The Pediatric Anesthesiology rotation is done at Children�s Healthcare of Atlanta- Egleston Children�s Hospital. The rotation is two months in duration competed during the CA-2 year of training. During the CA-3 level of training electives of one, two or three months may be taken. Resident physicians in anesthesiology should acquire experience and training in the anesthetic management of children of all ages in elective and emergency situation. This experience will include a wide range of surgical cases in all pediatric surgical specialties with the exception of cardiac anesthesia only being offered to the advanced CA-3 resident physicians. The Residents should acquire sound clinical competence for the management of the pediatric airway, pediatric trauma care, preoperative assessment, intra-operative management and post-operative diagnosis and treatment of acute pediatric pain. During the rotation the resident should be able to achieve increasing responsibility for clinical decision making in pediatric anesthesiology. Participation in didactic training includes attending and conducting teaching conferences in basic pediatric anesthesiology. Residents will be expected to complete the ACGME requirements for pediatric anesthesia during this rotation. CA-2 Pediatric Anesthesiology Rotation Goals:

• Perform a pre-anesthetic assessment of a pediatric patient and present the patient to a Faculty attending.
• Learn the various pediatric premedication strategies including various drugs and routes of administration.
• Learn to determine appropriate pediatric airway options for various procedures and the benefits of each option.
• Learn the pharmacology of volatile anesthetic agents and intravenous agents as they relates to pediatric patients.
• Learn to develop an anesthetic plan including pain management options for pediatric patients of different ages.
• Learn the major concerns of post anesthesia care of pediatric patients.
• Learn to effectively communicate an anesthetic evaluation and plan with the pediatric patient, the pediatric patient�s family and the attending anesthesiologist.
• Learn the age related differences and concerns with bag/mask ventilation, Laryngeal Mask Airways, endotracheal tube placement in pediatric patients.
• Learn the indications for and techniques for placement of invasive hemodynamic monitors such as arterial catheter placement and central venous catheter placement in the pediatric patient.
• Learn the indications, advantages and complications of regional anesthesia techniques such as caudal, epidural, spinal or regional nerve blocks in the pediatric patient.
• Become familiar with fluid and electrolyte administration to pediatric patients of different ages.
• Learn the indications and risks of blood and blood product administration to the pediatric patient including the immune compromised neonate.
• Become familiar with various modes of ventilation of the pediatric patient including volume control, pressure support, and pressure controlled mechanical ventilation.
• Learn the age related difference in responsiveness to neuromuscular blocking drugs.
• Learn to interpret laboratory values for patients of different ages including arterial blood gas analysis, electrolytes, and hemoglobinopathies,
• Learn the pharmacological approach to the pediatric patient who has hemodynamic instability.
• Learn to recognize and communicate intraoperative events of concern to the attending anesthesiologist and the surgical team.
• Learn to communicate in a concise manner a summary of the intra-operative course, anesthetic management and post-operative concerns to the Post Anesthesia Care Unit Staff, the Intensive Care Unit Staff and the Surgical Team including the attending surgeon.
• Become familiar with the more common pediatric co-existing diseases and how they affect the choice of anesthetic technique.
• Become familiar with the influence of the choice of anesthetic technique on the post-operative course.
• Learn the maturational differences in pediatric patients including differences in systems such as neurological, pulmonary, cardiac, renal, hepatic, temperature regulation and coagulation.
• Become familiar with anesthetic implication of the most common congenital syndromes.
• Become familiar with the treatment protocols for the patient with Malignant Hyperthermia, and the patient with a history of malignant hyperthermia and the anesthetic approach to the patient with a family history of malignant hyperthermia.

• Provide anesthetic management of pediatric patients with congenital heart defects.
• Obtain exposure to anesthetic management of pediatric patients having congenital heart defect repairs.
• Discuss with the patient, patient�s family, attending anesthesiologist and surgical team the anesthetic plan for more complex pediatric surgical procedures.
• Demonstrate increased proficiency with invasive hemodynamic monitor placement in the pediatric patient.
• Demonstrate increased proficiency in placement of blocks, caudal, spinal, epidural regional nerves etc, in the pediatric patient.
• Demonstrate a broad knowledge base about fluid and electrolyte balance and management in the pediatric patient.
• Assist with the educational mission of the department by sharing their fund of knowledge with medical students and/or CA-2 level residents.