Tips for your Neuro Anesthesia Rotation

Anesthesia for neurosurgery… Let’s goooo! It’s big brain time

1. Two very high-yield podcasts are from ACCRAC:

   1. Episode 81: Anesthesia for Craniotomies with Alyson Russo http://accrac.com/episode-81-anesthesia-for-craniotomies-with-alyson-russo/

   2. Episode 84: Anesthesia for spine surgery with Alyson Russo http://accrac.com/episode-84-anesthesia-for-spine-surgery-with-alyson-russo/

2. For this rotation, spend a little extra time on organization. It’ll make your days much smoother (and the days of everyone else in your OR too lol). Develop systems for things like turning the table 180, turning the patient prone, and different ways to connect your lines / syringes so that you can refill / disconnect / push things more conveniently, efficiently, or safely

3. Experiment with different ways to achieve no-cough wake ups: propofol drips, titrating in narcotics, etc.

4. Get there a little earlier, around 5:15 am (for reference, on previous rotations I planned to be in the locker room by 5:40 am). This is because:

   1. It really does take that long to set up all the crap you need: In addition to your regular MSMAID, you'll set up the A line (transducer/line and actual insertion kit), 2nd PIV kit, BIS, hotline, TIVA set up w at least 3 syringe pumps, double all the extensions... it's not difficult, it just takes a long time to collect all the items, open the packages, connect parts together, prime, hang, organize, etc. In the morning, I would literally grab a garbage bag and go through the anesthesia workroom just dumping all the supplies I needed in there, and then use my glidescope to cart the garbage bag to my OR. Yes grab the glidescope too for those cases that request minimal cervical spine manipulation

   2. You know all the supplies that I talked about up there ^ ? If you're new to the facility aka in the first half of your rotation, there's a good chance you don't know where some of the supplies are kept, or you do know but it's out of stock, or someone moved it to a new place and you don't have the code, etc.

   3. Around 6am is when the neuromonitoring techs, anesthesia techs, circulator, other students/interns/residents etc. start arriving and I personally can't talk while trying to complete a task that I haven't 100% mastered yet. It's kind of like when you first learned how to back a car out of the driveway... the first couple weeks, its kinda hard to simultaneously hold a conversation. Plus, I like to be done with all/most of my prep so that I can be free to help my fellow students / residents or just be free to chat with them haha

I might be slightly partial because my ICU specialized in neuro :) … but I really enjoyed my neuro rotation, and look forward to when I can do spines and cranis again!