Consultant - Anesthesia and ICU

at  Dar Al Shifa Hospital

EDUCATION

PhD/Royal College/Fellowship/Membership

EXPERIENCE

Minimum 7 years post Ph.D. /Fellowship/Membership experience in relevant specialty

PURPOSE AND SCOPE OF THE JOB

Consultant Anesthesiologists are responsible to examine patient, obtain medical history and use diagnostic tests to determine risk during surgical, obstetrical, and other medical procedures. Administer anesthetic or sedation during medical procedures, using various methods, monitor patient and counteract adverse reactions or complications, conduct medical research, coordinate and direct work of nurses, medical technicians and other health care providers.

MAIN DUTIES AND RESPONSIBILITIES/PERFORMANCE STANDARDS

1
Provides anesthesia care to elective as well as emergency cases.
2
Ensures implementation of the Ministry of Health regulations, the hospital Medical Staff Bylaws, Rules and Regulations and the Anesthesia Department Policy and Guidelines.
3
Follows the standard concepts, practices, and procedures within the field of anesthesia.
4
Exhibits appropriate personal and interpersonal professional behaviors and ethically practices medicine in consistent with the obligations of a physician.
5
Cooperates with other members in Anesthesia Department to work in a team directed and organized by the Head of the Department
6
Consider the patient’s safety as the first priority in his work
7
Periodically review his personal and professional performance against national standards set for the specialty
8
Include the patient in discussions concerning appropriate diagnostic and management procedures
9
Respect the opinions of fellow specialists, consultants and referring physicians in the management of patient problems and be willing to provide means whereby differences of opinion can be discussed and resolved
10
Show recognition of limits of personal skill and knowledge by appropriately consulting other physicians when caring for the patient
11
Show a pattern of maintaining current personal clinical skill and knowledge through continuing medical education
12
Attend the meetings of the Anesthesia Department to discuss the rules and regulations, obstacles to work, incidents and complications encountered and suggestions to improve the quality of service. Scientific presentations and refresher course lectures, whenever possible, are to be a part of the meeting
13
Participate in assessing, planning, implementing and evaluating patient care needs
14
Share in organizational performance improvement activities
15
Participate in continuous quality improvement programs for anesthesia service
16
The on-call anesthesiologists are responsible for covering the calls for 24 hours
17
Duties of the on-call anesthesiologist include: Anesthetic management for emergency and elective cases. Epidural analgesia for labor and delivery. Preoperative check-up for patients admitted the night before surgery and those referred by surgeons for check-up before booking/scheduling. Covering calls from ER, ICU and other areas of the hospital for conditions related to anesthesia service or resuscitation.
18
The specialist shall be aware of his limitations. Consultant cover/consultation is required in cases of: Neonates, infants and children under the age of 12 years with ASA status more than 3 or with uncontrolled medical problems undergoing major operations under general anesthesia. Patients older than 70 years with ASA status more than 3 undergoing major operations under general anesthesia. When technical difficulties are encountered Specific anesthesia service is the responsibility of the anesthesiologist assigned to give care to a certain patient. It covers the preoperative, the intraoperative and the postoperative period in the recovery area until discharge to the ward.

Preoperative check-up:

• Anesthesiologist shall be responsible for determining the medical status of the patient, developing a plan of anesthesia care and informing the patient or the responsible adult with the proposed plan
• The development of an appropriate plan of anesthesia care is based upon:
• Reviewing the medical record.
• Interviewing and examining the patient to: Discuss the medical history, previous anaesthetic experiences and drug therapy
• Assess the possibility of a difficult endotracheal intubation.
• Assess those aspects of the physical condition that might affect decisions regarding peri-operative risk and management.
• Obtaining and/or reviewing tests and consultations necessary to the conduct of anesthesia.
• Determining the appropriate prescription of preoperative medications as necessary to the conduct of anesthesia. The responsible anesthesiologist shall verify that the above has been properly performed and documented in the patient’s record

19

Intra-operative period:

• Positions patient safely on operating table.
• Uses the appropriate monitors before, during, and after anesthesia to evaluate oxygenation, ventilation and cardiovascular system. Basic monitoring includes ECG, BP, inspired oxygen concentration, peripheral oxygen saturation (oximetry) and end tidal carbon dioxide (capnography).
• The anesthesiologist shall be present in the OR throughout the conduct of anesthesia.
• Administers local, intravenous, inhalational, spinal, epidural, caudal, or other anesthetic or sedative according to prescribed medical standards.
• Uses mechanical ventilation appropriately when required and adjusts the ventilator settings according to the patient’s needs.
• Institutes remedial measures to counteract adverse reactions or complications.
• Administers intravenous fluids (crystalloids, colloids) as required.
• Estimates blood loss and transfuses blood (blood products) if required.
• Records timing, type and amount of anesthetics, sedatives, muscle relaxants and other drugs administered, IV fluids, blood loss and blood given, airway device used and ventilator settings, hemodynamic and ventilatory changes, events and complications encountered and condition of patient on leaving OR.

20

Post-operative period:

• Attends and supervises transporting the patient safely to the Recovery Room (Post Anesthesia Care Unit = PACU). Orders analgesics as required and manages any possible complications in the Recovery Room until discharge to the ward

21
Answer calls from the wards regarding conditions related to anesthetic care given to the patient
22
Accept all other additional assignments found necessary by the Head of Department