what is cardiac anaesthesia technician assignments?

Question

iam senior anaesthesia technician in tabba heart institutte karachi

Answer 1

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Page 1
(Date)
VHA HANDBOOK 1123
APPENDIX B
B-1
ANESTHESIOLOGIST ASSISTANT
GS-601
INTRODUCTION
The Anesthesiologist Assistant (AA) is a professional allied health member of the Anesthesia
Care Team who has satisfactorily completed an Anesthesiologist Assistant training program.
The Anesthesiologist Assistant administers anesthesia under the medical direction of an
Anesthesiologist who must be immediately accessible.
MAJOR DUTIES
Provides anesthesiologist support as a physician extender and part of the patient care team.
Conducts pre-anesthetic patient history and physicals, which include collecting preoperative
consults and data.
Describes the anesthetic risks, benefits, and options to the patient based on the anesthetic plan
approved by the attending physician.
Pre-tests, calibrates, and monitors anesthesia delivery systems.
Administers, within authorized limits; maintains; and monitors anesthesia.
Provides airway skills including: intubations, laryngeal mask airways, nasal/oral airways, and
fiber optic bronchoscopy.
Initiates and utilizes multi-parameter monitoring of patients prior to, during, and after anesthesia,
or in an intensive care or acute setting (including: electrocardiogram (EKG), capnography,
oxygen saturation, direct arterial pressures, central venous pressure, pulmonary artery pressures,
arterial blood gas determinations, necessary chemistry panels, temperature, respiration,
noninvasive blood pressure, heart rate, ventilatory parameters and additional monitors as
directed by an Anesthesiologist).
Maintains required perioperative documentation.
Administers cardiovascular or pulmonary supportive drug therapies as necessary.
Identifies and makes necessary anesthetic adjustments during the intraoperative period.
Calculates and replaces necessary fluids and blood products.
Provides safe transition into the post-anesthetic care unit and assists in postoperative pain
control.
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Initiates emergency resuscitation by using current advanced cardiac life support guidelines.
Maintains continuing educational activities and participates in administrative affairs and/or
research as directed.
FACTOR LEVELS
Factor 1. Knowledge Required by the Position
Mastery of the specialty area of anesthesiology in order to administer and monitor anesthesia to
complex surgical cases, solve a variety of problems, and make recommendations to the
supervising Anesthesiologist for improved case management. The AA must have a thorough
understanding of the effects of anesthesia agents and human physiology in order to intubate
patients and to monitor their vital signs during the surgical procedure.
Knowledge and ability to use basic and advanced airway interventions.
Ability to administer vasoactive drugs and infusions; adjuvant and accessory drugs; and blood,
blood products and supportive fluids.
Ability to perform advanced cardiac life support.
Factor 2. Supervisory Controls
The AA is given assignments with general instructions and works under the medical direction of
an Anesthesiologist. The AA carries out assignments and consults with the supervisor and with
other health care professionals on the team in identifying and resolving potential problems. The
AA’s work is observed by the Anesthesiologist for technical adequacy and conformance with
procedures and practices applicable to surgical procedure. The supervising Anesthesiologist
periodically performs record reviews and other assessments to determine the competency of the
AA.
Factor 3. Guidelines
The AA follows the plan approved by the supervising Anesthesiologist. The AA uses
established methods and techniques in gathering patient history; explaining the risks, benefits,
and options of anesthesia; administering and monitoring anesthesia; and responding to
emergency situations. The AA may initiate minor deviations to standard practice to meet patient
needs during procedures. Major deviations or serious problems are immediately referred to the
supervising Anesthesiologist.
Factor 4. Complexity
The AA performs the full range of functions required by anesthesiology as part of a surgical
team including taking patient history, conducting pre-anesthetic physicals, explaining the risks
and benefits of anesthesia, administering and monitoring anesthesia, and identifying and
responding to problems and emergency situations. The AA is expected to provide airway skills,
initiate and utilize multi-parameter monitoring, administer supportive drug therapies, and
calculate and replace fluids as necessary. The AA must adhere to the approved plan, identify the
need for and make minor adjustments during procedures, and recognize and respond to major
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(Date)
VHA HANDBOOK 1123
APPENDIX B
B-3
problems and emergencies. The AA participates in a broad and diverse range of complex
surgical procedures and variable and complex cases.
Factor 5. Scope and Effect
The purpose of the work is to perform as a physician extender in planning and administering
anesthesia for a wide range of surgical procedures. The work encompasses the full range of the
process from gathering patient history, through administering and monitoring anesthesia, and
including identifying and responding to problems and emergencies. The work enables the
medical center to provide more efficient and effective care to patients and directly impacts the
individual patient’s experience and well-being.
Factor 6. Personal Contacts
The AA interviews patients and their families in order to obtain physical history information
necessary to determine a safe dosage of anesthesia. At times, this information may be difficult to
obtain, but it is essential for a successful surgical outcome. In addition, the AA has frequent
contacts with numerous professionals and staff in the VA medical center, especially in the
Recovery Room, Intensive Care Unit, Step-Down Units, Outpatient Surgical areas, inpatient
wards, and Diagnostic Laboratory Services.
Factor 7. Purpose of Contacts
The purpose of contacts is to gather and give information and technical assessments, and to
persuade individuals and groups to accept findings and reach agreement on the technical points
of the procedures. Contacts with patients require skill in listening, explaining, and establishing
rapport to communicate effectively to patients the risks and benefits associated with the
proposed anesthetic to ensure an informed consent and to allay the fears and concerns of the
patients and their families.
Factor 8. Physical Demands
The AA’s work requires the extremely precise application of anesthetic agents in an aseptic
environment and includes long periods of standing, sitting, and bending. The incumbent must
use the appropriate technique to physically assist the patient.
Factor 9. Work Environment
The AA’s work is typically performed in a surgical suite setting that may expose the incumbent
to the communicable diseases common to the patient population. Uncontrolled exposure to some
anesthesia agents can be dangerous especially for prolonged exposure.
Other Significant Facts: ADP Security
The AA protects printed and electronic files containing sensitive data in accordance with the
provisions of the Privacy Act of 1974 and other applicable laws, Federal regulations, VA statutes
Page 4
and policy, and VHA policy. The AA protects the data from unauthorized release or from loss,
alteration, or unauthorized deletion; and follows applicable regulations and instructions
regarding access to computerized files, release of access codes, etc., as set out in the computer
access agreement that the employee signs.
NOTE
Where is this Tabba Hospital in Karachi?never heard of it.

Answer 2

The overall goals of treatment for cardiomyopathy are to:

Manage your symptoms
Prevent progression of your illness
Reduce your risk of complications
Treatment varies by which of the major types of cardiomyopathy you have:

Dilated cardiomyopathy. Doctors often prescribe medications for dilated cardiomyopathy. Angiotensin-converting enzyme (ACE) inhibitors — such as enalapril (Vasotec), lisinopril (Zestril, Prinivil), ramipril (Altace) or captopril (Capoten) — can improve the heart's pumping capability. Diuretics, such as furosemide (Lasix), can reduce fluid retention. Beta blockers — such as atenolol (Tenormin), carvedilol (Coreg) and metoprolol (Lopressor, Toprol XL) — can improve cardiac function and reduce the risk of death in people with dilated cardiomyopathy.

Another option for some people with abnormal electrocardiograms is a special pacemaker that coordinates the contractions between the left and right ventricle (biventricular pacing). In people who may be at risk of serious arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD) may be options. ICDs are small, minicassette-sized devices implanted in your chest to continuously monitor your heart rhythm and deliver precisely calibrated electrical shocks when needed to control abnormal, rapid heartbeats. The devices can also work as pacemakers.

Hypertrophic cardiomyopathy. Your doctor may recommend beta blockers such as Lopressor or calcium channel blockers such as verapamil (Calan, Isoptin), which can relax your heart, slow its pumping action and stabilize heart rhythms.

For some people, a pacemaker or an ICD may be recommended. In advanced cases of hypertrophic cardiomyopathy, a surgeon may remove a portion of the thickened muscle wall that interferes with normal blood flow. This procedure, called septal myotomy-myectomy, can reduce symptoms in most cases.

Your doctor also may recommend a new therapy called alcohol ablation. This nonsurgical procedure, which uses injected alcohol to destroy extra heart muscle, may reduce thickening and improve blood flow.

Restrictive cardiomyopathy. As with all forms of cardiomyopathy, your doctor will recommend you pay careful attention to your salt and water intake and monitor your weight daily. Treatment of fluid retention is with diuretics. You may be prescribed medications to lower your blood pressure and control fast or irregular heart rhythms.
Many of the medications that doctors prescribe for cardiomyopathy may have side effects. Be sure to discuss these possible side effects with your doctor before taking any of these drugs.

Heart transplantation
If you have advanced disease and medications can't adequately control symptoms or when the prognosis for survival is particularly poor, a heart transplant may be an option. Because of the shortage of donor hearts, even people who are critically ill may have a long wait before undergoing a heart transplant. In some cases, people can be supported with a mechanical heart assist device as they wait for an appropriately matched donor. These devices, known as ventricular assist devices (VAD), can support the circulation for a prolonged period and may allow you to live outside the hospital while you wait. In some people who aren't candidates for a heart transplant, VAD therapy may provide long-term support.