical conditions particular to pregnancy:

Hypertensive disorders of pregnancy/preeclampsia

HELLP syndrome

Eclampsia

Peripartum cardiomyopathy

Gestational diabetes

Acute fatty liver of pregnancy

Cholestasis associated with pregnancy

Rhesus iso immunisation

SS_OB 1.36

Discuss the pathophysiology and anaesthetic management of co-existing maternal conditions as described in the Perioperative medicine Clinical Fundamental, in particular:

Morbid obesity

Cardiac disease

Substance abuse

Psychiatric conditions

SS_OB 1.37

Discuss the implications of vertebral column abnormalities and intra-cranial pathology on provision of neuraxial blockade in pregnancy

SS_OB 1.38

Discuss the implications of drugs modifying haemostasis on the provision of neuraxial blockade in pregnancy

SS_OB 1.39

Discuss the differences in basic and advanced life support in the pregnant woman

SS_OB 1.40

Discuss the diagnosis and management of maternal collapse, including:

Thromboembolism

Amniotic fluid embolism

Air embolism

Anaphylaxis

Local anaesthetic toxicity (refer to the endorsed AAGBI Safety Guideline Management of Severe Local Anaesthetic Toxicity)

High spinal

Massive haemorrhage

Eclampsia

SS_OB 1.41

Discuss the diagnosis and management of neurological deficits in women after neuraxial blockade and delivery

SS_OB 1.42

Discuss intrauterine resuscitation of the at-risk foetus

SS_OB 1.43

Describe the unique aspects of management of resuscitation of the pregnant trauma patient including:

Optimally positioning to avoid aorto-caval compression

Altered maternal physiological responses

Maternal resuscitation as the first priority, representing best care of both the woman and the foetus

The need for early obstetric involvement and foetal monitoring

High possibility of placental abruption and uterine rupture

The need to give Rh immunoglobulin therapy to all Rhesus negative mothers

The place of perimortem caesarean birth

The clinical indicators and subsequent management implications of non-accidental injury in pregnancy

SS_OB 1.44

Discuss the unique aspects of management of anaesthesia for the pregnant woman having non-obstetric surgery

SS_OB 1.45

Outline the main causes of maternal mortality in Australasia and discuss methods to reduce maternal mortality

SS_OP 1.1

Describe the anatomy of the eye and the contents of the orbit with reference to the performance of regional eye blocks and their complications

SS_OP 1.2

Describe the determinates of ocular perfusion and intra-ocular pressure

SS_OP 1.3

Describe the eye reflexes (oculo-cardiac, oculo-respiratory, oculo-emetic) and their management during eye procedures

SS_OP 1.4

Discuss the selection of local anaesthetic solutions for regional and topical eye blocks

SS_OP 1.5

Discuss the use of adjuvant drugs for regional eye blocks and in particular Hyalase

SS_OP 1.6

Outline the anaesthetic implications of the perioperative use of drugs by eye surgeons; in particular topical local anaesthetic agents, vasoconstrictors, mydriatics, miotics, and intraocular pressure-reducing agents

SS_OP 1.7

Describe the common co-morbid disease and patient factors encountered in patients having ophthalmic procedures (also refer to the Paediatric anaesthesia specialised study unit)

SS_OP 1.8

Discuss the surgical requirements and implications for anaesthetic management of patients having surgery for:

Cataracts

Glaucoma

Retinal detachment

Penetrating eye injury

Enucleation for infection or tumour

Examination under anaesthesia

Strabismus

Blocked nasolacrimal duct

Extraocular procedures (also refer to the Plastics, reconstructive and burns surgery specialised study unit)

SS_OP 1.9

Discuss the specific anaesthetic requirements for emergency eye surgery and in particular the patient with a penetrating eye injury

SS_OP 1.10

Discuss the implications for anaesthesia of the intra-ocular injection of gas

SS_OP 1.11

Describe and compare regional blocks used for eye procedures, their possible complications and management including:

Subtenon block

Peri-bulbar block

Retrobulbar block

SS_OP 1.12

Describe the methods used to decrease or prevent a rise in intra-ocular pressure following a peri-bulbar block

SS_OP 1.13

Discuss how patient factors and co-morbid conditions influence choice of anaesthesia for eye surgery in particular:

Anticoagulation status

Ability to lie flat

Ability to cooperate

Axial length of the globe

SS_OP 1.14

Outline the issues to be considered in providing appropriate pre-operative care for patients having eye surgery

SS_OP 1.15

Describe sedation techniques for eye procedures

SS_OP 1.16

Discuss strategies to convert from regional to general anaesthesia during an eye procedure

SS_OP 1.17

Describe the patient and staff precautions required when using laser during eye surgery (also refer to the Safety and quality in anaesthetic practice clinical fundamental)

SS_OR 1.1

Describe the rationale for and outline initial methods of fracture immobilisation and analgesia in patients awaiting definitive surgery for major trauma, including:

Pelvic fractures

Long bone fractures

Spinal fractures

SS_OR 1.2

Discuss the initial assessment and management of (also refer to the Resuscitation, trauma and crisis management clinical fundamental):

Unstable spinal injury including clearing the cervical spine

Acute spinal cord injury and ‘neurogenic’ shock

SS_OR 1.3

Discuss the management of patients requiring anaesthesia for:

Pelvic fractures

Shoulder girdle fractures

Long bone fractures

Distal limb fractures

Reduction and fixation of spinal fractures

SS_OR 1.4

In the trauma patient undergoing orthopaedic surgery, discuss the management of the following potential complications:

Cemented implant syndrome

Haemorrhage

Massive transfusion

Crush injury

Compartment syndrome

Re-perfusion injury

Fat embolism syndrome

SS_OR 1.5

Discuss the diagnosis and prevention of chronic pain in musculo-skeletal trauma

SS_OR 1.6

Outline the implication of neuro-vascular compromise of a limb or compound fractures for timing of surgery

SS_OR 1.7

Discuss the assessment and anaesthetic management of the elderly patient with a hip fracture

SS_OR 1.8

Describe the indicators of non-accidental injury and outline an appropriate course of action when non-accidental injury is suspected

SS_OR 1.9

Evaluate the selection and use of thrombo-prophylaxis and antibiotic prophylaxis in orthopaedic trauma surgery

SS_OR 1.10

Describe the common co-morbid disease and patient factors encountered in patients having elective orthopaedic procedures (also refer to the Paediatric anaesthesia specialised study unit and the Perioperative medicine clinical fundamental)

SS_OR 1.11

Discuss the management of patients requiring anaesthesia for:

Joint replacement

Joint arthroscopy

Shoulder surgery

Ligament, peripheral nerve and/or artery repair, tendon

Lengthening or transfer

Compartment syndrome

Dislocated joint, including prosthesis

Joint infections

Pathological fractures

SS_OR 1.12

Outline the common comorbidities associated with scoliosis and the anaesthetic management of patients having scoliosis correction surgery

SS_OR 1.13

Discuss the implications of age and comorbidities in the perioperative plan of patients presenting for arthroplasty

SS_OR 1.14

Discuss the diagnosis and management of the possible complications of orthopaedic surgery including (also refer to the Resuscitation, trauma and crisis management clinical fundamental):

Cemented implant syndrome

Fat embolism syndrome

Pulmonary embolism

Compartment syndrome

Major blood loss

Neurological injury

Chronic and persistent pain

SS_OR 1.15

Discuss the safe use of tourniquets for orthopaedic procedures (also refer to the Safety and quality in anaesthetic practice clinical fundamental)

SS_OR 1.16

Discuss the choice and timing of antibiotic prophylaxis for orthopaedic patients

SS_OR 1.17

Discuss the use of thrombo-prophylaxis for orthopaedic patients especially joint replacement (also refer to the Safety and quality in anaesthetic practice clinical fundamental)

SS_OR 1.18

Discuss the perioperative management of patients on therapeutic anticoagulation requiring anaesthesia for orthopaedic procedures (also refer to the Perioperative medicine clinical fundamental)

SS_OR 1.19

Evaluate methods to reduce intra-operative and postoperative blood loss and minimise the need for blood transfusion during or following orthopaedic procedures

SS_OR 1.20

Describe the methods of spinal cord monitoring during spinal surgery

SS_OR 1.21

Discuss the use of NSAIDs in orthopaedics (also refer to the Pain medicine clinical fundamental)

SS_OR 1.22

Discuss the implications of the use of the beach-chair position for shoulder surgery

SS_OR 1.23

Discuss the implications of patients presenting with arthritis (osteoarthritis, rheumatoid arthritis or ankylosing spondylitis) (also refer to the Perioperative medicine clinical fundamental)

SS_OR 1.24

Discuss implications of morbidly obese patients presenting for major orthopaedic surgery. For example:

Airway management

Risk of postoperative pulmonary complications

Monitoring

Intravenous access

Regional anaesthesia/analgesia

Systemic analgesia

Early mobilisation

SS_OR 1.25

Discuss the options available for acute and subacute pain management following major orthopaedic surgery. For example:

Advantages and disadvantages of regional anaesthesia

Advantages and disadvantages of regional analgesia

Therapies to manage persistent post-surgical pain (neuropathic or nociceptive)

SS_PA 1.2

Describe airway and ventilatory equipment specific for paediatric patients, including:

Estimation of ETT size based on age

Accurate placement of ETT including fixation techniques

Issues relating to use of cuffed tubes in paediatrics

Breathing circuits

SS_PA 1.3

Describe how preoxygenation and rapid sequence induction may be modified in children

SS_PA 1.4

Describe how positioning for direct laryngoscopy differs in children

SS_PA 1.5

Describe how techniques for endotracheal intubation differ in neonates and children

SS_PA 1.6

Discuss indications for nasal intubation

SS_PA 1.7

Describe the clinical features associated with a difficult airway, including those of syndromes and congenital abnormalities such as Pierre Robin, mucopolysaccaridoses and Treacher Collins

SS_PA 1.8

Discuss the clinical features, possible causes, and management of perioperative upper airway obstruction including laryngospasm

SS_PA 1.9

Describe the clinical features of children with critical airway obstruction and outline a management plan for the child with critical airway obstruction.

SS_PA 1.10

Describe a technique for fibre optic intubation in children

SS_PA 1.11

Discuss the principles of mechanical ventilation in paediatric patients, including selection of appropriate modes of ventilation, normal volumes and pressures, and the role of PEEP

SS_PA 1.12

Describe the principles of the assessment of acute pain in children including the difficulties, relevance of functional assessment and the use of paediatric pain scales

SS_PA 1.13

Discuss the importance of psychological and social factors in the presentation and management of acute pain in children

SS_PA 1.14

Discuss the particular requirements for acute pain management in day-case anaesthesia

SS_PA 1.15

Discuss the factors which influence the choice of mode of delivery of parenteral opioids in acute pain management (patient controlled anaesthesia, continuous infusion and prn prescription) in children

SS_PA 1.16

Outline clinical situations where regional infusion techniques may be of benefit for management of acute pain in paediatric patients (also refer to the Regional and local anaesthesia clinical fundamental)

SS_PA 1.17

Describe appropriate prescription, set up, and monitoring of patient controlled anaesthesia (PCA) and parenteral opioid infusions for paediatric patients with acute pain

SS_PA 1.18

Outline the risks and appropriate monitoring of neonates receiving parenteral opioids

SS_PA 1.19

Outline a plan to transition paediatric patients with acute pain from parenteral to oral analgesic therapies

SS_PA 1.20

Formulate a plan for acute pain management that shows integrated knowledge of the interaction of analgesic agents, patient factors and the aetiology of pain

SS_PA 1.28

Define and use terms that describe paediatric age and development

SS_PA 1.29

Outline the implications of the developmental stage of children for their anaesthetic care

SS_PA 1.30

Discuss the clinical features and implications for anaesthetic care of the following medical conditions:

Prematurity and the problems of ex-premature infants

Asthma

Sleep apnoea

Cystic fibrosis

Quinsy

Croup

Epiglottitis

Down syndrome

Cerebral palsy

Autism

Obesity

Diabetes

SS_PA 1.31

Outline the clinical features and implications for anaesthetic care of the following medical conditions:

Muscular dystrophies

Congenital heart disease, including shunts, Fontan circulation and tetralogy of Fallot

Mediastinal mass

SS_PA 1.32

Describe the preoperative preparation of children and their parents in the preoperative consultation

SS_PA 1.33

Describe the assessment and management of a child with URTI or other intercurrent medical illness in the preoperative period

SS_PA 1.34

Describe the assessment and management of a child with an undiagnosed murmur detected in the preoperative assessment

SS_PA 1.35

Describe the clinical features helpful in recognising the critically ill child

SS_PA 1.36

Describe the aetiology of cardiac arrest in paediatric patients, both in the peri-anaesthetic and non-anaesthetic setting

SS_PA 1.37

Discuss the assessment of blood loss in children

SS_PA 1.38

Describe a fluid resuscitation regimen for acute blood loss appropriate for children

SS_PA 1.39

Discuss the assessment and management of dehydration

SS_PA 1.40

Outline an approach to obtaining vascular access in the shocked paediatric patient

SS_PA 1.41

Discuss the diagnosis and resuscitative management of children with the following life threatening conditions:

Cardiac arrest

Respiratory arrest

Shock

Anaphylaxis

Sepsis, including meningococcal sepsis

Aspiration of gastric contents

Severe bronchospasm

Post-tonsillectomy haemorrhage

Gas embolism

Fat embolism

Raised intracranial pressure

Local anaesthetic toxicity

Malignant hyperthermia

Coagulopathy

Severe electrolyte and acid-base disturbances

SS_PA 1.42

Describe the principles of safe intra- and inter-hospital transport of critically ill neonates and children (also refer to the Safety and quality in anaesthetic practice clinical fundamental and College professional document PS52: Guidelines for Transport of Critically Ill Patients)

SS_PA 1.43

Outline special preparations in the emergency department prior to the arrival of a paediatric trauma patient

SS_PA 1.44

Outline the use of the Broselow tape in paediatric trauma

SS_PA 1.45

Describe traumatic injury patterns in children that differ from adults, including spinal cord injury without radiological abnormality (SCIWORA) and tension pneumothorax

SS_PA 1.46

Describe indicators of non-accidental injury in paediatric populations and outline an appropriate course of action when non-accidental injury is suspected

SS_PA 1.47

Describe the initial assessment and management of the child with severe burn injury including (also refer to the Resuscitation, trauma and crisis management clinical fundamental):

Fluid management

Pain management

Diagnosis and management of inhalational injury (also refer to the Airway management clinical fundamental)

Diagnosis and management of carbon monoxide poisoning

SS_PA 1.48

Describe the initial assessment and management of the child who has experienced (also refer to the Resuscitation, trauma and crisis management clinical fundamental):

Electrocution

Drowning and near drowning

Envenomation

Severe hypothermia

SS_PA 1.49

Describe methods to optimise the environment during the induction of anaesthesia in children

SS_PA 1.50

Describe methods to minimise the anxiety of children and their parents during induction of anaesthesia

SS_PA 1.51

Discuss the advantages and disadvantages of parental presence at induction of anaesthesia

SS_PA 1.55

Describe the pharmacology of topical anaesthesia agents and their use for cannulation and venepuncture

SS_PA 1.56

Discuss the use of TIVA and target controlled infusions in children

SS_PA 1.57

Discuss the effects of anaesthesia on the developing brain

SS_PA 1.58

Describe fasting guidelines used in paediatric anaesthesia and their basis

SS_PA 1.59

Discuss the use of preoperative sedative premedication in children, including selection of patients, choice of drug, and appropriate route, dosing and timing

SS_PA 1.60

Evaluate the role of pharmacologic and non-pharmacologic preoperative preparation of children of different ages

SS_PA 1.61

Discuss the prevention and management of postoperative delirium

SS_PA 1.62

Discuss the physiological effects of pneumoperitoneum in children

SS_PA 1.63

Discuss temperature maintenance in the anaesthetised child

SS_PA 1.64

Describe the anatomy, including ultrasonic anatomy, of the peripheral venous system relevant to performing intravenous cannulation in children

SS_PA 1.65

Outline measures to minimise patient discomfort and to improve success with intravenous cannulation in children

SS_PA 1.66

Outline the differences in central venous cannulation between children and adults

SS_PA 1.67

Evaluate the prevention and management of postoperative nausea and vomiting in children

SS_PA 1.68

Calculate intravenous fluid requirements and choose intravenous fluid therapy appropriate to the clinical situation for children

SS_PA 1.69

Discuss the methods available for monitoring depth of anaesthesia and sedation and their utility in neonates and children

SS_PA 1.70

Discuss the anaesthetic management of children requiring more complex shared airway procedures, for example, cleft lip and palate, laryngoscopy, oesophagoscopy, removal of airway foreign body

SS_PA 1.71

Discuss the anaesthetic management of children requiring neurosurgical procedures of moderate complexity, for example, VP shunt, burr hole for subdural/extradural haematoma

SS_PA 1.72

Outline the general principles of anaesthetic management of children requiring major neurosurgery, for example, craniotomy for tumour

SS_PA 1.73

Discuss the anaesthetic management of children with penetrating eye injury

SS_PA 1.74

Outline the general principles of anaesthetic management of children requiring major abdominal surgery, for example, fundoplication

SS_PA 1.75

Discuss anaesthesia for laparotomy for trauma in children

SS_PA 1.76

Discuss the anaesthetic management of infants having pyloromyotomy

SS_PA 1.77

Discuss the anaesthetic management of neonatal hernia repair

SS_PA 1.78

Outline the principles of anaesthetic management of neonates and infants requiring major surgery, for example, necrotising enterocolitis

SS_PA 1.81

Describe the anatomy of the neonatal spine and spinal cord and how this changes with growth and development and the implications for neural blockade

SS_PA 1.82

Outline the physiology of nerve conduction in neonates and children

SS_PA 1.83

Outline the assessment of the adequacy of a regional technique in neonates and children

SS_PA 1.84

Describe the physiological response to a central neuraxial block in neonates and children

SS_PA 1.85

Describe the use of adjuvant agents to enhance the quality or extend duration of peripheral or neuraxial block in neonates and children

SS_PA 1.86

Describe the pharmacokinetics of drugs administered in the epidural and subarachnoid space in neonates and children

SS_PA 1.87

Describe how the use of ultrasound imaging differs between adults, children and neonates

SS_PA 1.88

Describe the methods used for checking for inadvertent intravenous and intraneural administration of local anaesthetic, particularly with caudal anaesthesia

SS_PA 1.89

Outline factors influencing dose and choice of anaesthetic agents for spinal anaesthesia and epidural anaesthesia/analgesia in neonates and children

SS_PA 1.90

Describe post-anaesthesia instructions for patients who have undergone regional anaesthesia with a plan for postoperative analgesia and surveillance for neurological injury

SS_PA 1.91

Describe the recognition, investigation and management of complications of regional techniques in neonates and children

SS_PA 1.92

Outline the differences in performance of spinal and epidural anaesthesia and major plexus blocks in neonates and children compared with adults

SS_PA 1.93

For the following blocks commonly performed in paediatric anaesthesia:

Describe the anatomy relevant to block performance and complications

Discuss the indications and contraindications, risks and benefits.

Describe the appropriate patient positioning, anatomical landmarks and insertion techniques and methods to minimise risk of complication

Ilioinguinal

Femoral

Fascia iliaca

Penile

TAP

Caudal epidural

SS_PA 1.94

Describe the ANZCA requirements for non-specialist paediatric hospitals providing paediatric anaesthesia and the principles to be considered in formulating protocols and making decisions regarding the transfer of a child to a tertiary centre (refer to College professional document: PS29 Statement on Anaesthesia Care of Children in Healthcare Facilities Without Dedicated Paediatric Facilities

SS_PA 1.95

Discuss requirements for postoperative monitoring in neonates and ex-premature infants

SS_PA 1.96

Discuss the safety of methods of manipulating body temperature during anaesthesia and sedation, including active warming and cooling of infants and children

SS_PA 1.97

Discuss the safety precautions and equipment requirements when providing anaesthesia and sedation in the MRI suite (also refer to the Safety and quality in anaesthetic practice clinical fundamental and to College professional document: PS55 Recommendations on Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and Other Anaesthetising Locations)

SS_PB 1.1

Describe the physiological principles relevant to optimising blood flow to tissue flaps, including:

Oxygen transport and delivery

Determinants and control of cardiac output

Physics of blood flow

Determinants and regulation of blood flow through the various components of the vasculature

Autonomic nervous system control of systemic vascular

Resistance and redistribution of blood volume

The integrated cardiovascular responses to anaesthesia and a central neuraxial block

The physiological mechanisms controlling and regulating body temperature and the effects of anaesthesia

SS_PB 1.2

Describe the different types of tissue flaps and the implications for flap survival

SS_PB 1.3

Discuss the issues involved with and the anaesthetic management of patients having surgery for tissue flaps. Including:

Optimising conditions for flap survival

Prolonged anaesthesia

Limited access to the patient

Potential for major occult blood loss over a period of time

SS_PB 1.4

Describe the common co-morbid disease and patient factors encountered in patients having plastic or reconstructive surgical procedures

SS_PB 1.5

Discuss the surgical requirements and implications for the perioperative anaesthetic management of patients having:

Removal of multiple skin lesions

Cosmetic surgery

Split skin graft

Full thickness graft

Resection or debridement of tissue (minor and major)

SS_PB 1.6

Discuss pain management for patients undergoing plastic surgery

SS_PB 1.7

Evaluate the use, safety and methods of providing induced hypotension to minimise blood loss and improve surgical operating conditions during dissection and extensive excision of tissue (also refer to the Head and neck, ear, nose and throat, dental surgery and electro-convulsive therapy specialised study unit)

SS_PB 1.8

Describe the pathophysiology of burns and the multisystem effects commonly encountered in these patients

SS_PB 1.9

Discuss temperature homeostasis in burns patients and the implications of hypothermia in this group

SS_PB 1.10

Evaluate warming measures used to maintain the temperature of burns patients intra-operatively

SS_PB 1.11

Discuss the methods of managing the metabolic effects of burns in the perioperative period

SS_PB 1.12

Discuss the problems associated with monitoring and venous cannulation in burns patients and their management

SS_PB 1.13

Discuss the implications for the perioperative anaesthetic management of patients with the following burn injuries:

Airway and facial burns (also refer to the Resuscitation, trauma and crisis management clinical fundamental)

Respiratory burns (also refer to the Airway management clinical fundamental and the Intensive care medicine specialised study unit)

Electrical burns

Chemical burns

Associated trauma

SS_PB 1.14

Discuss the methods of minimising or managing blood loss during the debridement of burns

SS_PB 1.15

Discuss the perioperative assessment and management of fluid status and blood transfusion requirements for the burns patient

SS_PB 1.16

Outline infection control in burns patients and the prevention of secondary sepsis

SS_PB 1.17

Outline the methods and materials used to provide temporary and long term coverage of burns

SS_PB 1.18

Discuss the specific pain issues encountered in the burns patient and their management (also refer to the Pain medicine clinical fundamental)

SS_PB 1.19

Discuss the risk of a hyperkalaemic crisis in burns patients

SS_PB 1.20

Describe the anaesthetic issues and the management of patients returning for scar revision following burns, especially for neck and facial scarring (also refer to the Airway management clinical fundamental)

SS_TS 1.1

Describe the anatomy of the:

Tracheobronchial tree including endoscopic anatomy to level of lobar bronchi

Lung lobes and segments including common variations that may occur in these structures

Thorax, including the pleura and its surface anatomy

Innervation of the chest wall of relevance to the performance of regional blockade for thoracic surgery and chest trauma

SS_TS 1.2

Describe the changes in lung physiology and the implications for anaesthesia management which occur with:

Lateral decubitus positioning

Open thorax

One lung ventilation

SS_TS 1.3

Discuss the physiology of hypoxic pulmonary vasoconstriction, including the effect of anaesthetic agents and the implications for anaesthesia management

SS_TS 1.4

Discuss the pathophysiology of pulmonary hypertension and methods available to the anaesthetist to manipulate pulmonary vascular resistance and pulmonary artery pressures

SS_TS 1.5

Discuss the pathophysiology of chronic obstructive pulmonary disease and the strategies available for artificial ventilation to minimise gas trapping

SS_TS 1.6

Discuss the assessment of patients with mediastinal masses for surgical procedures including the assessment of severity of vascular and respiratory obstruction and the implications for anaesthesia management

SS_TS 1.7

Describe the techniques used to position patients for thoracic surgery and to minimise risk of postoperative position-related injury

SS_TS 1.8

Describe the indications and contraindications for one-lung ventilation

SS_TS 1.9

Describe the different methods available to perform lung isolation including the use of double-lumen tubes, bronchial blockers, single lumen tubes and Univent tubes and the rationale for selecting different methods in different situations (refer to the Paediatric anaesthesia specialised study unit for issues specifically pertaining to paediatric patients)

SS_TS 1.10

Discuss the complications of double lumen ETT and the management of intraoperative problems associated with their use

SS_TS 1.11

Discuss the management of hypoxaemia during one-lung ventilation

SS_TS 1.12

Discuss the anaesthetic management of the following endobronchial procedures:

Flexible bronchoscopy

Diagnostic bronchoscopy

Bronchoalveolar lavage

Bronchoscopic ultrasound and biopsy

Placement of endobronchial stent

Rigid bronchoscopy

Spontaneous versus jet ventilation

Removal of foreign body in airway

Laser of endobronchial tumour

SS_TS 1.13

Discuss the anaesthetic management of the following procedures:

Surgery for mediastinal mass

Thymectomy, particularly the perioperative management of myasthenia gravis (also refer to the Perioperative medicine clinical fundamental)

Mediastinoscopy

Thoracoscopy and thoracotomy for:

Pleurodesis

Bleeding

Bronchopleural fistula

SS_TS 1.14

Outline the anaesthetic management of the following procedures:

Lobectomy

Pneumonectomy

Drainage of lung abscess

Drainage of empyema and decortication of lung

Lung volume reduction surgery

Giant bullous emphysema resection

Thoracoscopic sympathectomy (also refer to the Vascular surgery and interventional radiology specialised study unit)

SS_TS 1.15

Identify pain management issues specific to thoracic surgery and critically evaluate analgesic options for patients having thoracic surgery

SS_TS 1.16

Identify fluid management issues specific to thoracic surgery and discuss fluid management of the patient having lung resection

SS_TS 1.17

Discuss the management of chest drains and pleural drainage systems in the postoperative period

SS_TS 1.18

Compare the anaesthetic management of thoracoscopic and open approaches for thoracic surgery

SS_TS 1.19

Outline the specific issues for perioperative management of patients for pneumonectomy

SS_TS 1.20

Outline the critical times during thoracic procedures that will impact on anaesthesia management, including airway ligation and manipulation of pulmonary vasculature

SS_TS 1.21

Outline the management of the following postoperative complications associated with thoracic surgery:

Bleeding (airway, lung or pleural cavity)

Pneumothorax

Arrythmias

Bronchopleural fistulae

Nerve damage

Pulmonary torsion

Cardiac herniation

SS_TS 1.22

Discuss the diagnosis and management of:

Pneumothorax/tension pneumothorax

Haemothorax

Flail chest

Rib/sternal fractures

Pulmonary contusion

Traumatic aortic disruption

Tracheobronchial injury, bronchopleural fistula

In particular:

Evaluate methods of analgesia for rib/sternal fractures

Outline indications for thoracotomy in the management of chest trauma

SS_TS 1.23

Discuss the management of respiratory failure associated with chest trauma and the place of non-invasive ventilation

SS_TS 1.24

Discuss the management of chest drains and pleural drainage systems for thoracic trauma

SS_VS 1.1

Outline the pathophysiology of peripheral vascular disease including common co-morbidities

SS_VS 1.2

Discuss the perioperative management of the following co- morbidities in the patient presenting for vascular surgery including perioperative risk assessment and risk reduction (also refer to the Perioperative medicine clinical fundamental):

Ischaemic heart disease

Cardiac failure

Arrhythmia

Hypertension

Diabetes mellitus

Chronic obstructive airways disease

Renal failure

SS_VS 1.3

Describe the impact of vascular disease on:

Wound dehiscence and infection

Positioning injury

Perioperative myocardial ischaemia

Perioperative stroke

Perioperative renal failure

SS_VS 1.4

Discuss the surgical requirements and implications for anaesthetic management of patients having elective surgery for:

Peripheral arterial occlusive disease

Carotid artery stenosis

Aortic and aorto-iliac disease

Vascular access for haemodialysis

Thorascopic sympathectomy

SS_VS 1.5

Discuss options for postoperative analgesia and perioperative fluid therapy for these procedures

SS_VS 1.6

Evaluate the risks and benefits of regional anaesthesia and analgesia in vascular surgery

SS_VS 1.7

Discuss the perioperative management, including postoperative analgesia and perioperative fluid management of patients having an emergency vascular procedure for the following:

Ruptured aortic aneurysm

Aortic dissection

Major vessel occlusion

Limb ischaemia

Limb amputation

Arterial laceration

SS_VS 1.8

Discuss methods to minimise blood loss and transfusion requirements in aortic surgery

SS_VS 1.9

Describe the pathophysiology and implications for anaesthesia management of:

Aortic cross clamping and unclamping at various levels

Prolonged limb or gut ischaemia

Carotid clamping and unclamping

SS_VS 1.10

Discuss the prevention, diagnosis and management of intra- operative complications associated with vascular surgery including (also refer to the Resuscitation, trauma and crisis management clinical fundamental):

Major haemorrhage

Bradycardia associated with carotid artery surgery

Cerebral ischaemia associated with carotid artery clamping

Reperfusion syndromes

Spinal cord ischaemia

Acute renal impairment

Myocardial ischaemia

Acute arrhythmia

Stroke

Thromboembolism

SS_VS 1.11

Discuss strategies for spinal cord protection in aortic surgery

SS_VS 1.12

Discuss the diagnosis and management of postoperative complications associated with vascular surgery including (also refer to the Resuscitation, trauma and crisis management specialised study unit):

Haemorrhage

Perioperative stroke

Myocardial ischaemia

Limb ischaemia

Rhabdomyolysis

Post-amputation pain

SS_VS 1.13

Outline recovery room complications specifically associated with carotid endarterectomy and discuss their management

SS_VS 1.14

Discuss techniques used to monitor cerebral perfusion during carotid endarterectomy

SS_VS 1.15

Describe a technique for performing carotid endarterectomy under regional anaesthesia and evaluate the role of regional anaesthesia for carotid endarterectomy

SS_VS 1.16

Outline the implications for patient safety of the location of the interventional radiology service

SS_VS 1.17

Discuss the procedural requirements and implications for anaesthetic management of patients having interventional radiological procedures including:

Vascular embolisation

Vascular stenting

Insertion of intravascular devices including aortic grafts

Radiological-guided biopsy under anaesthesia

SS_VS 1.18

Discuss the diagnosis and management of complications associated with interventional radiological procedures including (also refer to the Resuscitation, trauma and crisis management clinical fundamental and to College professional document: PS55 Recommendations on Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and Other Anaesthetising Locations):

Reaction to intravenous contrast

Aortic occlusion

Acute renal impairment

Spinal cord ischaemia

High radiation dose

Haemorrhage

SS_VS 1.19

Outline the advantages and disadvantages of interventional radiological procedures as compared with open procedures for management of:

Aortic aneurysm

Aortic dissection

Carotid artery stenosis

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