Thoracic Anesthesia

Thoracic Anesthesia

2 Blocks

Lead

Dr. Stéphane Moffett

Welcome Message

The thoracic anesthesia team is made up of Drs. Stéphane Moffett, Larry Byford, Sylvain Gagné, Calvin Thompson, and the thoracic fellow. Drs Jason McVicar and Christopher Pysyk are thoracic anesthesiology enthusiasts that also will be participating in the thoracic module. Over the course of the thoracic module core I, we will support you in your learning to ensure you develop the required competencies to manage thoracic surgical cases of basic and intermediate complexity. Over the course of core II our expectations will be that you can manage cases of intermediate complexity.

Core I Thoracic Anesthesia serves as an introduction to thoracic anesthesia. During this rotation, it is expected that you develop the required knowledge and skills to competently manage anesthesia for common thoracic surgical cases.

Core II Thoracic Anesthesia serves as a consolidation to thoracic anesthesia. During this rotation, it is expected that you demonstrate the required knowledge and skills to competently manage anesthesia for common thoracic surgical cases and maybe some less common ones.

It is important to note that Core I and Core II are conceptualized as being a junior and a senior rotation in thoracic anesthesia. It is important to complete junior status before moving on to senior status. Due to various circumstances out of the program's control, randomness of exposure could make it so that some requirements are not fully met, notably number of days in thoracic anesthesia, number of learning cases completed, number of LIATs and Tea Tools completed.

EPAs & Milestones

  • Management of lung/esophageal surgery/disease
    • Demonstrates management of lung isolation techniques
    • Demonstrates management of hypoxemia and complications under OLV
    • Demonstrates understanding of intraoperative complications related to pulmonary resection
    • Demonstrates fiberoptic bronchoscopy (FOB) skills and its application to tracheobronchial tree
    • Demonstrates understanding of management of esophageal surgery
    • Demonstrates management of pulmonary or esophageal resection (VATS/thoracothomy).
    • Demonstrates understanding of complications for pneumonectomy.
    • Demonstrates lung isolation for critically ill patients (difficult AW, hemoptysis, broncho-pleural fistula)
  • Management of mediastinal mass
    • Demonstrates management of mediastinoscopy
    • Demonstrates management of intraoperative complications from mediastinoscopy
    • Demonstrates management of mediastinal mass resection.
    • Demonstrates understanding of intraoperative and postoperative complications for a mediastinal mass resection.

Academic Curriculum

Learning Cases

Core 1

  • Lobectomy
  • Anterior Mediastinal Mass
  • Pneumothorax
  • Lung Resection and Difficult Airway
  • Esophagectomy
  • Ventilation Under One Lung Ventilation (OLV)
  • Cervical Mediastinoscopy and Eaton-Lambert Syndrome

Core 2

  • Anterior Mediastinal Mass
  • Pulmonary Hemorrhage
  • Broncho-Pleural Fistula
  • Lung Isolation in a Difficult Airway
  • Pneumonectomy

Assessment Tools

  • Completed a minimum of 6 Thoracic Anesthesia clinical days (per Core)
  • Submitted a Thoracic Anesthesia case and staff assignment calendar for the module (per Core)
  • Submitted the required number of CCATs (12 per Core)
  • Compliant with Resident Logbook
  • Demonstrated evidence of self-learning
  • Obtained clinical exposure to all required areas
  • Attend Thoracic Anesthesia rotation orientation day (Core 1)
  • Completed 7 Core 1 Thoracic Anesthesia learning cases
  • Submitted 2 case summaries and achieved minimal mark required (Core 1)
  • Completed 5 Lung Isolation Assessment Tools and achieved minimal mark required (final LIAT with no items scored <3) (Core 1)
  • Completed 3 Thoracic Epidural Assessment Tools (paramedian technique) and achieved minimal mark required (final TEA with no items scored as a 1) (Core 1)
  • Completed 3 Thoracic Epidural Assessment Tools (hanging drop technique) and achieved minimal mark required (final TEA with no items scored as a 1) (Core 1)
  • Reoriented self to Thoracic Anesthesia module and previous requirements/skills (Core 2)
  • Complete 5 Core 2 Thoracic Anesthesia learning cases
  • Completed 5 Lung Isolation Assessment Tools - At least 3 LIATs must have all scores at 4 or 5. (Core 2)
  • Completed 3 Thoracic Epidural Assessment Tools (paramedian technique) - No TEA can have any items <3. At least 1 TEA should have all items scored at 4 or 5.  (Core 2)
  • Completed 3 Thoracic Epidural Assessment Tools (hanging drop technique) - No TEA can have any items <3. At least 1 TEA should have all items scored at 4 or 5.  (Core 2)
  • Completed summative module exam and achieved minimal mark required (Core 2)
  • Completed 2 formative module exams and achieved sufficient improvement (Core 2)
  • Demonstrated ability to independently manage a Thoracic Anesthesia case (i.e. lung resection, esophageal resection, bullectomy, anterior mediastinal mass) by achieving at least 1 CCAT with all items scored as 4 or above (during module) (Core 2)
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