Anesthesiology Lifeline to Modern Medicine

1799 British chemist Humphry Davy discovers anesthetic qualities of nitrous oxide 1840s Harvard professor Charles Jackson suggests ether has anesthetic properties 1905 The American Society of Anesthesiologists (ASA) is founded November 1846 Word spreads as the first article appears in The Boston Medical and Surgical Journal October 1846 Dentist William Thomas Green Morton successfully demonstrates ether anesthesia in public Anesthesiology: The Early Years 2

Anesthesiologists Make Modern Medicine Possible Anesthesiologists are the leaders in patient safety and each day save countless lives. –They are highly specialized physicians whose work transcends the operating room, including taking the lead in intensive care and pain medicine. –These specialists make modern medicine possible by maintaining a patient’s Vital Health when he/she is most vulnerable. 3

Anesthesiologists and Vital Health By definition, Vital Health is how effectively a person maintains a healthy lifestyle and how that impacts wellness and medical outcomes. –Vital Health measures include body mass index, cholesterol levels and blood pressure. –By ensuring that vital signs are optimized when patients are often at their most vulnerable, anesthesiologists are the keepers of Vital Health. –As such, they’ve created the Vital Health Tool, an interactive survey to assess patients’ Vital Health located at 4

Training and Education Requirements Anesthesiologists must fulfill extensive training and education requirements, through which they become eligible for board certification by the American Board of Anesthesiology. These requirements include: –Earning an undergraduate degree and fulfilling pre-med requirements (four years) –Graduating from medical school (four years) –Specializing in anesthesiology during a one-year internship and three- year residency program –Receiving subspecialty fellowship training that can last several additional years (optional) 5

Role on the Anesthesia Care Team –With at least eight years of post- undergraduate training, anesthesiologists are equipped to lead Anesthesia Care Teams. –In this role, they supervise and delegate tasks to non-physician anesthesia providers such as nurse anesthetists (NAs) and anesthesiologist assistants (AAs). –But anesthesiologists assume overall responsibility for the safety and well-being of patients before, during and after medical procedures. 6 Anesthesiologis t Anesthesiologist Assistant (AA) Nurse Anesthetist (NA)

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What Anesthesiologists Do Before Medical Procedures –Review their patients’ general medical history, including: Medical conditions and diseases Medications (supplements, herbals, OTCs, habits) Allergies Relevant family histories Experiences with anesthesia 8

What Anesthesiologists Do Before Medical Procedures –Conduct focused physical examinations –Order, review and interpret lab tests and diagnostic studies –Order preoperative medications –Develop comprehensive anesthesia plans –Obtain informed consent from their patients to undergo anesthesia 9

What Anesthesiologists Do During Medical Procedures –Administer and maintain appropriate levels of anesthesia –Monitor and support vital functions such as: Brain function Heart function Breathing Blood pressure Body temperature Body fluid balance –Diagnose and treat medical conditions –Manage fluid therapy and blood transfusions 10

What Anesthesiologists Do After Medical Procedures –Help safely transfer patients to the Post-Anesthesia Care Unit (PACU) –Provide necessary pain relief –Manage respiratory care –Provide immediate postoperative care –Evaluate patients for discharge 11

Beyond the Operating Room –As medical technology has advanced, so has the need for anesthesiologists to participate in procedures that occur outside the traditional operating suite. These procedures often include: Radiological imaging Gastrointestinal endoscopy Placement and testing of cardiac pacemakers and defibrillators –Beyond the operating room, anesthesiologists also frequently practice in settings such as: Intensive care units (ICUs) Labor and delivery suites Pain medicine offices 12

The ICU –Because of their extensive training in clinical physiology/pharmacology and resuscitation, anesthesiologists are uniquely qualified to coordinate the medical care of patients in the ICU. Responsibilities include: Medical assessment and diagnosis Respiratory and cardiovascular support Infection control 13

The ICU –Anesthesiologists also possess the medical knowledge and technical expertise to deal with many emergency and trauma situations. They often provide: Airway management Cardiac and pulmonary resuscitation Advanced life support Pain control –Anesthesiologists play an active role in stabilizing and preparing patients for emergency surgery, as well. 14

Labor and Delivery –Anesthesiologists protect the safety and well-being of expectant mothers and babies, and also provide pain relief during labor and delivery. –Working with obstetricians, anesthesiologists offer expectant mothers pain relief options such as: Breathing exercises and relaxation techniques Pain medications Local blocks Regional techniques 15

Labor and Delivery –Regional anesthetic techniques (spinal, epidural and combined spinal-epidural) are often used during labor and delivery because they: Provide better pain relief Allow patients to participate in the birthing process Don’t make babies sleepy after delivery –During emergency Caesarean sections, anesthesiologists provide surgical anesthesia while managing the life functions of mothers and babies. 16

Pain Medicine –Whether the result of injury, illness or a chronic condition, 70 million Americans experience pain annually. –Anesthesiologists are pain medicine specialists with extensive experience diagnosing and treating both acute and chronic pain conditions such as arthritis, back and neck pain, cancer pain, nerve pain, migraine headaches, shingles and pain caused by AIDS. –As pain medicine specialists, they develop appropriate treatment plans after thoroughly researching and evaluating patients’ conditions. This involves: Working closely with primary care physicians Reviewing medical records and X-rays Asking patients for detailed information such as the onset and location of pain Performing physical examinations Possibly ordering additional tests 17

Pediatric Anesthesia –As physicians, anesthesiologists know how children react to hospitals and surgery. They therefore work with other doctors to make hospital visits as pleasant as possible for children. –Anesthesiologists are specially trained to maintain the safety and comfort of children before, during and after medical procedures. Responsibilities include: Ensuring parents and children are well prepared for procedures Monitoring and supporting vital functions such as heart rate, breathing and blood pressure during procedures Providing pain relief and consultation in the pediatric ICU after procedures Providing consultation even when children do not undergo operations 18

Pediatric Anesthesia –The ASA has developed a set of tips located at medicine.com to help parents prepare their children for surgery. 19

Geriatric Anesthesia –More than 12 percent of the total U.S. population is over age 65 and, of that segment, more than half will undergo at least one surgical procedure as senior citizens. –Anesthesiologists inform and care for senior patients before, during and after medical procedures. 20

Geriatric Anesthesia –A person’s age can impact his/her anesthesia experience with: Cardiovascular, respiratory, kidney and mental functions Body temperature regulation Medication effects –The ASA has developed a set of tips located at to help prepare senior citizens and their caregivers for surgery. 21