Friday 26 April, 2024
المجلس العراقي للاختصاصات الطبية
Iraqi Board for Medical Specializations
(زمالة تخصصية) في تخدير عمليات القلب
الدراسة تكون تحت مظلة المجلس العلمي للتخدير والعناية المركزة
شروط القبول:
يمكن للاطباء الحاصلين على زمالة المجلس العراقي او ما يعادلها من شهادات في اختصاص التخدير والعناية المركزة التقديم للدراسة
يتدرب ألأطباء المقبولين في الدراسة تحت عنوان (طبيب زميل متدرب)
مدة الدراسة: سنتان
المراكز التدريبية:
منهاج الدراسة التدريبي:
السنة الأولى:
السنة الثانية:
يحصل الطالب عل لقب (زمالة تخصصية) في تخدير عمليات القلب/ المجلس العراقي للاختصاصات الطبية
بعد ان يجتاز الامتحان النهائي (الكتابي والعملي) في العلوم السريرية بعد اتمامه السنة الثانية وكافة متطلبات الدراسة الاخرى وبنفس شروط النجاح وعدد المحاولات المعتمدة في المجلس العربي للاختصاصات الطبية.
Modules:
1.Competencies
A.Anesthesia:
To develop competence in providing anaesthetic care for adult, paediatric & neonatal cardiac surgery including peri-operative assessment.
To develop competence in the intra-operative use of TEE as an adjunct to anesthesia.
Anesthesia for;
1-Adults;
-CABG SURGERY; Conventional & off pump.
-Valve replacement & repair.
-Emergency cardiac surgery.
-Major vascular surgeries.
-Mass in the heart.
2- Paediatric & neonatal;
-Congenital heart diseases.
-Palliative & corrective surgeries.
3-Anesthesia for cardiac catheterization
B.Intensive care (ICU);
To develop competence in the immediate postoperative management of cardiac surgical patients.
To develop competence in managing ventilator& haemodynamic problems in the surgical ICU.
To develop competence in the peri-operative use of TEE as an adjunct to anesthesia.
2- Pharmacology;
*The fellow will review the pharmacology of all anesthetic& cardiac drugs, & compile a portfolio of references that will serve both as a source of immediate reference & a basis for upgrading & continuing education.
3-Pathiphysiology;
Each fellow will;
*Complete a comprehensive review of adult & paediatric pathophysiology as it applies to cardiac anesthesia& demonstrate in the discussion & management of clinical problems, an understanding of the pathophysiologic basis of the speciality, this element may utilize external departments such as anatomy, physiology & pathology.
*Demonstrate an understanding of the scientific basis of the speciality, & the ability to solve clinical problems logically & systematically, as this will enhance their capability as a mentor for others in the future.
4-Equipment;
*Fellows will become adapted in the use of;-
- Anesthetic machines & ventilators.
- Monitors & alarm systems.
- Patient warming devices.
- Syringe & infusion pumps.
*Fellow will also be required to know the principles of operation of;-
- Pacemakers.
- Intra-aortic balloon pumps.
- Assist devices.
- The different types of Heart-Lung machines & extra-corporeal circuits with their primes & volumes.
5- Pre-operative assessment;
*Emphasis will be placed on determining co-morbidity, anesthetic risks & formulation of a peri-operative care plan for the individual patient.
*Assessment of the paediatric patient will be oriented towards identifying the relevant anatomy & physiology of the various types of cyanotic &acyanotic congenital heart diseases.
*Assessment of adult patients will focus on;
-Strategies to prevent peri-operative ischemia& to detect congestive heart failure.
-Myocardial contractile disorders.
-Other significant risk factors.
*Particular attention will be directed towards understanding & interpreting X-rays, Echo. & Cath. Lab. Reports in order to completely assess cardiac function &peri-operative risks.
6- Intra-operative care;
*Emphasis will be placed on application of physiological & pharmacological principles to provide optimal anesthetic care. Appropriate premedication & its rationale will be addressed as part of the anesthetic plan.
*Care of paediatrics will focus on the preparation of a cardiac grid to emphasise the physiologic principles of maintaining cardiac function in the pre-Bypass period.
*Care of adults in the operating room will focus on;
-Ischemia reduction.
-Detection & treatment of ventricular dysfunction.
-Optimal fluid management with attention to renal function.
-Management of diabetic patients with the gaol of minimizing post-operative infections.
-Use of anesthetic protocols that allow for early extubation.
*Learning objectives common to adults & paediatrics will be;
-Management of coagulation.
-Provision of appropriate invasive monitoring by central venous catheter & invasive arterial monitoring.
-Appropriate use of cardiac inotropic & vasoactive drugs.
-Advanced airway & ventilator management.
7- Post-operative care;
*Learning objectives will include risk management during patient transfer to ICU & maintaining continuity of care accordance with the anesthetic plan by appropriate transfer procedures.
*The rotation in the cardiac surgical ICU will also emphasise the application of physiological & pharmacological principles to develop competence in;
--Haemodynamic management.
--Ventilatory care & weaning.
--Risk management with respect to infection.
--Rescue strategies for the patient with renal dysfunction.
--Other aspects of ICU management.
8-TransEosophagial Echocardiography(TEE);
Learning objectives will include;
*Ischemia detection in the adult patient (regional wall motion abnormalities).
*Assessment of contractility, preload & afterload.
*Detection of air.
*Assessment of valve function (advanced skill).
*Diagnosis of tamponed.
