At the moment there is a med student from the UK being with us, he is from Penzance/ Exeter School, he has applied to work with us for a month long at the Surgical ICU, and working in the operating theatres as well (general, CVT! and paediatrics).
We discussed about the skills required for the new graduate doctors by the Thai Medical Council, after we had performed a spinal anaesthesia for an old lady scheduled for venous strippling, although spinal anaesthesia is a grade 4 skill meaning that a medical graduate has seen this skill or has helped during their undergraduate education or the three year working for more experience, however, the lumbar puncture is a must skill for an MD or he/she must be able to perform it.
We talked about monitoring for a healthy patient underwent a laparoscopic nephrectomy to donate her kidney to her daughter, we did not mention the choice of anaesthetics, but we just talked about how an anaesthetist thought about giving anaesthetics, about the position; what position she would be placed, and then which arm for what; an iv line or an NIBP cuff.
We also discussed about the administration of a muscle relaxant, he mentioned that the patient had a movement after an LMA placed during the surgical team scrubbing the operating site. However, we concluded that it was from the depth of anaesthesia that we should focus on not the movement of our patient, and also it may be too easy just giving a muscle relaxant to stop or eliminate the patient's move, but you have to realise that it is not the anaesthetic agent at all. It does not help reduce the pain, make him sleep or increase the anaesthetic depth.
Today Update: a small chat with him
He enjoyed his time working in the Acute pain service, and he had wonderful experience observing a patient requiring electroconvulsive therapy, tonic clonic convulsion. One psychiatric patient had the difficulty peripheral venous access need approximately 15 times!
He pretty much missed this good time at the surgical ICU, we discussed about the different world of anaesthesia from Preop. clinic to OR to ICU, and there is also pain clinic waiting for him to enjoy.
We discussed about the skills required for the new graduate doctors by the Thai Medical Council, after we had performed a spinal anaesthesia for an old lady scheduled for venous strippling, although spinal anaesthesia is a grade 4 skill meaning that a medical graduate has seen this skill or has helped during their undergraduate education or the three year working for more experience, however, the lumbar puncture is a must skill for an MD or he/she must be able to perform it.
We talked about monitoring for a healthy patient underwent a laparoscopic nephrectomy to donate her kidney to her daughter, we did not mention the choice of anaesthetics, but we just talked about how an anaesthetist thought about giving anaesthetics, about the position; what position she would be placed, and then which arm for what; an iv line or an NIBP cuff.
We also discussed about the administration of a muscle relaxant, he mentioned that the patient had a movement after an LMA placed during the surgical team scrubbing the operating site. However, we concluded that it was from the depth of anaesthesia that we should focus on not the movement of our patient, and also it may be too easy just giving a muscle relaxant to stop or eliminate the patient's move, but you have to realise that it is not the anaesthetic agent at all. It does not help reduce the pain, make him sleep or increase the anaesthetic depth.
Today Update: a small chat with him
He enjoyed his time working in the Acute pain service, and he had wonderful experience observing a patient requiring electroconvulsive therapy, tonic clonic convulsion. One psychiatric patient had the difficulty peripheral venous access need approximately 15 times!
He pretty much missed this good time at the surgical ICU, we discussed about the different world of anaesthesia from Preop. clinic to OR to ICU, and there is also pain clinic waiting for him to enjoy.
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