2021 Curriculum learning syllabus: stage 2

Published: 09/02/2021

General Anaesthesia

Stage learning outcome

  • Provides safe and effective general anaesthesia with distant supervision for ASA 1 - 3 patients undergoing non-complex elective and emergency surgery within all settings

Key capability A

A

Explains the specific factors in providing safe anaesthetic care for patients at extremes of age, including neonates, children and older people with frailty, and implements these in practice

Examples of evidence

  • SLEs throughout stage of training in a range of surgical specialties including paediatrics.
Personal activities and reflections:
  • Final FRCA.

Suggested supervision level

  • not applicable.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion
  • General Anaesthesia

Key capability B

B

Provides appropriate anaesthesia care for patients undergoing day case surgery in all settings

Examples of evidence

  • SLEs throughout stage of training in a range of surgical specialties.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion
  • Regional anaesthesia
  • Pain

Key capability C

C

Describes the principles of intra-operative haemostasis and manages major haemorrhage

Examples of evidence

  • SLEs throughout stage of training in a range of surgical specialties including out of hours work, trauma.
Personal activities and reflections:
  • mandatory training: blood transfusion.

Suggested supervision level

  • 2b - supervisor within hospital for queries, able to provide prompt direction/assistance.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion
  • Resuscitation and Transfer

Key capabilities D to F

D

Provides safe care for ASA 1-3 adult patients with multiple injuries from arrival in hospital to post-operative care and seeks help appropriately

E

Describes the anaesthetic-related problems associated with trauma including burns, poisoning, electrical injuries, and drowning

F

Applies physiological & pharmacological principles to reduce the risk of secondary brain injury in patients presenting with a severe head injury

Examples of evidence

  • SLEs throughout stage of training including out of hours work and experience in major trauma centre and neurosurgery.
Personal activities and reflections:
  • Simulation training: trauma resuscitation.

Suggested supervision level

  • 2b - supervisor within hospital for queries, able to provide prompt direction/assistance.

Cross links with other domains and capabilities

  • Resuscitation and Transfer

Key capability G

G

Recognises, mitigates against risks and manages complications relating to patient positioning during surgery, including reference to the obese patient

Examples of evidence

  • SLEs throughout stage of training in a range of surgical specialties including obstetrics and bariatric surgery.
Personal activities and reflections:
  • courses and e-Learning: anaesthesia for the obese patient.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • Safety and Quality Improvement

Key capability H

H

Applies a sound understanding of anatomy, physiology, biochemistry, pharmacology, physics and clinical measurement to anaesthetic practice

Examples of evidence

  • SLEs throughout stage of training in a range of surgical specialties.
Personal activities and reflections:
  • Final FRCA.

Suggested supervision level

  • not applicable.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion
  • Regional Anaesthesia

Key capabilities I & J

I

Safely manages patients with complex airways including the ability to perform videolaryngoscopy with local supervision
J Manages non-complex shared airway surgery with distant supervision

Examples of evidence

  • SLEs throughout stage of training in a range of surgical specialties including ENT and maxillo-facial surgery.
Personal activities and reflections:
  • simulation courses: airway management.

Suggested supervision level

Cross links with other domains and capabilities

  • General Anaesthesia

Key capability K

K

Explains the problems associated with laparoscopic, endoscopic and open procedures, including those with major blood loss, and provides safe general anaesthesia for these procedures with distant supervision for ASA 1 to 3 adult patients

Examples of evidence

  • SLEs throughout stage of training in a range of surgical specialties.
Personal activities and reflections:
  • Final FRCA.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion
  • General Anaesthesia

Key capability L

L

Provides safe general anaesthesia for diagnostic and therapeutic procedures in the non-theatre environment but within the hospital setting for ASA 1-3 adult patients independently, recognising when this is inappropriate

Examples of evidence

  • SLEs throughout stage of training. Case examples could come from radiology, ECT, cardioversion, Emergency Department.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • General Anaesthesia
  • Resuscitation and Transfer

Neuro anaesthesia: key capabilities M & N

M

Applies relevant anatomical, physiological and pharmacological principles to neurosurgical patients

N

Provides safe anaesthetic care to ASA 1-3 adults for simple elective and emergency intracranial, spinal and neuroradiology procedures under local supervision

Examples of evidence

  • SLEs from experience in neurosurgery.
Personal activities and reflections:
  • Final FRCA.

Suggested supervision level

  • 2a - supervisor in theatre suite, available to guide aspects of activity through monitoring at regular intervals.

Cross links with other domains and capabilities

  • General Anaesthesia

Cardiothoracic anaesthesia: key capabilities O to R

O

Applies basic science and clinical anaesthetic principles to patients undergoing cardiac and thoracic surgery

P

Describes the principles of anaesthesia for on and off bypass cardiac and thoracic surgery

Q

Provides safe anaesthetic care to ASA 1–3 adults undergoing elective cardiac revascularisation, valvular surgery and cardiology procedures under direct supervision

R

Demonstrates safe anaesthetic care for adults requiring non-complex thoracic procedures under direct supervision, including one lung ventilation

Examples of evidence

  • SLEs from experience in cardiac and thoracic surgery.
Personal activities and reflections:
  • Final FRCA.

Suggested supervision level

  • 2a - supervisor in theatre suite, available to guide aspects of activity through monitoring at regular intervals.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion

Key capability S

S

Explains the anaesthetic implications of ophthalmic surgery, in particular the penetrating eye injury and the presence of intraocular gas

Examples of evidence

  • SLEs from experience in ophthalmic surgery and trauma.
Personal activities and reflections:
  • e-Learning: ophthalmic anaesthesia.

Suggested supervision level

  • not applicable.

Cross links with other domains and capabilities

  • General Anaesthesia
  • Regional Anaesthesia

Obstetric anaesthesia: key capability T

T

Provides safe anaesthetic care for elective and emergency obstetric patients including those with co-morbidities and obstetric complications with distant supervision

Examples of evidence

  • SLEs throughout stage of training in obstetrics including out of hours work and experience in pre-operative assessment clinics.
Personal activities and reflections:
  • attendance at obstetric anaesthesia clinics
  • simulation training: obstetric emergencies.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion
  • General Anaesthesia 
  • Regional Anaesthesia
  • Resuscitation and Transfer

Paediatric anaesthesia: key capabilities U to W

U

Provides safe general anaesthesia for ASA 1-3 children undergoing non-complex elective and emergency surgery aged 1- 5 years with direct supervision, and 5 years and above with distant supervision

V

Explains the principles of anaesthetic care for children of all ages with complex medical problems and/or requiring complex surgical procedures

W

Explains the principles of the general anaesthetic care of neonates

Examples of evidence

  • SLEs throughout stage of training in paediatric anaesthesia including out of hours work and experience in pre-operative assessment clinics.
Personal activities and reflections:
  • simulation or other courses: paediatric anaesthesia.

Suggested supervision level

for ASA 1-3 children aged 1-5:

  • 2a - supervisor in theatre suite, available to guide aspects of activity through monitoring at regular intervals

for children 5 years and above:

  • 2b - supervisor within hospital for queries, able to provide prompt direction/assistance.

Cross links with other domains and capabilities

  • Perioperative Medicine and Health Promotion

Key capability X

X

Uses total intravenous anaesthesia safely in all areas of clinical anaesthetic practice

Examples of evidence

  • SLEs from appropriate surgical specialties.

Suggested supervision level

  • 2b - supervisor within hospital for queries, able to provide prompt direction/assistance.

Cross links with other domains and capabilities

  • General Anaesthesia