CHOC Anesthesia

One of the two week anesthesia rotations for EM PGY-2 residents takes place at Children's Healthcare of Orange County to practice intubating pediatric patients. The opportunities to place tubes are pretty much unlimited as there will be at most only one anesthesia resident on the service who is assigned to one room.

Check-In

Shoot an email to Dr Tran and Mrs Hernandez prior to the start of the rotation to let them know when you are supposed to be arriving; Dr Tran will not always get back to you, but often likes to talk on the phone to let you know what will happen the first day. Mrs Hernandez will send you some resources and required online training. She will also send you a map of the hospital including where to park for the day. After parking, walk across the breezeway from the parking deck to the second deck hospital lobby. Take the first bank of elevators in front of you (by the security guard) and head to the 3rd floor. The folks at the front desk can let you into the operative area to check out some scrubs; you will have to give them keys or an ID to do this (we do not have access to their scrub machine, but they use dark blue; Scripps Mercy scrubs are a close match and they didn't notice when I wore those rather than check out their scrubs every day). Arrive at the hospital by 0700, and Dr Tran will have arranged for one of the anesthesiologists to welcome you, or if not you should ask to speak to the Floor Walker for the day. You will get a brief tour of the OR and later in the morning, you will have a meeting with Mrs Hernandez to fill out some forms and pick up a meal card and parking permit (which will allow you to park in the staff lot without buzzing security every time). During this time, she will have arranged a time at security to get a hospital badge and with the OR educator to go over some things back on the third floor. 

This is all assuming that CHOC anesthesia is before CHOC PICU.

What to Expect

There is a huge opportunity to  get a ton of airways during this rotation; I had upwards of 50 intubations in 2 weeks. The hours of the OR can change somewhat during the week. In general, the start time is 0700, except on Tuesday/Friday when they start at 0600 for ENT cases. Try not to be late on those days because the ENT cases go fast and most of them are intubated for the procedure. The goal at CHOC is similar to Camp Pendleton; get the tube and head to another room. Check in with the anesthesiologists in the room when you show up for the day to let them know that you are there. I was able to intubate patients in 4-5 rooms some days depending on the cases available and the surgeons/anesthesiologists in the case. Hang out in the pre-op area between cases and try to catch the anesthesiologist on the way to the patient's room for the pre-op assessment and then shadow the patient back to the OR. Try to intubate patient's of different ages while you are there; there will be procedures on newborns to teenagers.

The anesthesia resident, if there is one, generally works in the more complex cases. If there is no other resident, try to get in those cases because not only will you be able to intubate, but there is the potential to place central lines or a-lines as well; these are often the cardiac or spine cases.

This is an adult learning environment and you can leave when you choose. There are some days that are slower than others and if all of the cases are done early, feel free to leave whenever. You do not have to check out with anyone at the end of the day. Log all of your procedures under Dr Tran, and just put the anesthesiologist in the room in the comments section.

There is a Starbuck's on the second floor with a cafeteria as well as a doctor's lounge, though we don't have access to it as residents. Another cafeteria is located on the first floor. The meal card provided by Mrs Hernandez has $70 on it to be used as you will and is accepted at the Starbuck's.