Published: 05/09/2019

Optional Units: Plastics/burns

This ‘optional’ Intermediate level unit of training, which may not be available to all trainees as this will be dependent upon the distribution and availability of local services. Severe burns, although initially admitted to many Emergency departments will, following resuscitation, be transferred to a specialist unit and training opportunities will be limited. However since all anaesthetists may be involved in the initial resuscitation of burns at a receiving hospital teaching in this field is essential. This may take a number of forms including classroom, CD-ROM and e-learning presentations or simulator training. Knowledge in this area is assessed in the Final FRCA examination

Learning outcomes:

  • To gain knowledge of the initial resuscitation and management of a patient with severe burns prior to transfer to a specialist centre 
  • To gain an understanding of the specific requirements of anaesthesia for burns and plastic surgery including the principles of safe perioperative anaesthetic care to patients for a wide range of surgical procedures undertaken by plastic surgeons [to include microsurgery and free-flap reconstructive techniques] 

Core clinical learning outcome:

  • Delivers safe perioperative anaesthetic care to ASA 1-3 adult patients for minor to intermediate plastic surgery [e.g. tendon repair or split skin grafting] with distant supervision

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Final examination identified in the FRCA examination blueprint section.

Knowledge:

Plastics

Competence

Description

Assessment

Methods

GMP

PL_IK_01

Can explain the specific features of preoperative assessment of patients for major plastic surgery procedures

A,C,E

1,2

PL_IK_02

Explains and critically evaluates anaesthetic techniques appropriate for plastic surgical procedures including major reconstructive cases procedures

A,C,E

1,2

PL_IK_03

Explains the factors affecting tissue blood flow with respect to free-flap surgery

A,C,E

1,2

PL_IK_04

Describes methods for improving blood flow to the surgical field during plastic surgery

A,C,E

1,2

Burns

Competence

Description

Assessment

Methods

GMP

PL_IK_05

Describes the pathophysiology of burn injury including thermal airway injury and smoke inhalation

A,C,E,S

1,2

PL_IK_06

Describes the initial assessment and management of a patient with severe burns, including electrical & chemical burns

A,C,E,S

1

PL_IK_07

Explains the principles of anaesthetic management of burns patients for surgery including dressing changes, grafting and related procedures

A,C,E

1

Skills:

Plastics

Competence

Description

Assessment method

GMP

PL_IS_01

Demonstrates safe perioperative anaesthetic management of ASA 1-3 patients requiring major plastic surgical procedures

A,C,D

1,2,3,4

PL_IS_02

Demonstrates strategies to improve the surgical field by pharmacological [including induced hypotension] and non-pharmacological methods 

A,C,D

1,2,3,4

BURNS [if clinical placement and/or simulator-based training available]

Competence

Description

Assessment method

GMP

PL_IS_03

Demonstrates appropriate initial assessment and management of the patient with severe burns including analgesia, airway and fluid management

A,C,D,S

1,2,3,4