Head, neck, maxillo-facial and dental surgery
It is anticipated that this unit of training will not be delivered as a dedicated block and that the learning outcomes will be gained throughout the duration of Core Level training and that these should be achievable in most general hospitals at this level.
Learning outcomes:
- Gain knowledge and skills of the perioperative anaesthetic care of patients undergoing minor to intermediate ear, nose and throat [ENT], maxilla-facial and dental surgery
- To be able to recognise the specific problems encountered with a ‘shared airway’ and know the principles of how to manage these correctly
Core clinical learning outcome:
- Deliver perioperative anaesthetic care to ASA 1-3 adults, and ASA 1 and 2 children over 5, for non-complex ear, adenotonsillar and nasal surgery under direct supervision
NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Primary examination identified in the FRCA examination blueprint on page B-99 or in the Final examination identified in the Final FRCA blueprint on page C72 of Annex C.
| Knowledge |
|---|
|
Competence |
Description |
Assessment Methods |
GMP |
|---|---|---|---|
|
EN_BK_01 |
Lists specific conditions that may complicate airway management [e.g. anatomical variation; tumour; bleeding] |
A,C,E |
1,2 |
|
EN_BK_02 |
Describes how the surgeon operating in the airway, or requiring access via the airway, complicates anaesthesia for this type of surgery |
A,C,E |
1 |
|
EN_BK_03 |
Recalls/describes the pathophysiology of obstructive sleep apnoea and its relevance to anaesthesia [AM_BK_07] |
A,C,E |
1,2 |
|
EN_BK_04 |
Recalls/describes the specialised devices used to maintain the airway during head and neck surgery |
A,C,E |
1 |
|
EN_BK_05 |
Identifies the indications for the special surgical devices used during surgery including gags, micro-laryngoscopes, oesophagoscopes and laser surgery equipment |
A,C,E |
1,2 |
|
EN_BK_06 |
Describes appropriate anaesthetic techniques for common ENT and dental procedures and lists the particular difficulties that face the anaesthetist including but not exclusively: tonsillectomy, septoplasty, myringotomy, middle ear surgery, dental extractions and apicectomies |
A,C,E |
1,2,3 |
|
EN_BK_07 |
Recalls/explains the principles of correct and timely recognition/management of bleeding tonsils |
A,C,E |
1,2,3 |
|
EN_BK_08 |
Explains the principles of the emergency management of the obstructed airway including tracheostomy |
A,C,E |
1,2,3,4 |
|
EN_BK_09 |
Describes the special risk of transmitting prion diseases by contamination with tonsillar tissue and explains how this risk is minimised in practice |
A,C,E |
1,2,3,4 |
| Skills |
|---|
|
Competence |
Description |
Assessment Methods |
GMP |
|---|---|---|---|
|
EN_BS_01 |
Demonstrates development of preoperative assessment and preparation/optimisation knowledge and skills [as identified in the basis of anaesthetic practice], focused on the specific difficulties presented by these surgical sub-specialties |
A,D,M |
1,2,3 |
|
EN_BS_02 |
The provision of safe perioperative anaesthetic care for a wide range of commonly performed procedures, with good operating conditions and an appropriate level of analgesia, including:
|
A,D,M |
1,2,3,4 |
|
EN_BS_03 |
Demonstrates the correct use of a variety of specialised airway devices, including RAE tubes, LMAs, throat packs and intubating forceps |
A,D |
1 |
|
EN_BS_04 |
Manages anaesthesia so as to achieve smooth emergence, with minimal airway disturbance, laryngospasm and bronchospasm |
A,D |
1 |
|
EN_BS_05 |
Demonstrates awareness of the increased risk of airway complications postoperatively and takes precautions to assist in their early recognition and prompt management |
A,D,M |
1,2,3,4 |