Vascular surgery
This is one of the ‘optional’ Intermediate level units of training; whilst trainees are not expected to gain practical experience in this area of practice, they should obtain the competencies identified in the knowledge section as this forms part of the FRCA curriculum and therefore may be assessed. Where vascular is available at the intermediate level, the skill competencies are identical to those defined for higher vascular. The difference between intermediate and higher vascular is that the core clinical learning outcome is under direct supervision for intermediate and distant supervision for higher.
Core clinical learning outcome:
- To gain knowledge of the perioperative anaesthetic management of patients undergoing elective and emergency abdominal aortic surgery and newer stenting techniques
- To anaesthetise patients for carotid endarterectomy and aortic aneurysm surgery with direct 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 |
|---|
|
Competence |
Description |
Assessment Methods |
GMP |
|---|---|---|---|
|
VS_IK_01 |
Recalls/describes the cardiovascular physiology and pharmacology relevant to perioperative vascular surgery |
A,C,E |
1 |
|
VS_IK_02 |
Lists the methods of assessment of the patient’s functional cardiovascular capacity |
C,E |
1 |
|
VS_IK_03 |
Explains the preoperative management of the patient with atherosclerotic disease |
C,E |
1,2 |
|
VS_IK_04 |
Describes the perioperative management of the patient for major vascular surgery |
A,C,E |
1,2 |
|
VS_IK_05 |
Describes the resuscitation and management of major vascular accidents including the management of ruptured aortic aneurysms |
C,E |
1,2,3,4 |
|
VS_IK_06 |
Explains the management of patients for endovascular radiological procedures [e.g. Stenting] including anaesthesia in isolated locations [Cross reference non-theatre anaesthesia] |
C,E |
1,2,3,4 |
|
VS_IK_07 |
Describes the management of elective carotid artery surgery with general or regional anaesthesia |
A,C,E |
1,2,3,4 |
|
VS_IK_08 |
Explains the principles and anaesthetic implications of sympathectomy, including thoracoscopic procedures |
C,E |
1,2 |
|
VS_IK_09 |
Describes the postoperative management and critical care of vascular patients |
C,E |
1,2,3,4 |
|
VS_IK_10 |
Explains the effects of smoking on health |
C,E |
1,2,3,4 |
|
VS_IK_11 |
Recalls/describes the morbidity and mortality associated with vascular surgery |
C,E |
1,2,3,4 |
|
VS_IK_12 |
Recalls/explains the principles of blood conservation and red cell salvage when major haemorrhage is predicted |
A,C,E |
1,2 |
|
VS_IK_13 |
Recalls the pathophysiology of aortic cross-clamping and of renal protection strategies |
A,C,E |
1,2 |
| Skills |
|---|
|
Competence |
Description |
Assessment methods |
GMP |
|---|---|---|---|
|
VS_HS_01 |
Demonstrates the pre-operative assessment of vascular patients with coexisting disease |
A,D,M |
1,2,3,4 |
|
VS_HS_02 |
Performs the pre-operative optimisation of high risk vascular patients |
A,C,D,M |
1,2 |
|
VS_HS_03 |
Manages the effects of aortic clamping, including the implications of supra-renal or thoracic aortic clamping with distant supervision |
A,D |
1,2 |
|
VS_HS_04 |
Demonstrates safe peri-operative anaesthetic care of patients having combined surgical / radiological procedures, including those performed in isolated sites using either regional or general anaesthesia |
A,,D,M |
1,2,3,4 |
|
VS_HS_05 |
Demonstrates the ability to perform either general or regional anaesthesia safely and effectively for carotid artery surgery |
A,D |
1,2,3,4 |
|
VS_HS_06 |
Demonstrates the ability to perform safe and effective regional anaesthesia for vascular surgery including placement and management of thoracic and lumbar epidural, spinal and combined spinal –epidural |
A,D |
1,2,3,4 |