Vascular – Logistics

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Who's Who?
  • Rotation Education Director: none
  • Division Lead: Paul Alfille, M.D.
Case/Room Assignments
  • Case assignments are prepared one day in advance by Hovig Chitilian, M.D.
Call
  • While on Vascular Anesthesia, you take part in the regular Main OR call pool.
Day to Day Flow
  • Huddle occur at the patient’s bedside in the holding area at 7:10 AM. OR setup, IV access and consent should be complete prior to this. Plan to enter the OR with the patient at 7:30 AM.
  • Procedures pro-tip
    • Prioritize what’s most educationally valuable to you and let your staff know during your pre-op phone call. For example, if you really want to work on the PA line, but don’t need the arterial line, you can parallel process an extra IV and the arterial line with your attending or CC nurse in order to “buy” yourself more time for the PA line.
  • Preoperative arterial lines
    • Lunder 4 nursing policy requires that arterial lines placed preoperatively be connected to a transducer and cable, so make sure to connect your arterial lines unless you are immediately transporting to the OR.
    • Please involve your staff after 1 failed attempt at an awake arterial line (or earlier if you have difficulty palpating pulses). They don’t need to take over the arterial line, but they should be involved. This is because there have been several patient complaints about failed arterial line attempts.
  • Intraoperative communication. All staff should be notified prior to:
    • Initial dosing of heparin
    • Prior to clamping
    • Prior to unclamping
Didactics
  • None

ACGME / Program Requirements
  • During residency, you must perform anesthetics for 20 patients undergoing operations on major vessels, including carotid surgery, intrathoracic vascular surgery, intraabdominal vascular surgery or peripheral vascular surgery.
    • This should NOT include surgery for vascular access or repair of vascular access.