i know the basic stuff but i need some more detail.
i have a few questions:
1. could you please describe what you do
2. what are the hours?
3. is there any way i could stand by and watch an anesthesiologist do whatever they do, so i can know whether it is the right thing for me?
4. whats is the pay?
5. if you are an anesthesiologist, what do you like and dislike about the job?
6. what kind/how many years of college/training/ect. do you need, i know its like 11 years, but what exactly must you do in that time?
7. how much money do you need, would u think, for the 11 years of whatever it is you need to do.
8. what can i do now, in high school to prepare for this job?
i know its a lot of questions, i would really appreciate it if u answered all of them, but if u just answer a few thats fine too. thanks alot! 1.Here is a description of what I do for a very simple case. Keep in mind that this is the kind of stuff I can do in my sleep. Challenging cases require a LOT more. How about a lap chole? That's easy!
Meet the patient - evaluate his physical condition, medical history, look at his airway, develop an anesthetic plan based on what I find. We'll make this guy otherwise healthy with an easy airway. Explain to him what I'm going to do, and what the risks of anesthesia are, and have him sign the consent form.
Go to the OR and prepare my area for the case. Draw up the drugs - we'll use propofol, rocuronium, fentanyl, hydromorphone, midazolam and neostigmine mixed with glycopyrrolate to reverse the paralysis. Get the airway stuff out and ready - laryngoscope (check to see that the light works), endotracheal tube (check that the cuff works), oropharyngeal airways, tongue blade, stylette - all ready to go.
Check the anesthesia machine to see that it is functional. Check that suction is on and ready. Alternate airway modalities available. Now we are ready for the patient.
He moves from the stretcher to the OR table, and we attach our monitors - blood pressure cuff, pulse oximeter, EKG - and give him some oxygen to breathe. Give some fentanyl and midazolam for sedation and pre-emptive analgesia. Make sure the surgeon is available (gotta keep an eye on them so they don't run off).
Induction - give enough propofol to put the patient to sleep (1-3 mg/kg) but not too much. Ventilate by mask. If we can breathe for him, we give the paralyzing drug and turn a little sevoflurane on to deepen the anesthetic while we wait for the rocuronium to work. When he loosens up, do a direct laryngoscopy and put the endotracheal tube through the vocal cords. Attach to anesthesia machine and ventilate. Check tube palcement by end-tidal CO2 and breath sounds. Tape in place. Tape eyelids shut. Place orogastric tube into the stomach. Put the patient on the ventilator at the appropriate settings. Make sure the gas in on at a reasonable setting, and turn down your fresh gas flows. (Don't want to waste sevo - it's expensive) All this time you've been watching the vital signs. If the BP goes too low, you might need to give a drug to bring it up as you turn down the anesthetic gas.
Let the surgeon/scrub team know they can prep. Now you have to keep the patient anesthetized without any surgical stimulation, which is tough to do. Turn down the gas, and keep your pressors handy in case the BP drops. Check neuromuscular blockade with a nerve stimulator. Write down everything you've done and all the vital signs on the anesthesia record.
We haven't even started the surgery yet.
Before they cut, turn up the anesthesia to blunt the patient's response. Keep watching all the vital signs, and keep them just where you want them by giving anesthetic gas, and narcotic. Don't forget to record the vitals every five minutes. Keep an eye on the surgery so you know what''s going on and can anticipate anything that you might have to account for in terms of blood loss or increased (or decreased) surgical stimulation.
Chat with the nurses and surgeon. Gotta be cordial.
Continue keeping the patient alive and comfortable throughout the surgery, as well as paralyzed. Not too much paralysis, though, or you'll never get him breathing again. Give the hydromorphone incrementally, and don't overdo it.
As the surgery is starting to wind down, get ready to wake up (the pateint, not yourself, unless it was a particularly boring case - just kidding). You'll need to increase the end-tidal CO2 to get him breathing, reverse the paralysis and turn down the gas. While they're closing, get him back breathing. When he has good tidal volumes, turn off the gas and let him wake up. When he's awake and strong enough to keep breathing, suction the orophrynx and pull the tube - make sure he's ventilating OK by mask.
Have your narcs ready in case he's in pain. Transport to the recovery room and sign out to the nurse there.
Go clean up your OR, and get ready to do it again.
2. SOMEBODY has to be available 24/7. Sometimes that's you, sometimes it isn't. Every place has a different schedule.
3. Contact the anesthesia department and/or volunteer office at your local hospital and ask. There are regulations about who can be in an OR. You might need the patient's and surgeon's permission.
4. The pay is good, but we don't make as much as many surgeons. Or lawyers. Or corporate CEOs.
5. I love my job. I like seeing physiology in action. I like taking care of people. I like the OR environment. I like being able to make my patients stop talking. I like life and death excitement (in small doses) and being in control of the situation. I like sticking needles into people (spinal anesthesia = best anesthetic EVER!) I like working PJs. I don't like wearing a hat. I am not a hat person.
6. 4 years undergrad college. 4 years of medical school - 2 yrs "book learnin'" and 2 yrs clinical, where you learn to be treated like crap. Get used to it. It's not much better in residency. Internship - I did internal medicine. Hated it. 3 yrs anesthesia residency. Learned SO MUCH but worked SO HARD. I never knew what true exhaustion was until residency.
7. Your guess is as good as mine. They do start paying you when you become an intern, so you only need to support yourself through the 8 yrs of college and med school.
8. Learn how to learn. Develop good study habits and learn how to memorize lots of stuff quickly. Try learning all the bones and muscles in the body. (In med school, you'll need to memorize every bump on every bone, and the insertions and innervations of all the muscles). Also, have fun. Ditto for college. Nobody likes a one-dimensional geek. Be a multi-faceted geek :) I found a site that has some information about it.
Or you can Google it.
http://www.lcanesthesia.com/whatisana.ht... they put you to sleep before surgery...like the do the medication and stuff Yes, anesthesiologists put you to sleep before surgery, but their scope of practice is much broader than that.
They put the patient to sleep, but they also must monitor that patient's airway (make sure the patient is able to breathe, or if they are intubated-or are on a breathing machine with a tube as their airway-make sure that they are being properly ventilated, and if not, make appropriate changes).
They make sure the patient is sedated (or asleep) enough, but just enough, not too much.
In the hopsital where I work, there is a team of doctors, PAs, and Nurse Practitioners who follow the ICU patients, and there is an anesthiologist on that team.
They also do procedures like epidurals (for example when a woman is in labor, or if someone has severe pain.
They also do regional epidural like in ouptatient surgeries.
As for the hours, it depends on what you do. If you work in a hospital, you can have any variety of hours because hospitals are open 24/7. If you work in surgeries, you may be on call, and you can never know what time you'll need to be there. But most days, surgeries are scheduled to start early in the morning, but you may be in one surgery for hours, and you may have several cases in one day.
As for the pay, anesthesiologists are very well paid. Depending on what you do and how much of it you do, you make well over 100K/year, probably more like 200-300,000/year or more.
The years of training and such, although I'm not exactly sure how many years of what you do, I know you have to go through undergrad, then med school, then residency, then fellowship, and then I think you can become an attending.
All you can do is make good grades, study hard, especially science courses, get into a really good college, make friends with your college professors (especially the science and math professors, science is more important, lol, you'll need good letters of recommendation), and network, make connections.
That's as well as I can do, I hope this helps you. |
