The following is a list of possible topics for the SAQ section.
Think about your anaesthetic room and the equipment you use. For each piece of equipment, ask yourself if you can answer the following?
What does it do/measure?
- What are the indications for use?
- What information does it give you?
- How do you interpret the information? (remember this is a clinical exam!)
How does it do this?
- How do the inside of it work?
- What are the underlying principles?
- Are there any equations or laws associated with it?
What are its limitations?
- What are the sources of error of the device?
- What increases/decreases the error present?
Remember every piece of equipment is fair game. Sometimes people are suprised by what is asked in the exam, but they use the piece of equipment every day!
For all of the items on this list, you can easily make up a question an examiner could ask you. Remember, all of this comes up in the VIVA also!
And now for that list….
Cardiac output monitoring
- Suprisingly not asked yet!
- Oesophogeal doppler – Ultrasound basics, flow basics, Sources of error
- PICCO/LIDCO/PA catheter – Thermo/dye dilution techniques, continuous CO measurement
- Thoracic impedence measurement – How it works, sources of error
Ultrasound
- Basics of signal generation and image generation
- Sources of image degradation
- Needling techniques (in plane, out of plane: advantages/disadvantages of these)
Arterial lines
- Properties of arterial cannulae
- Properties of tubing
- How transducers work (all that wheatstone bridge stuff etc)
- Sources of error
- Calibration (one point vs two point vs multipoint)
- Information which can be inferred from the arterial trace
NIBP measurement
- Methods of measurement (e.g. dynamap, penaz, Von Recklinghausen etc)
- Sources of error (cuff size, obesity, extreme BP etc)
Pulse oximetry/co-oximetry/non invasive haemoglobin monitoring
- How they work (see this post)
- Sources of error
- Non invasive continuous haemoglobin monitoring (Masimo make them)
Gas analysis
- Expired gas analysis (See this post)
- Monitoring of gases out of theatre (resus calls, ward intubations etc)
Depth of anaesthesia monitoring
- Relevant due to NAP5 study
- BIS – Basics of how it works, sources of error
- Other techniques
Electrical safety
- Microshock etc
- Burns intraoperatively
- precautions to reduce these happening
- Isolated circuits
Temperature monitoring
- Methods of monitoring
- Types of thermometer (thermistor vs thermocouple vs resistance thermometer)
- Response times and limitations
- Causes of heat loss
- Methods of warming
- NICE guidelines on perioperative hypothermia
Humidity
- Measures of humidity
- HME filters, inspired gas humidification methods
MRI
- How MRI works
- Problems with monitoring
- Contraindications for MRI
- Terminology (MRI Safe, MRI conditional etc etc)
Pacemakers/implantable devices
- Indications for insertion of devices
- Perioperative implications of their presence
- Intrathecal devices and neuroaxial anaesthesia?
Vapourisers
- How they work (yes it has been asked!)
- Traditional plenum type vs Injection vaporisers (desflurance/TEC 6 and newer vaporisers like those in the Maquet I-Flow machine)
Detection of air emboli
- Methods of detection
- Relative sensitivity
Viscosity/density
- Asthma? (e.g heliox etc)
- Effects on flow
Gas Supplies/Cylinders
- Properties of cylinders (has been asked!!)
- Supplies for transfer
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