Today we will discuss one of the most critical devices utilised by anesthetists and throughout the anesthetic communities—the oxygen delivery devices. From anesthesia circuits, nasal prongs, and basic face masks to ventilators in the ICU environment, these devices are integral to guaranteeing optimal oxygen delivery. It is important to understand these devices in determining the oxygen flow, the needed fraction of inspired oxygen (FiO2), and categorizing these devices according to patient requirements.
Significance of Oxygen Therapy
Oxygen is crucial to life, and its administration becomes important in the management of hypoxemia, which may occur because of hypoventilation, ventilation-perfusion (V/Q) mismatch, atelectasis, or anesthetic-induced respiratory depression. Oxygen therapy is important for:
The management of hypoxemia and enhancement of tissue oxygenation
Carbon monoxide poisoning
Maintaining survival during low atmospheric pressure environments, e.g., mountaineering
Aiding patients undergoing anesthesia who cannot breathe on their own
The World Health Organization (WHO) has indicated that an FiO2 of 80% is acceptable, though in the majority of ICU environments, 50-60% FiO2 is usually acceptable. Oxygen delivery can be administered via simple face masks, nasal cannulas, or invasive ventilatory assistance based on a patient’s ventilatory needs.
Classification of Oxygen Delivery Systems
Oxygen delivery systems can be classified into two general categories:
Normobaric Oxygen Therapy – Oxygen is delivered at atmospheric pressure.
Hyperbaric Oxygen Therapy – Oxygen is administered at greater-than-atmospheric pressures.
Additional Classification Based on Patient Dependency
Low Dependency Systems:Supplemental oxygen alone is adequate to correct hypoxemia in spontaneously breathing patients.
Medium Dependency Systems: Patients need further assistance like Continuous Positive Airway Pressure (CPAP) or High-Flow Nasal Cannula (HFNC).
High Dependency Systems: Patients need mechanical ventilation or Non-Invasive Positive Pressure Ventilation (NIPPV).
Low Dependency Oxygen Delivery Systems
Low dependency systems are subdivided into:
Low Flow Devices:
Nasal Cannula: Supplies variable oxygen concentration (FiO2 varies with respiratory rate and tidal volume).
Simple Face Mask: Supplies more FiO2 than a nasal cannula but less accurately.
Reservoir Masks:
Partial Rebreather Mask: Permits some rebreathing of exhaled gases, which raises FiO2.
Non-Rebreather Mask: Fitted with one-way valves to avoid rebreathing, providing increased FiO2 levels.
High Flow Devices:
Venturi Mask: Offers a constant and reliable FiO2 irrespective of patient effort.
High-Flow Nasal Cannula (HFNC): Provides warm, humid oxygen at high flow rates (max. 60 L/min), facilitating improved oxygenation and comfort.
Determinants of Delivered FiO2
Several factors affect the actual FiO2 that a patient inhales:
Equipment Factors: Oxygen flow rate, mask volume, quality of fit, and effectiveness of mask seal.
Other Factors: Whether or not humidification is present, patient compliance, and external air entrainment.
Conclusion:
Knowledge of oxygen delivery devices is essential to maximize patient care, especially in ICU and anesthesia environments. Selecting the appropriate oxygen therapy modality according to patient requirements and levels of dependency ensures proper oxygenation, reduces complications, and improves overall treatment outcomes.
Stay updated, stay ready, and keep moving forward in the specialty of anesthesiology and critical care!
Anesthesia residency is challenging, and keeping books, apps, and study timetables in sync is daunting. The Conceptual Anesthesia App has been developed to guide you along the way, providing a learning pathway from first-year residency through final exams and super speciality preparation.
Book Suggestions for Every Year of Residency
First-Year Residency
For first-year residents, a good starting point is Lee’s Synopsis of Anesthesia, a short and easy-to-read book that helps with answering OT questions but is not sufficient for exams.
This book provides a basic understanding of anesthesia.
Second-Year Residency
Miller’s Anesthesia: This is also called the bible of Anesthesia, It is a standard reference book, but it is complex and difficult to memorize.
To make it more manageable, starting with systemic topics like neuro, respiratory, and cardiac anesthesia can be helpful.
Morgan and Mikhail’s Clinical Anesthesiology:This is an alternative to Miller’s Anesthesia, it is simpler than Miller’s but more detailed than Lee’s.
This book presents information in a more understandable format and is useful for exam preparation.
Important Tips:
Miller’s Anesthesia was useful for systemic topics like transplant, cardiac, neuro, and respiratory anesthesia but was not used directly for theory answers.
Referencing Miller’s Anesthesia in exams (MD, DNB, DA) impresses examiners.
A strategic study approach is to read Morgan and Mikhail’s for six months and make notes. Instead of writing extensive handwritten notes, highlighting key points, bookmarking, or using sticky notes can make revision easier.
Objective Anesthesia Review (ARC Book): This book Includes case presentations, explanations, instruments, and machines.
Yao and Artusio’s Anesthesiology: Comprehensive case presentation guide. Extra points from this book can be added to the ARC book.
Stoelting’s Anesthesia and Co-Existing Disease: Helpful for extra case-related questions.
For Anesthesia Equipment:
Dorsch’s Anesthesia Equipment is detailed but difficult to remember.
Understanding Anesthestic Equipment & Procedure a Practical Approach by Dr. Baheti and Dr. Laheri: It is simpler and sufficient for exams.
Note: If you are too loaded with your training, thesis and studies the ARC book is the ultimate solution, it also covers equipment, but only enough to pass, not to excel.
For Anesthesia Pharmacology:
Stoelting’s Pharmacology and Physiology in Anesthetic Practice covers all anesthetic and related drugs comprehensively.
Subject-specific books for super speciality preparation or deeper understanding:
These are books not only for people who want to take NEET SS but also for those who want to understand the subject in a better way.
Neuroanesthesia: Cottrell and Patel’s Neuroanesthesia (comprehensive), if you don’t have the time you can for the shorter version of this book or Handbook of Neuroanesthesia (shorter).
Cardiac Anesthesia: Kaplan’s Cardiac Anesthesia, is well written, in detail yet easy to understand.
Pediatric Anesthesia: Gregory’s Textbook of Pediatric Anesthesia or Principles and Practice of Pediatric Anesthesia by Dr. Snehalatha and Dr. Nandini Dawe (simpler, Indian perspective).
Regional Anesthesia:
Hadzic’s Textbook of Regional Anesthesia and Acute Pain Management– Well-structured with anatomy, sonoanatomy, block procedures, and key takeaways. Ideal for exam answers.
Herman Sehmbi’s (MCQs in Regional Anesthesia and Pain Therapy) – Essential for practising MCQs, especially for the regional anesthesia fellowship entrance exam at Ganga Hospital, Coimbatore.
Ganga Hospital Handbook – Summarized, well-organized, and useful for specific blocks. Covers:
Instagram Channel for the latest updates and information.
Anesthesia residency can be tricky to balance with books, apps, and study schedules, but strategic learning and wise resources make it simple. Streamline your preparation with the Conceptual Anesthesia App, guided book suggestions, and online resources and ace your exams!
Click here to visit the Conceptual Anesthesia website to learn more about the platform and how it can help you during your residency.
Anesthesia is a field that requires accuracy, in-depth knowledge, and a deep understanding of both theoretical and practical principles. Most of the resources available in the market either they are either unreliable or do not provide a methodical approach tailored to postgraduate students and working anesthesiologists.
Conceptual Anesthesia books fill this gap with meticulously designed content that caters to MD, DNB, and DA students while also serving as a comprehensive reference for experienced practitioners. In this blog, we explore why these books stand out from the available study materials and why every anesthesiology student should purchase them.
1. Handbook of Drugs Used in Anesthesia & Allied Specialties(for MD/DNB/DA Theory & Practical Exam Preparation)
What Makes This Book Unique?
Offers a comprehensive categorization of anesthetic medications by the mechanism of action, pharmacokinetics, pharmacodynamics, and side effects.
This textbook concentrates exclusively on anesthesiology and critical care for focused learning.
Organized in a clear manner that simplifies drug knowledge and its application to medical practice.
Necessary for postgraduate students require detailed information for examinations and practitioners require an accessible, instant reference.
How Does it Stand Compared to Other Market Resources?
Focused more on anesthesia-specific medications than general pharmacology texts.
Has a clear and organized structure compared to most drug books in which drugs are given without proper description.
Made for ease of practical use, as opposed to theory-oriented resources.
2. Handbook of Instruments & Machine in Anesthesia (for MD/DNB/DA Theory & Practical Exam Preparation)
What Makes This Book Unique?
Provides a comprehensive review of all major anesthetic instruments, such as endotracheal tubes, LMAs, laryngoscopes, and regional anesthesia equipment.
Well-illustrated with high-quality photographs and diagrams, facilitating visual learning and identification.
It breaks down complex ideas into simple terms and uses clear pictures to show how everything works.
Gives step-by-step instructions on the application and working of each instrument, which is hardly discussed in such detail in other anesthesia books.
How Does it Stand Compared to Other Market Resources?
In contrast to books on general surgical instruments, this one is exclusively devoted to machines and tools of anaesthesia-related devices.
While most resources mention instruments very little, this one has thorough explanations with a clinical perspective.
A necessity for exam prep as well as everyday knowledge.
7. DNB Master Solutions in Anesthesiology (2021-19) with Recent Advances Vol. 2
Why This Book Is a Must For DNB/MD Students?
Supplements Volume 1, covers DNB last year’s paper from 2019 to 2022, with detailed explanations.
Emerging trends and the latest developments in anesthesiology so that students remain abreast of the times.
Fills the gap between theoretical concepts and practical application in clinical practice.
How does It compare to Other Market Resources?
In contrast to old resources that fail to account for recent developments, this book makes students aware of the most up-to-date guidelines and methods.
A worthy supplement for anyone seeking to deepen their knowledge of modern anesthesia practice.
The books are not available from bookstores or online websites. They are exclusive and are available only with a premium subscription to Conceptual Anesthesia. A combined learning package integrating structured books, expert online lectures, and interactive case discussions. This specially curated collection offers detailed insights, case-based education, and systematic approaches that are essential for anesthesia residents and practitioners.
Subscribe to Conceptual Anesthesia Now!! And get access to these precious resources and revolutionize your anesthesia residency.
Conclusion
Conceptual Anesthesia books revolutionize learning anesthesiology by providing well-organized, exam-focused, and clinically applicable content. Contrary to textbooks that are vague, unstructured, or irrelevant to practice, Conceptual Anesthesia books deliver an effortless and effective learning process.
Whether you’re studying for theory, practicals, or super speciality entrance exams, Conceptual Anesthesia books will grant you an unparalleled edge. Spend in the finest study aids and start heading down the success road with Conceptual Anesthesia books!
The decision between DNB (Diplomate of National Board) and MD (Doctor of Medicine) for a career in Anesthesia usually pops into the mind of many medical aspirants. Both provide highly excellent career prospects, however, with different advantages and challenges. In this blog, we will try to compare both of them and help you make an informed choice.
Understanding DNB and MD in Anesthesia
MD in Anesthesia
MD in Anesthesia is a postgraduate degree offered by medical colleges associated with universities and is regulated by the Medical Council of India (MCI) (now under the National Medical Commission – NMC). Admission to MD programs is through the NEET PG examination.
DNB in Anesthesia
The DNB examination is conducted by the National Board of Examinations (NBE). DNB courses are available in accredited hospitals all over India, and admission is also based on the NEET PG examination.
Differences Between DNB and MD in Anesthesia
1. Training and Exposure
MD Residency: Training is conducted in medical colleges with a structured academic curriculum, regular case discussions, and a strong focus on theoretical knowledge.
DNB Residency: The practice is done in private hospitals and some government institutions. The hands-on clinical exposures may be highly rewarding, but formal academics may not always receive a top priority.
2. Examination Structure
MD Exam Preparation: The MD exam is conducted by the university and includes internal assessments, theory papers, and practicals.
DNB Exam Preparation: The DNB examination is considered more challenging as it has a national-level standardized exam, with stringent practicals and evaluations.
3. Recognition and Job Opportunities
MD in Anesthesia is widely recognized in both government and private hospitals, making it easier to secure academic positions.
DNB in Anesthesia is equally valued, but some hospitals and state governments may prefer MD candidates for academic roles.
TheMS residency is not relevant to Anesthesia because it is a non-surgical speciality.
4. Private Practice and Academics
MDs are likely to get more opportunities for teaching jobs in medical colleges.
DNBs require extra effort to settle down in academia, but they can shine well in private and corporate hospitals.
How Conceptual Anesthesia Can Help in Anesthesia Residency?
Conceptual Anesthesia offers structured resources and expert-led sessions for aspiring anesthesiologists. With our Premium Membership, you get unlimited access to the following:
Clinical Examination and Demonstration
Theory Notes & Discussions
DNB OSCE Sessions
Conceptual Anesthesia Books (Hardcopy)
Live Sessions by Legendary Faculties on Important & Rare Cases
Solved Question Papers
Live MCQ Discussions for SS Exams
Question Bank to practice MCQs for SS Exams
Pearls to Revise Important & High Yield Points
… and many more worthy resources to facilitate your preparation and clinical skills.
Which One Do You Choose?
Your choice must be guided by your career expectations:
If you want a well-structured academic environment and find it easier to get into teaching positions, the MD is more suitable.
If you want immense clinical exposure and are okay with self-learning, DNB will be the most suitable for you.
No matter what the way is, preparation for DNB exams, MD exams, and NEET PG is a must to get admission in a reputed institution.
Conclusion
Both DNB and MD in Anesthesia provide excellent career opportunities. Although MD has a traditional edge in academics, DNB provides solid clinical training. As regulations are changing, DNB is now widely accepted and recognized. Your focus should be on choosing a good institute, working hard, and ensuring quality MD residency or DNB residency training for a successful career in Anesthesia.
If you’re preparing for NEET PG, DNB examination, or MS exam preparation, stay dedicated and choose the path that aligns with your career goals!
Anesthesia residency is an exciting journey that demands adaptability, continuous learning, and a commitment to excellence. Each year of residency offers unique challenges and opportunities. Here’s a structured guide to navigating the do’s and don’ts for your first, second, and third years of anesthesia residency, ensuring a successful and fulfilling experience.
First Year of Residency: Building a Strong Foundation
Do’s:
Prioritize Punctuality: Aim to arrive at least 15 minutes before the Operating Theatre (OT) sessions, typically starting around 8 to 8:30 AM. Early arrival allows you to prepare necessary equipment and medications, demonstrating professionalism and ensuring active participation in procedures.
Establish a Consistent Routine: Set regular wake-up times aligned with your responsibilities. Allocate specific periods for study, recreation, and rest to maintain a healthy work-life balance.
Engage in Continuous Learning: Utilize educational resources like the Conceptual Anesthesiaapp, which offers over 400 recorded lectures covering essential anesthesia topics. Participate actively in live sessions and practical demonstrations to reinforce your knowledge.
Master the Basics: Familiarize yourself with the dosages of commonly used drugs and the necessary equipment for various procedures. This foundational knowledge builds confidence and competence in clinical settings.
Show Honesty and Responsible Behavior: A diligent and proactive student creates an excellent impression with consultants and seniors, which, in turn, fetches greater responsibilities and learning experiences for the next years.
Don’ts:
Do not Neglect Self-Developing Projects: Don’t skip meals or compromise on rest. Keep healthy snacks at hand for crucial changes in schedules and understand that work hours would vary, adaptability is the key.
Overlook early thesis planning. You should agree on a topic for your thesis with your guide by the end of your first year, formulate the protocol, and apply for ethics clearance. This will allow you to begin collecting data during your second year.
Second Year of Residency: Expanding Competence and Responsibility
Do’s:
Deepen Your Knowledge: Start reading about essential topics from available material such as “Morgan and Mikhail’s Clinical Anesthesiology.” Progress to heavier texts such as “Miller’s Anesthesia” only when the prior knowledge is consolidated.
Take on More Responsibilities: Consultants may delegate independence in managing cases. Accept the challenges to broaden your decision-making capabilities and clinical competencies.
Balance Work and Study: Even in relatively easy periods, keep doing academic work like reading articles, making notes, and preparing for exams.
Innovative Practices: Look for new techniques or procedures being implemented in your institution. Team up with consultants who are interested in new methods, and volunteer to help after proper preparation.
Don’ts:
Avoid Taking Responsibility in the OT: Senior anesthesiologists appreciate when junior residents demonstrate responsibility, allowing seniors to take short breaks. Always ensure a responsible individual is present in the OT before considering stepping out. Stay attentive: avoid using mobile phones and monitor the patient vigilantly.
Building a Supportive Study Group: Get a few study buddies to work through cases and share your notes with one another. This group can make studying and even residency life easier.
Third Year of Residency: Preparing for Independent Practice
Do’s
Define Your Career Path: Based on the intent after completion of residency, identify which examination is necessary and which procedures need to be followed in each case.
Refine Clinical Skills: Continue refining your clinical skills, preparing yourself for independent practice.
Build a Professional Network: Connect with peers, mentors, and senior anesthesiologists. Networking can lead to job opportunities and mentorship even after your training
Review Certification Requirements: Ensure you’ve met all the requirements for board certification or licensure in your region.
Dont’s:
Ignore Revision Preparation: Take the first two and a half years to consolidate your knowledge. In the last three months, revised intensively from consistent sources.
Neglect Professional Conduct: Maintain amicable relations with colleagues; do not argue over duties or procedures. Respect authority figures, as they are involved in your training and assessment.
Ignore Personal Well-being: Refrain from practising unhealthy habits like smoking, excessive alcohol, or drug use. Take care of your health to support a lengthy and productive career.
Neglect Commitment to Responsibilities: Report to all tasks; do not take undue absence which puts a responsibility on colleagues and hampers your professionalism.
Conclusion:
Embarking on an anesthesia residency is a transformative journey that demands adaptability, continuous learning, and a commitment to excellence. By adhering to the outlined do’s and don’ts throughout each year of your residency, you’ll be well-prepared to transition into a competent and confident anesthesiologist, ready to make meaningful contributions to patient care and the medical community.
Remember, the habits and knowledge you cultivate during this period will serve as the foundation for your future practice. Embrace each challenge as a learning opportunity, and remain steadfast in your dedication to both personal and professional growth.
In the medical field, anesthesia is a very specialized and fulfilling job path. Anesthesia residents are extremely important to guarantee the patient’s safety and comfort throughout surgeries and other medical procedures.
Here in this blog, you will see how to become the bestanesthesia resident, the necessary courses, job profiles, salary expectations, and opportunities in the field:
Who is an Anesthesiologist?
Anesthesia resident who focuses on controlling the patient’s vital signs and delivering anesthesia during and after surgical procedures is an anesthesia resident. They ensure the effectiveness of pain management and give patients critical care both during and after procedures.
How to be the best Anesthesia Resident?
Education path
Pursue MBBS degree
Complete your MBBS program within 5 years with the internship.
Clear PG Entrance Exam
Enroll in a reputable medical college by passing competitive entrance exams such as NEET-PG in India.
Postgraduate Specialization in Anesthesia
Pursue the MD or Diploma in Anesthesiology after completing your MBBS by completing the postgraduate entrance exams, NEET-PG in India.
Alternatively, you may choose to pursue a DNB course in Anesthesiology.
Licensing
Obtain a license to practice from the medical council in your country.
Courses for Anesthesia
MD (Anesthesiology): It is a 3-year master’s degree that focuses on anesthesia practices.
Diploma in Anesthesiology: shorter duration compared to an MD, typically 2 years.
DNB (Anesthesiology): It is a 3-year course and it is equivalent to MD.
Job Profiles in Anesthesia
Clinical Roles
Anesthesiologist
Administer anesthesia, monitor vital signs, and oversee patient recovery after surgery.
Intensive Care Expert
Work in ICUs to manage critically ill patients.
Pediatric/Obstetric Anesthesiologist
Specialize in anesthesia for pediatric patients or women during childbirth.
Academic Roles
Teaching and research roles in medical colleges and universities.
Non-Medical Roles
You can work in medical consulting, healthcare administration, or pharmaceutical work.
Salary of an Anesthesiologist
Private sector positions typically offer higher salaries than government roles.
The salary of an anesthesiologist may depend on location, experience, specialization, and type of healthcare institution.
In India: Experienced anesthesiologists earn between₹8–20 LPA and fresh graduates typically earn between₹5–6 LPA.
In USA: The anesthesiologist in USA gets paid somewhere around between $250,000–$400,000 per year.
Salary may be different depending upon the country.
Scope of Anesthesiologist Growing Demand
Increased surgical procedures and advancements in medical technology are driving the global demand for anesthesiologists. Wide Opportunities
Anesthesia residents are in high demand, and they can also expect to earn high salaries in countries like the USA, Canada, Australia, and the Middle East. Subspecialization
Emerging fields such as pain medicine, neuro-anesthesia, and regional anesthesia present significant opportunities for growth. Research and Development
You can grab opportunities in clinical trials, drug development, and academic research.
Skills to Pursue a Career in Anesthesiology 1)Robust understanding of pharmacology and physiology. 2)Capacity to maintain composure under pressure. 3)Meticulousness and focus on detail. 4)Effective communication and collaboration skills.
What is the Function of Conceptual Anesthesiology During Your Residency?
Conceptual Anesthesia is an excellent learning platform for anesthesia residents. It inspires the anesthesia residents to concentrate on understanding the basic ideas and concepts that underlie anesthesia practice rather than just learning procedures and protocols. For anesthesia residents, this approach is highly advantageous as it improves their capacity for critical thinking and adaptability to complex clinical situations and ultimately leads to better patient care.
Conclusion
It demands a stable base within the scientific subjects, years of precise schooling, and a committed dedication to affected person protection and care. The anesthesia residents develop with surgical techniques, essential care, and ache control.
Aspiring anesthesiologists have to be equipped for a lengthy yet gratifying career, beginning with an MBBS degree and advancing through postgraduate specialization and, optionally, subspecialty training. This career presents diverse opportunities in clinical practice, academia, research, and healthcare management.
The subject’s competitive salary, high job satisfaction, and innovation potential make it an excellent choice for those passionate about medicine and technology. As the need for personalized and specialized patient care grows, the scope for anesthesiologists is anticipated to expand significantly in the future.
To sum it up, you can take help from conceptual anesthesia to become an anesthesiologist, which merges the challenge of mastering critical medical skills with the reward of making a significant difference in patients’ lives.
As Anesthesia residency comes to an end, residents struggle with the thought of what is next now. As you stand at this crossroads in your career, you need to carefully make up your mind. There are two alternative paths a fellowship or scholarship. These both have their respective boons, so you should choose carefully.
Let’s take a look at each to make a better decision.
Pursuing a Fellowship
Fellowship Provides very specialized training in certain areas of anesthesia, such as:
Pain management: Focusing itself on the diagnosis and treatment of chronic pain with nerve blocks and spinal injection tools.
Critical care medicine: This will prepare you to manage critically ill patients in an ICU setting.
Cardiac anesthesia: A subspecialty that is driven by anesthesiologists providing anesthesia for patients undergoing cardiovascular surgery.
Pediatric anesthesia: Training and specializing in providing anesthesia care to neonates, infants, and children.
Regional anesthesia and acute pain medicine: Focusing on nerve block anesthesia and managing post-surgical pain.
Benefits of a Fellowship
Career development: One becomes a subject-matter expert after finishing a fellowship, which opens opportunities in academia or leading hospitals.
A higher pay: In addition to being specialty certified, specialization also may increase looking at an increase in income.
Job satisfaction: You will more likely be excited to work in a niche area in anesthesia if it affords you the satisfaction that practices into your near and long-term goals.
Choose Fellowship If:
You have a strong interest in one subspecialty of anesthesia.
You aspire to further enhance your skills while enhancing your chances at career opportunities.
You plan to work in an academic medicine or research-oriented position.
Pursuing for Scholarship (Research and Academia)
A scholarship route focuses on academic contribution, research, and teaching in the field of anesthesia. Scholars contribute to the advancement of medical knowledge while often working in academic institutions or an R&D organization.
The benefits of a scholarship route:
Contribution to Science: Help in new and ground-breaking research, from results to publications that can shape and change the future of anesthesia.
Teaching Role: Teaching and training future generations of anesthesiologists.
Flexible Career Track: Academic positions typically maintain a more reasonable work-life structure than clinical positions.
Consider a Scholarship If
You are passionate about research and innovation.
You enjoy teaching and contributing to academic development.
You want to become involved in global health initiatives or policymaking.
How to Decide Between a Fellowship and Scholarship?
The choice of paths ultimately depends on your priorities and long-term goals. Below are a few pointers for consideration:
Passion and Interest: Think about what exactly you are interested in. Are you interested in a certain clinical field or more geared towards research and teaching?
Finances: Fellowship training might pay a higher diagnostic salary, whereas in a scholarship, there might be a somewhat more stable income by being engaged in academic activities.
Work-Life Balance: Academic roles would often come with greater structure in terms of working hours, while fellowship-trained specialists tend to have lifestyles with on-call duties that are often heavy going.
Mentoring and Mentorship: Ask for advice from mentors and colleagues who have taken one of these paths.
Job Market: Research the demand for either subspecialists or academic positions in your area or area of interest.
Are You Struggling with Your Residency?
Anesthesia residency is a tough call, filled with arduous hours and a rigorous schedule. Feeling lost? You’re not the alone. Conceptual Anesthesia is here for you with, personalized guidance, support, and resources towards your residency and in preparing yourself for whatever lies ahead.
Start creating a future you’re excited about. Choose your path with confidence and let your career in anesthesia take off!
Starting your Anesthesia Residency is a breathtaking step to a wholesome career. But with the anesthesia field being so demanding, nothing else matters more than the availability of the right resources and guidance. Conceptual Anesthesia provides one-stop solutions for all your academic and practical needs. With a combination of detailed study materials, live mentor sessions, and several live practice sessions, Conceptual Anesthesia ensures that you are well-equipped to thrive in the best Anesthesia Residencies.
This is how Conceptual Anesthesia would fit you better through your residency:
1. Clinical Examination and Demonstration
Mastering clinical skills is vital for everyanesthesia resident. Conceptual Anesthesia provides detailed clinical examination guides and demonstrations to help you excel in practical scenarios. These sessions prepare you for real-world challenges faced by anesthesia residents.
2. Notes and Discussion on Theory
Conceptual Anesthesia is well crafted by expert faculty. These resources target the anesthesia residency programs and make even the most difficult concepts smoothly assimilate.
3. DNB OSCE Classes
If you’re preparing for DNB exams, our OSCE sessions are a game-changer. Designed by experts, these sessions provide practical insights and tips to excel in objective structured clinical examinations, a crucial component of top anesthesiology residency programs.
4. Conceptual Anesthesia Books-Hard Copy
Conceptual Anesthesia offers an exclusive set of 7 books created by the expert faculty. These anesthesia books provide high-quality material on every important concept and should be part of every anesthesia residency.
5. Live sessions by Legendary Faculty
You will learn from the legends of anesthesiology! Our live sessions cover important and rare cases, giving you an edge in understanding these pivotal cases in any discussions occurring in anesthesia residency programs.
6. Solved DNB OSCE Papers and MCQ Practice
Ace your residency exams with the help of solved question papers and an exhaustive question bank for SS exams. These resources are perfect for anesthesia residents aiming for top scores in competitive exams.
7. Interactive MCQ Discussions
MCQ discussion engages you in a very interactive way, sharpens your mind, and pinpoints weak areas. Sessions are held specifically to the needs of anesthesia residency programs for effective medical practice in preparation for SS exams.
8. Pearls for High Yield Revision
With Conceptual Anesthesia, residents get quick revision tricks, like high-yield pearls, to help retain what is critical. This feature has great benefits for residents preparing to give their best in competitive exams for the best anesthesia residencies.
Conclusion:
Conceptual Anesthesia bridges the gap between learning and practice, making it the perfect partner for every anesthesia resident aiming to excel in their field.
Are you ready to step your residency experience up to the next level? Join Conceptual Anesthesia, and develop the foundation for a successful career in anesthesiology!
Good evening everybody. We will be having a case discussion today on anesthesia management in a pregnant patient with mitral stenosis who’s posted for a cesarean section. So Dr. Vignesh will be presenting the case and then we will be discussing, so for the initial 15 to 20 minutes we will be talking about the pathophysiology of MS and basically, the medicine part and for the remaining 15-20 minutes we’ll talk about the anesthesia management.
So I think we can start. Okay, Dr. Vignesh, you can start the case. Yes ma’am.
So my patient like Mrs. Swati, 33 year old female.
My patient, a 33-year-old female with education qualification till 12th standard, like a resident of Jahangir, Puri. She is a gravida 3, para 2, live 1, abortion 1, currently with 9 months of amenorrhea, that is 36 weeks plus 5 days, weeks of gestation and with complaints of licking for the past 2 hours and has been admitted for safe confinement. And she had presented 4 months ago with complaints of breathing and cough for 1 week.
Her current pregnancy was a spontaneous conception and booked at nearby PHC and there was no excessive vomiting, no bleeding PV, no burning maturation and no fever with rash. She felt quickening at 18 weeks and she can do all her daily activities and no issues of any headache, blurring of vision or abdominal pain and she pursues normal fetal movements. 4 months ago she developed breathlessness over 1 week which was insidious and onset and gradually progressive in nature initially, she had breathlessness only during exertion that is during climbing stairs and stairs activities and later it progressed to even at rest when she was having breathlessness.
And breathlessness got aggravated while lying down and got relieved in a sitting position. She also had a cough for 1 week at that time and not associated with any fever or sputum production and it got aggravated while lying down and relieved by sitting position. That time she had a history of breathlessness on lying down flat so she used 2 pillows while lying down there was a history of swelling of both the lower limbs and extending up to the ankles which was relieved by rest, which was reduced by rest.
And no issue of any chest pain, palpitations, or loss of consciousness at that time no issue of abdominal pain or loss of appetite and no issue of cough or blood in sputum no issue of bluish discolouration of fingers or toes and no issue of any frequent hospitalization for respiratory illnesses. And coming to the presenting illness, she was evaluated, that time she was evaluated in the cardiology, diagnosed to have severe heart disease at that time and she underwent a procedure in the cath lab. Her symptoms resolved over a period of 2 days and there was no issue of any ICU stay or mechanical ventilation and she was discharged after 2 days.
And in the past, like 7 years before also, she had a similar episode, like that time she had palpitations and syncope and was taken to emergency and that time itself she was diagnosed with a heart disease and she underwent a procedure in the cath lab following which her symptoms got resolved over 3 days and that time also she was not admitted on any ICU and no issue of any mechanical ventilation and she was prescribed cardiac medications and injections once every 3 weeks that time itself. And she doesn’t have any other co-morbidities and no issue of any fever or joint pain or swelling in childhood and no issue of any recurrent sore throat in the childhood. And past surgical history, there is no issue of any major surgeries in the past and post-op static history, she had a normal regenerative delivery 5 years ago and no issue of any symptoms suggestive of cardiac illnesses during that pregnancy and the issue of spontaneous abortion in first trimester 3 years ago.
And coming to treatment history, currently, the patient is on Metaprolol 25mg OD and Torzimide 10mg OD and she is on Acitrom 2mg OD which was stopped. She was admitted for safe confinement one week before in the ward. So, the Acitrom was stopped 4 days before and she was switched to an injection of low molecular weight heparin 40mg subcutaneous BD she is taking a tablet of Ecosprin 75mg and an injection of penicillin 1.2 million units once every 3 weeks and there is no known drug allergy.
And menstrual history, she had menarche at 12 years old and was having regular cycles the LMB was at 12-20-23 personal history, she was a housewife, studied till 12th standard has no issues with any addictions, consumes a mixed diet and has normal bowel and bladder habits and no issue of any heart diseases in the rest of the family members. So, my professional diagnosis is Gravida 3 Para 2, live one, abortion one, pregnant lady at 36 plus 5, 36 weeks plus 5 days of gestation. A known case of Rheumatic Valvular Disease with no signs of heart-to-heart failure has been admitted for safe confinement.
Okay, so far from the history, what are your positive findings? Ma’am, she is a known case of rheumatic heart disease and had an episode of breathlessness and cough at that time she underwent a balloon valve mitral valve autoimmune and currently she is not having any cardiac symptoms and has been admitted for safe confinement. Okay, consider that this patient does not have any history papers, she does not have any papers related to her previous admission and she is not that educated and she cannot actually tell you what procedure she underwent. So, let’s forget for a moment that she has rheumatic heart disease, she is a known case.
So, just based on the history, what do you think are her positive symptoms? Ma’am, cough with breathlessness, it is due to exertion the patient had, ma’am. She also has a cough, right? Yes, ma’am. So, based on only these two symptoms, breathlessness and cough, it could be either a cardiac or a respiratory cause.
We do not know what it is. Is there anything specific that is pointing towards cardiac in the positive history of this patient? This patient also had, it was not associated with any sputum production or any other thing, ma’am. Yeah, okay.
So, Vignesh, my question was is there any positive history in this patient which is pointing towards the diagnosis of a cardiac disease? A patient doesn’t have any other sputum production or any other thing, so which might be a fever with sputum production which suggests pneumonia or any other respiratory cause? And the patient had a history of lower limb swelling, ma’am? No, the lower limb swelling can be a sign of pregnancy also, right? So, the most important finding in this patient which points towards cardiac is orthopnea. Yeah, orthopnea and PND. Right, right.
So, it’s okay. So, orthopnea, can you tell me why it happens? Ma’am, orthopnea, basically it happens like all these, like, if one wants, like orthopnea is basically the patient develops breathlessness while lying supine and it is because of increased venous return, like leading to pulmonary congestion.
The pulmonary vasculature is already non-compliant because of chronic increased pulmonary blood flow or increased pulmonary venous congestion. So, like, these patients develop this thing. Right.
So, it could be mainly because of, probably because of LV failure, something which has caused an increase in the LV pressures leading to the transmission of the, increased backward transmission of the pressures to the left atrium and then finally to the pulmonary vasculature leading to orthopnea. So, orthopnea is a very, it’s a positive factor in this patient. What about PND? This patient doesn’t have PND, but what do you mean by PND? Ma’am, PND usually, happens in night, like when the patient lies, when the patient goes to sleep, like the patient will be sleeping.
It can happen in the daytime also, it depends upon, yeah, yeah, yeah, right. Okay, ma’am. So, like, when the patient lies, when the patient sleeps for, like, two to three hours, like the sympathetic discharge will be reduced and then, like, again, like increased venous return will also be there.
