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PDF | On Apr 1, , G. M. Hall and others published Core Topics in Perioperative Medicine. J. Hudsmith, D. Wheeler and A. Gupta (editors).
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- SHM Consults: Perioperative and Consultative Medicine
- Anesthesiology E-Books
- - Core Topics in Perioperative Medicine by Jonathan Hudsmith; Dan Wheeler; Arun Gupta
Developing perioperative services will call for careful consideration in order to establish appropriate services to meet local needs. Anaesthetists are well placed to lead the development of multi-professional services, using a collaborative approach with medical and surgical staff, and other healthcare professions.
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Within the anaesthetic profession, there is a need to ensure that appropriate focus is given to perioperative medicine within training programmes, so that future consultants have the appropriate knowledge and skills to contribute to perioperative services and assume leadership roles where required. Although many areas of knowledge and skills are already included within the anaesthetic Certificate of Completion of Training CCT curriculum, the subject lends itself to the development of specific units of training that can then form a baseline for anaesthetic consultant practice, as well as supporting the development of expertise in those who wish to specialise in this area.
The anaesthetic training programme is also highly influential in developing the professional values of future consultants, and underpinning new areas of clinical practice. Perioperative medicine also forms part of the core medical and surgical curricula, as well as numerous higher specialty curricula.
SHM Consults: Perioperative and Consultative Medicine
Developing competencies in perioperative medicine offers the opportunity to share those competencies across multiple specialties and facilitate a multi-professional approach to education and training. It will also be important to establish perioperative medicine within undergraduate and foundation training programmes. Developing perioperative services represents, to some extent, a new departure away from the confines of the operating theatre, for many anaesthetists.
The profession is already well along this pathway, with around 80 per cent of departments already having established anaesthetist-led pre-operative assessment clinics, for example. Further developments in perioperative services will have to be supported by developing the consultant workforce, both in terms of training and numbers.
The Centre for Workforce Intelligence has recently published a report on workforce planning in anaesthesia, and consideration for perioperative services will form an important part of the plans that arise from this work. There should be no question of anaesthetists simply taking over roles from other medical specialties; this would be neither efficient nor lead to effective developments in care.
What is required is to establish carefully planned, team-based solutions to provide high quality perioperative care at a local level. By doing so, we can try to ensure that patients at high risk of complications receive the care they need as individuals, rather than a formulaic standardised approach for any given surgical procedure.
This way, we can ensure that NHS resources are used effectively to improve the care that our patients receive.
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- Core Topics in Perioperative Medicine by Jonathan Hudsmith; Dan Wheeler; Arun Gupta
Perioperative Evaluation and Treatment of Adrenal Insufficiency. Perioperative Cardiac Risk Management. Perioperative Cardiac Risk Assessment. Perioperative management of endocrine disease Dan Wheeler and Ingrid Wilkins; Perioperative management of diabetes Mike Masding and Wendy Gatling; Causes and treatment of aspiration Paul Hughes; Transfusion and blood products Andy Johnston; The critically ill patient Bilas Navapurkar; Inotropes Andy Gregg; Arterial blood gases Simon Fletcher; Drugs used in anaesthesia and sedation Mike Palmer; Local anaesthetics Sue Abdy; Monitoring used in the perioperative period Ian Bridgland and Katrina Williams; Deep vein thrombosis and thrombo-embolic disease prophylaxis Jonathan Hudsmith; Postoperative nausea and vomiting Pete Young; The management of perioperative pain Parameswaran Pillai and Richard Neal;