1.Clinical anesthesia work
In order to do a good job in clinical anesthesia, we must master the basic theory of anesthesia and skillfully apply various anesthesia techniques, and also be familiar with the characteristics of surgery for various conditions. When performing each case of anesthesia, the following specific work must be carried out.
a. Pre-anesthesia preparation
The main task is to understand the condition, make a correct estimate, determine the anesthesia plan with the condition, and choose the most appropriate anesthesia method and drugs. To fully estimate the problems that may occur during anesthesia, make adequate preparations and preventive measures in order to prevent problems before they occur, and develop a plan to deal with possible problems.
b.Work during anesthesia
Make good anesthesia according to the anesthesia operation protocol to obtain the best anesthesia effect, so that the patient can complete the operation without pain, quiet, memory and adverse reactions. At the same time, create good conditions for the surgery and try to meet the special requirements of certain surgeries (such as muscle relaxation, low temperature, low blood pressure, etc.). Do the monitoring of the surgical anesthesia process, including the continuous monitoring of circulation, respiration, water electrolytes, body temperature and other functions, and write anesthesia records. Make effective treatment according to the changes of the anesthesia process, such as maintaining smooth hemodynamics and performing respiratory management.
c.Post-anesthesia work
Return the patient to the ward (or anesthesia recovery room) after anesthesia and make a good handover. According to different conditions and surgeries, do all kinds of post-anesthesia treatment, including continuous monitoring of patients, preventing complications, dealing with accidents in time, and assisting clinical departments in treating complications so that patients can heal as soon as possible. Make a good record of post-anesthesia follow-up and summary.
2.Anesthesia recovery room and strengthen the work of monitoring and treatment room
With the increase of complex anesthesia and surgery for critical and difficult patients, the end of surgery does not mean the disappearance of anesthesia and the complete recovery of major physiological functions, plus the failure to completely correct the disorders of circulation, respiration, metabolism and other functions that have occurred during surgical anesthesia, there is still a risk of various complications after anesthesia. Due to the development of anesthesia and the progress of monitoring technology, patients after anesthesia surgery still need to be carefully treated and cared for by professionally trained medical personnel to promote early recovery.
For patients under general anesthesia, they should be completely awake, and the local sensory-motor function of patients under various nerve blocks should be completely normalized, and the important physiological functions of patients such as circulation, respiration, liver and kidney should be normalized and in a stable state. Patients who have had anesthesia complications should be actively treated. Therefore, anesthesia recovery room and enhanced monitoring and treatment room play an increasingly important role in the recovery of anesthesia patients, the monitoring of critical patients and the prevention and treatment of anesthesia complications, and are an important part of modern anesthesia departments. Its establishment and perfection or not is one of the important symbols to measure the advanced modern hospital.
3.Emergency resuscitation
Anesthesia workers make full use of the professional knowledge and techniques they have acquired, including theoretical knowledge of applied physiology, pathophysiology and clinical pharmacology, endotracheal intubation, artificial ventilation methods, various measures to maintain circulatory function and restore cardiac activity, hypothermia therapy to protect the function of the central nervous system, and experience in monitoring techniques and drug therapy for important physiological functions such as heart, lung, liver and kidney, etc. play an important role in emergency resuscitation. Thus, first aid and resuscitation have become an important part of modern anesthesiology and one of the important tasks of the anesthesia specialty.
4.Pain treatment
For acute and chronic pain caused by various diseases and traumas, we can achieve good results by setting up pain treatment clinics or wards using the analgesic drugs and nerve block techniques mastered by the anesthesia specialty, as well as diagnosing and treating certain vascular diseases with peripheral vascular disorders as the main signs and nerve paralysis or spasticity. It has been gradually applied in the clinical work of anesthesia.
The role of anesthesiologists in modern medicine Most people think of anesthesiologists as doctors who relieve pain and render patients unconscious through pharmacological treatment. However, few people realize that the task of today’s anesthesiologists in the operating room is not only to ensure the comfort of the patient, but also to monitor and diagnose changes in vital functions caused by a variety of factors (anesthesia, surgery, etc., primary disease) during surgery and recovery from anesthesia, and to treat them as a result to ensure the safety of the patient in the perioperative period.
Anesthesiologists need to have a wide range of knowledge to perform this job, and are required to have multidisciplinary knowledge of basic and clinical medicine such as pathophysiology, pharmacology, internal medicine, surgery, gynecology and pediatrics, and anesthesia. As an anesthesiologist, he or she has to relieve the patient’s pain and manage the vital signs of the patient, including respiration, heart rate, blood pressure, heart, nervous system, liver and kidney function.
The anesthesiologist treats medical problems that arise in patients during the perioperative period (during surgery and the period before and after surgery). The anesthesiologist makes preoperative judgments about the condition, considers individual differences based on the patient’s physical condition, and formulates treatment plans accordingly, using advanced instruments to monitor the patient’s vital functions during surgery. Anesthesiologists must rely on a variety of complex and sophisticated instruments to make accurate diagnoses of conditions and to maintain the lives of patients, some of whom are already very fragile.
At the end of surgery, patients are sent to a recovery room or intensive care (ICU) unit, to recover from anesthesia, and then sent back to their rooms. In addition to the operating room, the anesthesiologist’s scope of work includes intensive care, pain management, etc.
What is the job description
Anesthesiologists are also known as internal medicine doctors in the operating room. They are not only skilled in various anesthesia techniques to ensure painless surgery and smooth operation, but also use advanced instruments to monitor patients’ vital functions at any time, and take various therapeutic measures to maintain the stability of patients’ vital functions and ensure their safety if they are found to have life-threatening problems due to surgery, anesthesia or patients’ pre-existing diseases.
Generally speaking, clinical anesthesiologists are responsible for.
1.Deciding together with the patient’s supervising physician whether the patient can tolerate surgical anesthesia;
2. deciding on the type of anesthesia and monitoring measures to be used;
3.To administer anesthesia to the patient;
4. making every effort to ensure the safety of the patient during the entire procedure;
5.To make the patient recover safely and smoothly after the surgery;
6.Postoperative pain treatment;
7.Treatment of chronic pain.
What is the anesthesiologist doing during surgery?
The work of anesthesiologists is like the work of an airplane pilot. Aircraft takeoff and landing are equivalent to anesthesia induction and recovery, and the autopilot used during flight is equivalent to anesthetics, muscle relaxants and mechanical breathing. During surgery, the anesthesiologist must continuously observe the patient, continuously access the central nervous system with information obtained through the eyes, ears and hands, analyze and think about the monitoring data to form certain detailed and complex judgments, and then make some adjustments to the drugs (including anesthetics, muscle relaxants, fluids and hemostatic drugs, etc.) in order to maintain the smooth physiological function of the surgical patient as much as possible, and perform emergency treatment in case of emergency. Resuscitation.
The eye can be observed in the following areas
(1) Skin: cyanosis or pink indicates improper breathing or other causes; pallor and sweating indicate bleeding or shock.
(2) Head and neck: Eye movements indicate superficial anesthesia; dilated pupils (although dilated with atropine) indicate deep anesthesia, the effects of ganglion blocking drugs, acute hypoxia and/or respiratory and circulatory failure.
(3) Chest: chest motion indicates air entry into the lungs; is there symmetry of bilateral expansion? If the patient is breathing spontaneously, changes in respiratory rhythm are accompanied by changes in respiratory depth. Tracheal traction indicates that the effect of inotropes has not completely disappeared; retraction of the intercostal muscles in the lower chest suggests airway obstruction.
(4) abdomen: during dissection, observe the surgical operation to determine whether muscle relaxation is appropriate? Is the patient mentally tense? Is there a large amount of bleeding? What is the amount of blood in the suction bottle? What is the degree of contamination of the abdominal cavity? (This is related to postoperative shock)
(5) Instruments: Does the rotor flowmeter indicate proper airflow? Is the volume of the volumetric cylinder appropriate? Is the volumizer properly set up? Is there any anesthetic in the volumetric device? Does the respiratory valve need to be adjusted? Is the respiratory bag properly inflated? If sodium lime is used, what color is it? Is the soda lime not working? Check the ventilator device: inflation pressure, inflation rate, and negative pressure. Can the ventilator expand the chest? Is the articulation appropriate? Is the air flow rate appropriate? Check the amount and rate of intravenous infusion; if blood is transfused, check the vial number and the patient’s number to ensure that the blood transfused is correct for the patient.
(6) Physiologic monitoring: Measure pulse and blood pressure and record every 5 minutes; also take the reading on the monitor or the flashing display on the pulse monitor if a cardiac monitor is used. Blood loss from the procedure must be recorded throughout the procedure.