department of anesthesia and Perioperative medicine

Project Madaktari: Bugando Anesthesia Curriculum

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Bugando Curriculum
Month One

Section 1: Basics of Anesthesia and Pharmacology

Week One

Basic Life Support – 2 hours


Advanced Cardiac Life support 2 - hours


Weekly QUIZ and Review


 Week Two

Preoperative Assessment
     -History and physical exam
     -Optimization
     -Premedication


Practical Training Physical Examination of the patients (2 Hours)


Weekly QUIZ and Review


Week Three

The Anesthesia Machine and OR setup
Breathing circuits


Patient Monitors
The electrocardiogram


Weekly QUIZ and Review


Week Four

Capnography
Non-invasive blood pressure monitoring


Neuro-muscular blockade monitoring
Temperature


Weekly QUIZ and Review


Month Two

Week One

The Airway
     - Airway Anatomy
     - Evaluation of the Airway


Intubation
     - Endotracheal tubes
     - Laryngeal Mask Airways


Weekly QUIZ and Review


Week Two

The Difficult Airway
    - ASA Protocol to handle the difficult airway
    - Airway Adjuncts


Basic Principles of Pharmacology
    - Distribution, Onset of Action
    - Half Life Time and Elimination


Weekly QUIZ and Review


Week Three

Nonopioid Intravenous Induction Agents
     - Thiopental
     - Propofol
     - Ketamine


Muscle Relaxants
     - Succinylcholine
     - Pancuronium 
Reversal agents
Anticholinergic agents


Weekly QUIZ and Review


Week Four

Opiates in Anesthesia
     - Morphine
     - Fentanyl
     - Meperidine
     - Dilaudid


Local Anesthetics


Weekly QUIZ and Review


Month Three

Week One

Anesthesia Adjuncts
    - Adrenergic Agonists and Antagonists
    - Hypotensive Agents


Pharmacology: Inhalational Anesthetic Volatile Agents
     - Isoflurane
     - Halothane
EMO


Weekly QUIZ and Review


Section 2: Cardiovascular System

Week Two

The Sympathetic Nervous System


The Parasympathetic Nervous System
    -Autoregulation and the effects of anesthesia on autoregulation


Weekly QUIZ and Review


Week Three

Cardiac and vascular anatomy


Cardiac physiology
     - O2 supply and demand
     - Ventricular function; the Starling curve
     - Electro physiology and rhythm disturbances
     - Baroreceptors and cardiac reflexes
     - Central Venous Pressure and Pulmonary Artery Pressure monitoring


Weekly QUIZ and Review


Week Four

Cardiovascular pharmacology
     - Ephedrine, phenylephrine, norepinephrine, epinephrine, dopamine
Ischemic heart disease
Valvular heart disease
Cardiomyopathy


Preoperative evaluation of the cardiac patient
Anesthesia for the Cardiac Patient


Weekly QUIZ and Review


Month Four

Section 3: Respiratory System

Week One

Respiratory anatomy
Preoperative evaluation of the patient with respiratory disease


Respiratory physiology
     - Pulmonary function tests, flow-volume loops
     - ABG analysis, oxygen supply and demand, oxygen therapy
     - Ventilation/perfusion (V/Q) concepts and the effect of position
     - The effects of anesthesia on lung function


Weekly QUIZ and Review


Week Two

Reactive airway disease, asthma
    - Chronic obstructive lung disease (COPD)
    - Infectious diseases of the lung
    - Respiratory failure (ARDS)


Anesthesia for patients with respiratory disease


Weekly QUIZ and Review


Section 4: The Central Nervous System

Week Three

The Somatic Nervous System
    - Neurotransmission


The Neuromuscular Junction
    - Action potentials


Weekly QUIZ and Review


Week Four            

Cerebral Physiology
    - Cerebral blood flow (CBF), and the regulation of CBF
    - The determinants of cerebral metabolic rate (CMR)
    - Intracranial pressure


The effect of anesthesia on CBF and CMR and ICP


Weekly QUIZ and Review


 Month Five

Week One

Anesthetic considerations for neurosurgery
Patient positioning in neurosurgery


Neuroendocrine pathophysiology in the neurosurgical patient
Anesthetic considerations/approach for spine surgery


Weekly QUIZ and Review


Section 5: Hepatic and Endocrine system

Week Two

Hepatic physiology and hepatic blood flow (HBF)
Hepatic metabolic function


Hepatic hematological function
The effect of anesthesia on hepatic function 


Weekly QUIZ and Review


Week Three

Thyroid disorders
Parathyroid disorders
Adrenal gland disorders


Diabetes mellitus
Steroid replacement
Pituitary gland disorders


Weekly QUIZ and Review


Week Four

Section 6: Renal System

Basic Physiology and Anatomy: The Kidneys


Pharmacology: Diuretic Drugs


Weekly QUIZ and Review


Month Six

Week One

The effects of Anesthesia on Renal Function


Patients with renal disease


Weekly QUIZ and Review


Week Two

Acid-base balance
Fluid and Electrolyte therapy and Fluid Management


Hemotherapy and Hemostasis


Weekly QUIZ and Review


Section 8: Regional, Urologic and Gynecologic Anesthesia

Week Three

Spinal Cord Anatomy


Spinal and Epidural


Weekly QUIZ and Review


Week Four

Anesthesia for Orthopedic surgery


Complications of Orthopedic surgery


Weekly QUIZ and Review


Month Seven

Week One

Anesthetic concerns of the lithotomy position
Physiological consequences and anesthetic concerns of abdominal laproscopic techniques


Anesthesia for abdominal hysterectomy, vaginal hysterectomy, myomectomy


Weekly QUIZ and Review


Week Two

6 months exam review session


6 month exam    


Exam Review


Section 9: Pediatrics

Week Three

The anatomical and physiological considerations of the newborn, infant and child.    


The pharmacological concerns of the newborn, infant and child.    


Weekly QUIZ and Review


Week Four

Resuscitation of the newborn and child
Fluid therapy and blood loss and replacement in children


Pediatric breathing circuits
Inhalational versus intravenous induction of anesthesia


Weekly QUIZ and Review


Month Eight

Week One

Anesthetic consideration in the newborn
     - Congenital diaphragmatic hernia, tracheo-esophageal fistula, 
       gastroschisis, omphalocoele, Prune-Belly Syndrome, pyloric stenosis,


Anesthesia for common pediatric conditions
     - Aspiration of a foreign body, epiglottitis, tonsillectomy and             
       adenoidectomy, myringotomy and insertion of ear tubes, scoliosis


Weekly QUIZ and Review


Section 10: Obstetrics

Week Two

The anatomical and physiological changes of pregnancy


Anesthesia for labor and vaginal delivery
     - Parenteral agents
    - Inhalational analgesia (N2O)
    - Paracervical and pudendal nerve blocks
     - Regional anesthetic techniques


Weekly QUIZ and Review


Week Three

Anesthesia for Cesearan Section
    - regional anesthesia

    - spinal anesthesia
   
- epidural anesthesia
    - general anesthesia


Anesthesia for the complicated obstetrical patient
     - Pre-term labor, premature rupture of membranes and chorioamnionitis
     - Abnormal presentations and dystocia
     - Placental abruption
     - Placenta previa, placenta accreta and placenta percreta


Weekly QUIZ and Review


Week Four

Prolapsed umbilical cord
     - Uterine rupture
     - Post-partum hemorrhage and uterine atony
     - Amniotic fluid embolism
     - Hypertensive disease of pregnancy, eclampsia and pre-eclampsia
     - Cardiac disease in pregnancy


Anesthesia for the obstetrical patient for non-obstetrical emergencies


Weekly QUIZ and Review


Month Nine

Section 11: Trauma, Shock and Burn Management

Week One            

Review of Adult Life Support
Review of Pediatric Life Support


Anesthetic considerations of the trauma patient


Weekly QUIZ and Review


Week Two

-Hemorrhagic shock
-Septic shock
-Spinal shock


Anesthetic considerations for the burn patient
     - Electrolyte disturbances and fluid replacement
     - Monitoring challenges


Weekly QUIZ and Review


Section 12: Anesthesia for Orthopedic Surgery

Week Three

Anesthesia for hip fracture
Anesthesia for total joint replacement


Anesthetic considerations of the patient with osteoarthritis or rheumatoid arthritis
    - Transfusion


Weekly QUIZ and Review


Section 13: Anesthesia for General Surgery

Week Four                       

Preoperative assessment of the patient with an acute abdomen
Anesthesia for laparoscopic/open cholecystectomy


Anesthesia for intestinal obstruction
Anesthesia for liver resection
Anesthesia for splenectomy


Weekly QUIZ and Review


Month Ten

Section 14: Anesthesia for Eye, ENT and Dental Surgery

Week One                       

Preoperative evaluation of the patient for eye surgery
The effects of anesthetic drugs on intraocular pressure


The oculocardiac reflex
Anesthesia for emergency eye surgery (the open eye)
Anesthesia for elective eye surgery


Weekly QUIZ and Review


Week Two

Preoperative evaluation of the patient for major OTL surgery
    - The shared airway
    - Anesthesia for nasal and sinus surgery


Anesthesia for major head and neck surgery
Tracheostomy
Anesthetic techniques to reduce blood loss (controlled hypotension)


Weekly QUIZ and Review


Section 15:  Pain Management

Week Three

The definition and classification of pain
The systemic response to pain


Evaluation of the patient with pain
Acute post-operative pain management
Oral agents
Chronic Pain management


Weekly QUIZ and Review


Section 16: Anesthetic Complications and Postoperative Care

Week Four                       

Airway injury and Fires


Malignant Hyperthermia


Weekly QUIZ and Review


Month Eleven

Week One

Peripheral Nerve Injuries
Eye Injuries


Post-anesthesia care


Weekly QUIZ and Review


Section 17: Anesthesia and Rare Diseases

Week Two

Pseudocholinesterase deficiency
Neuromuscular disorders


Hemoglobinopathies
Myasthenia gravis


Weekly QUIZ and Review


Section 18: Critical Care

Week Three

 Oxygen therapy
 Mechanical ventilation
    - modes of mechanical ventilation
    - sedation, paralysis and monitoring
    - Weaning from the ventilator
    - PEEP


Respiratory failure
Renal failure
Myocardial infarction


Weekly QUIZ and Review


Week Four

The Anesthesia Machine and Equipment
Breathing circuits


Patient Monitors
The electrocardiogram


Weekly QUIZ and Review


Month Twelve

Week One

Sepsis and septic shock
Gastrointestinal hemorrhage


Hemodynamic monitoring


Weekly QUIZ and Review


Week Two

Anesthesia Review Session


Anesthesia Review Session


Review


Week Three

Final Exams