CCT in Anaesthetics - Core Level Training

Published: 14/08/2019

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 aorto-caval 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