Essential Anesthesia skills

Anaesthesia postgraduate should make a continuous and constant effort to develop the appropriate technical skills during the training period. The techniques should be learnt under supervision and practiced extensively and reviewed constantly for refinement and high degree of success.

Following skills are required to be learnt during residency:


1)Vascular access: venous, arterial and intraosseous

  • Peripheral venous access in adults and children
  • Central venous access: femoral, internal jugular and subclavian
  • External jugular vein cannulation
  • Peripherally inserted central venous catheters (PICC)
  • Pulmonary artery catheterization : desirable
  • Arterial cannulation : radial, ulnar, brachial (in children), femoral and dorsalis pedis
  • Intraosseous injection in pediatrics (Iliac Crest and tibia)


2) Airway skills

  • Mask ventilation
  • Selection and insertion of oral and nasal airway
  • Insertion of supraglottic airway devices
  • Endotracheal intubation by direct laryngoscopy
  • Use of intubation aids like stylet, bougie, airway exchange catheter
  • Video laryngoscopy
  • Fiberoptic guided awake nasotracheal intubation
  • Blind nasotracheal intubation
  • Double tube placement and confirmation
  • Placement of bronchial blockers
  • Jet ventilation
  • Retrograde intubation
  • Cricothyrotomy
  • Use of ultrasound for airway management


3) Regional anaesthesia skills

  • Subarachnoid block
  • Lumbar and thoracic epidural
  • Brachial plexus block : different approaches
  • Wrist block
  • Digital block
  • Caudal block
  • Ankle block
  • Femoral nerve block
  • Sciatic nerve block
  • Lumbar plexus block
  • Intercostal block
  • Paravertebral block
  • Stellate ganglion block
  • Obturator nerve block
  • Infra orbital nerve  block
  • Intravenous regional analgesia (ILMA) or Bier’s block

All regional anesthesia techniques require sound knowledge  of anatomy (including root values), selection of local anesthetics, avoiding adrenaline containing solutions in some of the blocks, test dose for epidural, different techniques of location of the nerves, plexus ( blind based on anatomical knowledge, nerve stimulation and ultrasound guided),contraindications and complications.


4) Others

  • Cardioversion
  • Defibrillation
  • Intra aortic balloon pump(IABP) placement
  • Coeliac plexus block

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