All CA-2 residents spend one month on the OB service at Good Samaritan Hospital. To help guide residents' learning while they are away from UC, Dr. Andye Girnius has created the self-guided OB learning outline below:
The main goal of the rotation is to provide our residents exposure to a private practice obstetric anesthesia practice. They will gain increased repetitions of neuraxial procedures and learn to manage patients of varying acuity more efficiently and effectively. While there, their education will also be supported by anesthesiology staff. We have created a list of reading material for self-directed learning. We have also formulated a series of brief problem-based learning discussions (PBLDs) that target one or two key learning points and are designed to integrate into a busy clinical practice. These can be reviewed with the attending as time allows.
The self-directed readings & PBLDs are listed below in a suggested timeline for completing them.
Local Anesthetics (local anesthetic spread after subarachnoid injection.)
Post dural puncture headache
(management of unintentional dural puncture; spinal catheter vs resite epidural, injection of saline; non-epidural blood patch treatment of PDPH).
Placenta accreta (management of a known accreta: risk factors, anesthesia type, lines/monitors, and recovery.
Pregnancy changes in coagulation (thrombocytopenia → when to place an epidural/spinal?)
Pre-eclampsia/eclampsia
Medications used for pre-eclampsia and their impact on anesthesia management.
Airway during pregnancy
Pregnancy airway/oxygenation changes.
Difficult airway algorithm in a pregnant patient (to place an LMA or not?).
Placental abruption
Risk factors and presentation.
Things to watch out for that affect anesthetic management.
Uterine rupture
Should VBAC patients get an epidural? Include signs and symptoms of uterine rupture.