Obstetrics
Wherever possible, this Core Level unit of training should occur in a dedicated block. The use of simulators may assist in the teaching and assessment of some aspects of this section e.g. general anaesthesia for Caesarean section
Learning outcome:
- To gain knowledge, skills and experience of the treatment of the healthy pregnant woman
Core clinical learning outcomes:
- To pass the formal practical initial assessment of competence in obstetric anaesthesia and, having achieved this, be able to provide analgesia and anaesthesia as required for the majority of the women in the delivery suite
- To understand the management of common obstetric emergencies and be capable of performing immediate resuscitation and care of acute obstetric emergencies [e.g. eclampsia; pre-eclampsia; haemorrhage], under distant supervision but recognising when additional help is required
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 |
|---|---|---|---|
|
OB_BK_01 |
Recalls/describes the anatomy, physiology and pharmacology related to pregnancy and labour [cross ref basic sciences] |
A,C,E |
1 |
|
OB_BK_02 |
Lists common obstetric indications for anaesthetic intervention on the delivery suite |
A,C,E |
1 |
|
OB_BK_03 |
Describes the effects of aortocaval compression and how to avoid it |
A,C,E |
1,2 |
|
OB_BK_04 |
Recalls/describes how to assess fetal well being in utero |
A,C,E |
1,2 |
|
OB_BK_05 |
Discusses the management of pre-eclampsia and eclampsia |
C,E |
1,2 |
|
OB_BK_06 |
Lists risk factors and describes the management of major obstetric haemorrhage |
C,E |
1,2 |
|
OB_BK_07 |
Explains local feeding / starvation policies and the reasons behind them |
A,C,E |
1,2 |
|
OB_BK_08 |
Explains the thromboprophylaxis requirements in pregnancy |
A,C,E |
1,2 |
|
OB_BK_09 |
Describes the grading of urgency of Caesarean section |
A,C,E |
1,2 |
|
OB_BK_10 |
Explains why anaesthetic techniques must be modified in the pregnant patient |
A,C,E |
1,2 |
|
OB_BK_11 |
Lists methods of analgesia during labour and discusses their indications and contraindications |
A,C,E |
1,2 |
|
OB_BK_12 |
Describes epidural or CSE analgesia in labour and recalls/discusses the indications, contraindications and complications |
A,C,E |
1,2 |
|
OB_BK_13 |
Explains how to provide regional anaesthesia for operative delivery |
A,C,E |
1 |
|
OB_BK_14 |
Understands the need to call for assistance after several attempts at placement of regional blocks proves unsuccessful |
A,C,E |
1,2,3 |
|
OB_BK_15 |
Describes the immediate management of accidental dural puncture |
A,C,E |
1 |
|
OB_BK_16 |
Recalls/describes maternal and basic neonatal resuscitation |
A,C,E |
1,2 |
|
OB_BK_17 |
Describes how to access local maternity guidelines and the value of having these guidelines |
A,C,E |
1,2 |
| Skills |
|---|
|
Competence |
Description |
Assessment Methods |
GMP |
|---|---|---|---|
|
OB_BS_01 |
Undertakes satisfactory preoperative assessment of the pregnant patient |
A,D |
1 |
|
OB_BS_02 |
Demonstrates the ability to clearly explain and prepare an obstetric patient for surgery |
A,C,D |
1,3,4 |
|
OB_BS_03 |
Demonstrates the use of techniques to avoid aortocaval compression |
D |
1 |
|
OB_BS_04 |
Demonstrates the ability to provide epidural analgesia in labour |
A,D,M |
1 |
|
OB_BS_05 |
Demonstrates the ability to provide spinal anaesthesia for caesarean section |
A,D |
1 |
|
OB_BS_06 |
Demonstrates the ability to convert epidural analgesia to epidural anaesthesia for surgical intervention |
A,C,D |
1 |
|
OB_BS_07 |
Demonstrates the ability to provide general anaesthesia for caesarean section [S] |
A,C,D,S |
1 |
|
OB_BS_08 |
Demonstrates an appropriate choice of anaesthesia/analgesia for instrumental delivery |
C |
1 |
|
OB_BS_09 |
Demonstrates an appropriate choice of anaesthesia for retained placenta |
C |
1,2 |
|
OB_BS_10 |
Demonstrates safe and effective management of post-delivery pain relief |
C,M |
1 |
|
OB_BS_11 |
Demonstrates ability to recognise when an obstetric patient is sick and the need for urgent assistance |
C,M |
1 |
|
OB_BS_12 |
Demonstrates the ability to provide advanced life support for a pregnant patient [S] |
D,S |
1 |
|
OB_BS_13 |
Demonstrates the ability to provide basic neonatal life support [S] |
D,S |
1 |
|
OB_BS_14 |
Obtains the Initial Assessment of Competence in Obstetric Anaesthesia |
A,C,D |
1,2,3,4 |