CHALLENGES FACED BY CHALLENGES FACED BY PRACTISING ANAESTHESIOLOGISTSPRACTISING ANAESTHESIOLOGISTS

DR.C.RATHNA KUMARDR.C.RATHNA KUMAR

CONSULTANT ANAESTHESIOLOGISTCONSULTANT ANAESTHESIOLOGIST

NOTHING IN THE WORLD IS WITHOUT A NOTHING IN THE WORLD IS WITHOUT A CHALLENGECHALLENGE

TO BE A SUCCESSFUL ANAESTHESIOLOGIST ONE TO BE A SUCCESSFUL ANAESTHESIOLOGIST ONE SHOULD HAVE A HIGH DEGREE OF KNOWLEDGE , SHOULD HAVE A HIGH DEGREE OF KNOWLEDGE , SKILL AND MENTAL AND PHYSICAL STAMINA TO SKILL AND MENTAL AND PHYSICAL STAMINA TO FACE THE CHALLENGESFACE THE CHALLENGES

OUR PROFESSION IS MANY A TIMES EQUATED OUR PROFESSION IS MANY A TIMES EQUATED TO THAT OF THE PILOTS.TO THAT OF THE PILOTS.

CLASSIFICATION OF CHALLENGESCLASSIFICATION OF CHALLENGES

PROFESSIONALPROFESSIONAL

HEALTHHEALTH

FAMILY LIFE & OTHER SOCIAL ACTIVITIESFAMILY LIFE & OTHER SOCIAL ACTIVITIES

PROFESSIONALPROFESSIONALWORKING SET UPWORKING SET UP

PRIMITIVE SET UP - ATTRACTING MIDDLE CLASSPRIMITIVE SET UP - ATTRACTING MIDDLE CLASS POORLY EQUIPPED THEATRESPOORLY EQUIPPED THEATRES LITTLE IMPORTANCE TO ANAESTHESIA & I C ULITTLE IMPORTANCE TO ANAESTHESIA & I C U FORCED TO WORK TAKING ALL RISKS & FORCED TO WORK TAKING ALL RISKS &

COMPROMISESCOMPROMISES ANYTHING GOES WRONG WE ARE BLAMEDANYTHING GOES WRONG WE ARE BLAMED SET UP CONTINUES TO WORK WITHOUT ANY SET UP CONTINUES TO WORK WITHOUT ANY

CHANGE BUT FOR THE ANAESTHESIOLOGIST CHANGE BUT FOR THE ANAESTHESIOLOGIST THANKS TO THE C P A AND M C ITHANKS TO THE C P A AND M C I

MINIMUM MANDATORY REQUIREMENTS IN MINIMUM MANDATORY REQUIREMENTS IN THE OPERATION THEATRETHE OPERATION THEATRE

A WELL MAINTAINED ANAESTHESIA MACHINEA WELL MAINTAINED ANAESTHESIA MACHINE MINIMUM 2 O2 AND N2O CYLINDERS ATTACHED MINIMUM 2 O2 AND N2O CYLINDERS ATTACHED

TO THE MACHINE AND 1 EACH KEPT STANDBYTO THE MACHINE AND 1 EACH KEPT STANDBY TWO WORKING LARYNGOSCOPES WITH BLADES TWO WORKING LARYNGOSCOPES WITH BLADES

OF ALL SIZESOF ALL SIZES AIRWAYS OF ALL SIZESAIRWAYS OF ALL SIZES ENDOTRACHEAL TUBES OF ALL SIZESENDOTRACHEAL TUBES OF ALL SIZES SUCTION APPARATUSSUCTION APPARATUS TILTABLE OPERATING TABLETILTABLE OPERATING TABLE DIFFICULT INTUBATION AIDS LIKE STYLET , DIFFICULT INTUBATION AIDS LIKE STYLET ,

MAGILL’S FORCEPSMAGILL’S FORCEPS

AN ANAESTHETIST’S ASSISTANTAN ANAESTHETIST’S ASSISTANT UNINTERRUPTED POWER SUPPLY FOR ESSENTIAL UNINTERRUPTED POWER SUPPLY FOR ESSENTIAL

EQUIPMENTSEQUIPMENTS ALL EMERGENCY DRUGS & AMBU BAG WITH O2 ALL EMERGENCY DRUGS & AMBU BAG WITH O2

TUBINGSTUBINGS A STETHOSCOPE , SPHYGMOMANOMETER , PULSE A STETHOSCOPE , SPHYGMOMANOMETER , PULSE

OXIMETER , ECG MONITOROXIMETER , ECG MONITOR A DEFIBRILLATORA DEFIBRILLATOR

ESSENTIAL NARCOTICS & VAPOURIZERSESSENTIAL NARCOTICS & VAPOURIZERS N P O FOR ATLEAST 6 HOURSN P O FOR ATLEAST 6 HOURS MAINTAINENCE OF ANAESTHESIA RECORDMAINTAINENCE OF ANAESTHESIA RECORD INFORMED & WRITTEN CONSENTINFORMED & WRITTEN CONSENT A MECHANICAL VENTILATORA MECHANICAL VENTILATOR

TIMING OF SURGERYTIMING OF SURGERY

UNLESS AN EMERGENCY,DISCUSS AND FIXUNLESS AN EMERGENCY,DISCUSS AND FIX

DAY TIME IS BETTERDAY TIME IS BETTER

VIGILANCE IS ESSENTIALVIGILANCE IS ESSENTIAL

PREOPERATIVE EVALUATIONPREOPERATIVE EVALUATION

OFTEN NEGLECTEDOFTEN NEGLECTED EVALUATE AS EARLY AS POSSIBLEEVALUATE AS EARLY AS POSSIBLE GOOD HISTORYGOOD HISTORY RELEVANT INVESTIGATIONSRELEVANT INVESTIGATIONS SPECIALISTS OPINION AS REQUIREDSPECIALISTS OPINION AS REQUIRED IMPORTANT IN MEDICOLEGAL CASESIMPORTANT IN MEDICOLEGAL CASES FITNESS IS OUR DECISIONFITNESS IS OUR DECISION OPTIMIZATION BEFORE SURGERYOPTIMIZATION BEFORE SURGERY GOOD RAPPORT WITH THE PATIENTS AND GOOD RAPPORT WITH THE PATIENTS AND

FAMILIESFAMILIES

IS THE CENTRE APPROPRIATE FOR A CASE?IS THE CENTRE APPROPRIATE FOR A CASE?

NO PROTOCOLNO PROTOCOL

ISA SHALL FORMULATE ONE ISA SHALL FORMULATE ONE

CAREFUL PREOPERATIVE INSTRUCTIONSCAREFUL PREOPERATIVE INSTRUCTIONS

NO ANTIBIOTICS JUST BEFORE ANAESTHESIANO ANTIBIOTICS JUST BEFORE ANAESTHESIA

NO DRUG WITHOUT OUR KNOWLEDGE TO BE NO DRUG WITHOUT OUR KNOWLEDGE TO BE GIVEN IN THE PERIOPERATIVE PERIOD GIVEN IN THE PERIOPERATIVE PERIOD

ANAESTHETIC MANAGEMENTANAESTHETIC MANAGEMENT

CHOICE OF ANAESTHESIA SHOULD BE OURSCHOICE OF ANAESTHESIA SHOULD BE OURS PERFECT COCKPIT DRILLPERFECT COCKPIT DRILL ENSURE GOOD I/V LINESENSURE GOOD I/V LINES ASSURE THE SAFETY OF PTS POSTOP AND LEAVEASSURE THE SAFETY OF PTS POSTOP AND LEAVE MOST RISKY PERIOD-WHILE SHIFTING TO POSTOP MOST RISKY PERIOD-WHILE SHIFTING TO POSTOP

WARDWARD

FOR ICU CARE GOOD NETWORK IS REQUIREDFOR ICU CARE GOOD NETWORK IS REQUIRED

INSTITUTE AND FREELANZING PRACTICEINSTITUTE AND FREELANZING PRACTICE

SCHEDULESCHEDULE CONTOL OF OTCONTOL OF OT CONTROL OF STAFFSCONTROL OF STAFFS OPTIMIZATIONOPTIMIZATION REPLACEMENT RISKREPLACEMENT RISK OFFS FROM DUTYOFFS FROM DUTY INCOME INCOME

HEALTH PROBLEMSHEALTH PROBLEMSSTRESSSTRESS

HYPERTENSION-HR>100/MT, DBP>1OOMM HGHYPERTENSION-HR>100/MT, DBP>1OOMM HG INSOMNIA AND OTHER SLEEP DISTURBANCESINSOMNIA AND OTHER SLEEP DISTURBANCES IRRITABLITYIRRITABLITY ANXIETYANXIETY HEADACHEHEADACHE ASTHMAASTHMA LACK OF CONCENTRATIONLACK OF CONCENTRATION ACIDITYACIDITY BODYACHEBODYACHE DEPRESSION AND OTHER CHANGES IN BEHAVIOURDEPRESSION AND OTHER CHANGES IN BEHAVIOUR SUICIDAL TENDENCYSUICIDAL TENDENCY SUBSTANCE ABUSESUBSTANCE ABUSE

CAUSES OF STRESSCAUSES OF STRESS

SENSE OF INSECURITYSENSE OF INSECURITY CHANGING WORKING ENVIRONMENTCHANGING WORKING ENVIRONMENT LACK OF CONTROL OVER WORKING TIMELACK OF CONTROL OVER WORKING TIME LACK OF CONTROL OVER OT MANAGEMENTLACK OF CONTROL OVER OT MANAGEMENT UNSATISFIED EGOUNSATISFIED EGO

MANAGEMENT OF STRESSMANAGEMENT OF STRESS

A BREAK FROM ROUTINEA BREAK FROM ROUTINE MENTAL RELAXATION TECHNIQUES LIKE YOGAMENTAL RELAXATION TECHNIQUES LIKE YOGA MAINTAIN PHYSICAL FITNESSMAINTAIN PHYSICAL FITNESS SOME LEISURE ACTIVITYSOME LEISURE ACTIVITY DISCIPLINED ANAESTHETIC PRACTICEDISCIPLINED ANAESTHETIC PRACTICE

FAMILY AND OTHER SOCIAL ACTIVITIESFAMILY AND OTHER SOCIAL ACTIVITIES

PLANNING OF HOLIDAYSPLANNING OF HOLIDAYS RISE IN PRACTICERISE IN PRACTICE COMPETITION COMPETITION CATASTROPHESCATASTROPHES ILLNESS AND DISABILITYILLNESS AND DISABILITY INVESTING IN EQUIPMENTSINVESTING IN EQUIPMENTS ALLOTING TIME FOR SELF & FAMILYALLOTING TIME FOR SELF & FAMILY ATTENDING CME AND CONFERENCESATTENDING CME AND CONFERENCES PRACTICE PRESSURES-UNETHICAL METHODSPRACTICE PRESSURES-UNETHICAL METHODS INCREASED RISKS OF ACCIDENTSINCREASED RISKS OF ACCIDENTS

TAKE HOME MESSAGETAKE HOME MESSAGE

DO A DIGNIFIED & SAFE PRACTICE OF DO A DIGNIFIED & SAFE PRACTICE OF ANAESTHESIAANAESTHESIA

FACE CHALLENGES WITH A BRAVE HEARTFACE CHALLENGES WITH A BRAVE HEART

BE CONTENDEDBE CONTENDED

OUR SPECIALITY HAS THE POTENTIAL TO DO GREAT OUR SPECIALITY HAS THE POTENTIAL TO DO GREAT BENEFIT & HARM TO THE PATIENTBENEFIT & HARM TO THE PATIENT