Table 4 EPA 1
Title | Induction of general anaesthesia in a fasting adult ASA-1 / ASA-2 patient for a low-risk procedure |
|---|---|
| Â | Anaesthesiology |
Specifications & limitations | 1. Identification of patient, operation, side if applicable and documents using a standardized checklist including clinical evaluation of the patient to verify the preoperative patient status 2. Establishment / interpretation of basic monitoring (RR, SpO2, ECG) and intravenous access 3.Brief device check according to the recommendations of the German Society for Anaesthesiology and Intensive Care Medicine 4. Team briefing (induction and emergency strategy) 5.Induction of general anaesthesia induction with dose-appropriate use of hypnotics, opioids, muscle relaxants and perioperative antibiotic prophylaxis 6. Basic airway management a. Preoxygenation including checking FiO2 und etCO2 b. After onset of hypnosis, adequate bag mask ventilation, if applicable with aid techniques (2-hand method, oropharyngeal airway aids) c. Airway management with endotracheal tube, laryngeal mask including tube and position evaluation d. Performing a volume or pressure-controlled ventilation therapy Context: Elective anaesthesia induction in the operating room Limitation: Surgical indication urgent/emergency, age < 18 years, expected difficult airway, ≥ ASA 3, non-fasting |
Competency domain | Medical Expert, Communicator, Collaborator, Professional |
Knowledge, skills and professional attitudes | Knowledge • Anatomy of the cardiovascular system, airway and thorax • Cardiovascular und respiratory physiology • Indication, contraindication, adverse drug reactions, pharmacokinetics/-dynamics and dosage of hypnotics, opioids and muscle relaxants in anaesthesia • Predictors for assessing the depth of hypnosis / quantitative state of consciousness (e.g. RASS) • Instructions for adequate bag mask ventilation • Indication and contraindication of airway aids (Guedel/Wendl tube, laryngeal mask, endotracheal tube) • Signs of correct positioning of the endotracheal tube • Signs of adequate ventilation and placement in the case of supraglottic airway aids (e.g. bubble, suprasternal notch and performance test) • Clinical standards (Standard Operating Procedures) Skills • Adequate placement of a peripheral venous cannula, taking into account the cannula size and puncture site • Opening the patient’s airway (e.g. jaw thrust handle) and performing adequate bag mask ventilation, if necessary with the use of oropharyngeal airway aids • Airway management with tube, laryngeal mask or laryngeal tube • Documentation (e.g. in a patient data management system) • Performing a volume and pressure-controlled ventilation therapy Professional attitudes • Professional, respectful interaction and targeted communication in a team and with patients, including consideration of diversity (age, gender, origin) • Closed-loop communication technique • Comply with national hygiene guidelines • Recognition of one's own limits with regard to knowledge, abilities and skills. Continuous reflection on one's own actions and immediate request for help if necessary |
Assessment | Structured oral examination, case-based discussions Observation: Mini-CEX, DOPS |
Entrustment at the end of undergraduate training | 2b |