A Day of Cardiac Anesthesia
Cardiac Anesthesia at UVA
A Day in Cardiac Anesthesia: update provided by Andrew Lex, CA-2
Our cardiac anesthesia rotation here at UVA is one of our most challenging and rewarding rotations we do as a resident! We have a busy cardiac surgery service here and without any cardiac anesthesia fellows we are involved in any and all of the cases – from a simple 2 vessel CABG to an LVAD placement to a heart transplant. Our exposure to cardiac anesthesia starts as early as our CA-1 year for those residents in the categorical track and early in the CA-2 year for those in the advanced track. The days start early – typically around 6 AM – in order to get the room set up for the first cases of the day (which start at 7 am). After you get your room set up you’ll go to see the patient in the preop area and go over the plan for the case with your patient as well as ask gather any other relevant details about their medical history that you hadn’t yet gone over in their chart. After someone from the surgical team and your OR circulator see the patient you are ready to go back to the room to get the case started!
Many of these patients have a pre-induction arterial line placed and after you have gotten them off to sleep you’ll place a central line, a PA catheter and a TEE. Once the procedure finishes you’ll transport your patient to the cardiac surgery ICU, sign out to the team there and get ready for your next case. It can feel a little frantic getting the cases started initially as there is a lot to keep track of but these case provide an excellent opportunity for real time learning with respect to procedural skills, cardiovascular pathophysiology, fluid resuscitation, anesthetic management of a critically ill patient and using a wealth of information to guide clinical decision making on a minute to minute basis. It’s a busy month but one that can totally change your perspective as a resident after you finish – all of the sudden sick patients and complex cases aren’t nearly as intimidating as they once were! We also have a wonderful team of cardiac attendings to work with who are enthusiastic about resident education and do a wonderful job helping you to get the most out of your cardiac rotation. I consider this rotation one of the strongest aspects of our clinical training here at UVA!