Finished With Pediatric Anesthesiology As A CA-2

A final second-call shift tomorrow stands between me and completing this three month rotation in pediatric anesthesiology. What an experience its been!

The beauty of working at such a large teaching hospital is the variety of styles we’re exposed to as trainees. Anesthesiology is inherently very flexible, but in pediatrics, there are even more variables to consider.

One example – how do we even get the child back to the operating room? Older patients will usually walk back with us whereas neonates are brought in cribs. Children of all ages often require distraction techniques (and sometimes pharmacologic sedation) to safely begin their anesthetics. We use iPad games, books, toys, wagons, scented masks, videos, music, and the like to put their anxiety at ease. 🙂

Pediatric anesthesiology is also all about the details. Sometimes we’re working with premature newborns who weigh less than 1 kilogram and literally require only drops of IV medication to achieve a full anesthetic… anything more would be a crazy overdose. Sometimes we have patients with undefined genetic syndromes involving multiple organs. How will this affect their cardiopulmonary reserve? Their post-operative course? Their minute-to-minute needs during surgery? What backup plans do I need to ensure their safety?

In the three months I’ve been here, I’ve performed countless general and regional anesthetics. Some of the cases I’ve done:

  • Kidney transplant
  • Liver transplants
  • Organ harvest
  • Pectus repairs
  • Palatoplasties
  • Video-assisted thorascopic surgeries
  • Tympanomastoidectomies
  • Neurovascular repair of Moya Moya
  • Pelvic osteotomies
  • Scoliosis surgery
  • Mitrofanoff creation and bladder augmentation
  • Ureteral reimplantations
  • VP/VA shunt creations
  • Dental procedures
  • Lots of laparoscopic appendectomies
  • Even more tonsillectomies and adenoidectomies

…and that’s just a sample. The breadth of cases allowed me to gather experience and comfort dealing with a variety of patients and comorbidities. I’m so thankful for all the wonderful anesthesia attendings, surgery attendings, nurses, and ancillary staff that made the last three months exceptional! 🙂

Time to get ready to go back to Texas Heart Institute for my first rotation as a CA-3 resident! 🙂

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