Fellowship - safety and quality

Question 1

Discuss the safety precautions and equipment requirements for providing anaesthesia in the MRI suite

Question 2

For the following devices, describe the design features that ensure the safe delivery of oxygen during anaesthesia: a) cylinders b) pipeline oxygen delivery systems c) anaesthesia machines

Question 3

Evaluate the use of cerebral oximetry monitoring in non-cardiac surgery.

Question 4

How does a residual current device (RCD) work? (30%) Evaluate its usefulness to protect patients from injury. (70%)

Question 5

Describe how the safety of anaesthetised patients undergoing surgery is ensured in the event of a power failure to the hospital.

Question 6

A new hospital is setting up its pain service and you have been asked to write the administration guidelines for ketamine infusions on the ward. Outline the information you would include in these guidelines.

Question 7

Evaluate the use of 10% povidone−iodine compared to 0.5% chlorhexidine/70% isopropyl alcohol as skin preparation prior to the institution of lumbar epidural analgesia.

Question 8

Operating theatres starting late have been identified as a problem in your hospital. How would you design and implement a quality improvement program to assess and improve operating theatre starting times in your hospital?

Question 9

The anaesthetic machine is designed to deliver gases and anaesthetic vapours to patients via a breathing circuit. Outline the safety features of an anaesthetic machine.

Question 10

Outline the steps to ensure the safe storage, handling and administration of blood to a patient once the packed red blood cells (RBC’s) have arrived in the theatre suite.

Question 11

Outline methods available to minimise intraoperative drug errors

Question 12

Outline the features of the anaesthetic machine that ensure safe gas delivery to the patient.

Question 13

You are the consultant who has been tasked with introduction of the WHO SSCL (surgical safety checklist) to your hospital.1. What are the principles behind the checklist that enhance patient safety, with reference to each component? (70%)2. What do you expect the barriers to its effective implementation to be? (30%)

Question 14

A developmentally delayed, unco-operative adult requires a magnetic resonance imaging scan (MRI) for investigation of deteriorating control of seizures. What issues do you foresee in terms of providing general anaesthesia in the MRI suite for this patient?

Question 15

a. What do the terms decontamination, disinfection and sterilisation mean? (30%)b. What measures should be in place to minimise the risk of transmission of infection to the respiratory tract of patients via anaesthetic equipment? (70%)

Question 16

a. Define quality assurance. (30%)b. How would you design and implement a Quality Improvement programme to assess patient satisfaction with the preoperative visit? (70%)

Question 17

You are on the interview panel appointing new Assistants for the Anaesthetist. What are the educational requirements and the practical responsibilities expected of the applicants?

Question 18

a. Describe the aims of a quality assurance program. (40%) b. Outline the steps you would take to set up a quality assurance program for your anaesthesia department. (60%)

Question 19

a. What do you understand by the term “Universal Precautions”? (40%) b. Describe how you apply these precautions in your daily anaesthesia practice. (60%)

Question 20

Discuss the perioperative strategies you would use to mitigate the risks of prolonged surgery in the prone position.

Question 21

Outline the mechanisms that may contribute to visual loss associated with spinal surgery in the prone position. (50%) Describe strategies that may reduce the risk of visual loss in this situation. (50%)

Question 22

A 55-year-old male with severe steroid-dependent rheumatoid arthritis requires spinal surgery in the prone position. Discuss your considerations for patient positioning for the procedure.

Question 23

Outline the risk factors for, possible mechanisms of, and methods to prevent, postoperative ulnar neuropathy.

Question 24

A patient is scheduled to undergo prolonged steep head-down surgery.a. Outline the potential anaesthetic implications of this position in this situation. (50%)b. Describe how you would modify your anaesthetic plan to minimise these. (50%)

Question 25

A patient is scheduled on your list for arthroscopic shoulder surgery. The surgery is to be performed in the beach chair position. List the problems associated with this position and describe how you could minimise them.

Question 26

What are the hazards of the prone position for patients under general anaesthesia and how can they be minimized? 

Question 27

A 65-year-old man is on your list for an arthroscopic acromioplasty that is to be performed in the beachchair position. a. List the complications associated with this position (30%) b. Describe how the risk of these complications can be minimised (70%)

Question 28

Four hours after multi-level laminectomy with instrumentation, your patient complains of unilateral visual loss. a. What is your differential diagnosis? (40%) b. How can you minimise the risk of visual complications in the prone patient? (60%) 

Question 29

a. List the hazards to the patient associated with the prone position under general anaesthesia. (60%) b. How can these hazards be minimised? (40%) 

Question 30

A 65 year old patient requires Anaesthesia in the prone position for lumbar fusion. What are the hazards associated with the prone position? (60%) Mid-way through the case the patient is accidentally extubated. Outline your management of this complication (40%)

Question 31

Describe macroshock and microshock.Outline mechanisms for preventing macroshock and microshock in the operating room

Question 32

Describe the benefits and limitations of meta-analyse

Question 33

Below is a vacuum insulated evaporator. Describe how it works (50%). Describe the passage of oxygen from outside the hospital to the outlet in theatres (50%)