The first several weeks of anesthesia training are spent working very closely with fellow trainees and anesthesia faculty. The case selection is aimed to provide basic experience in patient evaluation, anesthetic selection, and anesthetic management.
Case selection is expanded over the first several months to include a broader variety of patient disease states and more complicated surgical procedures (for example, cases prone to acid-base abnormalities and significant blood loss).
New patient positions (lateral, prone and beach chair) are included. By the end of basic anesthesia training, you will be prepared to take on the subspecialties.
You might expect that urology cases would be dull, but don't be fooled. First, the camaraderie among the urology nurses, faculty and resident surgeons, and the anesthesia team is something we enjoy and nurture. Second, we provide anesthesia to a diverse patient population from neonates to the elderly, otherwise healthy to the very ill. Finally, the surgical procedures vary from the simple hydrodistension, ESWL (extracorporeal shockwave lithotripsy) and cystoscopy to the complicated nephrectomy with tumor invasion into major blood vessels, adrenalectomy for pheochromocytoma, and urinary bladder cystectomy.
Monitoring can be simple standard ASA monitors or extensive, including invasive arterial blood pressure monitoring, central venous catheters/pulmonary artery catheters, or even intraoperative ECHO. Our surgeons perform many procedures laparoscopically and use robotic technology for some procedures. Urology offers a diverse experience.
The patients can be severely ill or otherwise healthy. Cases often require invasive monitoring procedures (arterial lines and central venous lines) and can be done with straight regional techniques, monitored anesthesia care, general anesthesia or combined regional/general anesthesia. Expect the unexpected!
We are privileged to provide anesthesia services for this department which is consistently ranked highly by U.S. News & World Report. While on this rotation, residents become experts at airway management.
Jet ventilation with heliox is used in pediatric airway management. Residents learn to evaluate the compromised airway and plan appropriate anesthesia techniques.
Head and neck cancer surgery is a major component and residents become familiar with management of fluid, electrolytes, and blood replacement during surgical procedures that are of long duration.
This department is also ranked highly by U.S. News & World Report. Residents balance the need for a quiet operating field while maintaining the ability to awaken the patient in a timely fashion.
Corrective eye procedures for children are commonly performed at UI Stead Family Children’s Hospital. Residents also learn to manage as many as ten cataract surgeries in one day, thus gaining valuable private practice-like experience.
Because oral surgeons need unimpeded access to the mouth, residents become expert at nasal intubation. Residents gain expertise in blood pressure control with vasoactive agents as many of the jaw advancement surgeries also require induced hypotension.
All residents participate in the night float ("call") rotation. A combination of residents, SRNAs, and CRNAs form a team that helps relieve non-call anesthesia providers and provides anesthesia care to emergency and trauma patients needing surgery after hours and on weekends/holidays.
Nights and weekends are busy because the University of Iowa serves as the major referral center for all of Iowa and many surrounding states. It is the only Level 1 trauma center in Iowa to care for both adults and children.
CA1 and CA2 residents have two-week blocks of Night Float call several times each year. In general, the CA1 and CA2 residents, SRNAs, and CRNAs provide anesthesia care.
CA3 residents are the team leaders and help triage resources and guide the more junior residents with patient management. CA3 residents also attend "codes" on the floors and attend "trauma activations" in the Emergency Department to manage patient airways in these potentially difficult situations. CA1 and CA2 residents are encouraged to accompany the CA3 resident to codes and traumas as these are valuable learning experiences and another pair of hands is often helpful.
By the end of training, residents are confident and capable of handling any challenging case that comes along.