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    Skills Checklist: Modsed@uw - Edu

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    Lana
    This document outlines the requirements and instructions for a moderate sedation training program's airway management supervised experience. Trainees must be evaluated by an attending or CRNA on their skills like assessing the airway, monitoring vitals, performing airway maneuvers, and bag mask ventilation on two patients. The checklist provided must be completed by the evaluator for each patient and signed before being submitted. The document also provides location-specific instructions for trainees to schedule their evaluations and identifies points of contact for arranging the required experience.

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    Skills Checklist: Modsed@uw - Edu

    Uploaded by

    Lana
    22 views4 pages
    This document outlines the requirements and instructions for a moderate sedation training program's airway management supervised experience. Trainees must be evaluated by an attending or CRNA on their skills like assessing the airway, monitoring vitals, performing airway maneuvers, and bag mask ventilation on two patients. The checklist provided must be completed by the evaluator for each patient and signed before being submitted. The document also provides location-specific instructions for trainees to schedule their evaluations and identifies points of contact for arranging the required experience.

    Original Description:

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    Original Title

    HandsOn-Airway-Session-Checklist-Updated-Feb-2020

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    This document outlines the requirements and instructions for a moderate sedation training program's airway management supervised experience. Trainees must be evaluated by an attending or CRNA on their skills like assessing the airway, monitoring vitals, performing airway maneuvers, and bag mask ventilation on two patients. The checklist provided must be completed by the evaluator for each patient and signed before being submitted. The document also provides location-specific instructions for trainees to schedule their evaluations and identifies points of contact for arranging the required experience.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    22 views4 pages

    Skills Checklist: Modsed@uw - Edu

    Uploaded by

    Lana
    This document outlines the requirements and instructions for a moderate sedation training program's airway management supervised experience. Trainees must be evaluated by an attending or CRNA on their skills like assessing the airway, monitoring vitals, performing airway maneuvers, and bag mask ventilation on two patients. The checklist provided must be completed by the evaluator for each patient and signed before being submitted. The document also provides location-specific instructions for trainees to schedule their evaluations and identifies points of contact for arranging the required experience.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Moderate Sedation Training Program. Airway Management Supervised Experience.

    Skills Checklist

    MD /ARNP /PA (circle one) Attending / Fellow/ Senior Resident (circle one)
    Name: ____________________________________________
    Skill S U NP Comments
    S = Satisfactory
    U = Unsatisfactory
    NP = Not Performed
    1. Assess baseline vitals, LOC, O2 saturation, pain level.
    2. Assess airway- look externally (beard, obesity short
    neck, edentulous), Mallampati,
    Upper Lip Bite Test, mouth opening,
    Thyromental distance
    3. Monitor HR, O2 saturation and ETCO2 continuously;
    visually monitor LOC & level of responsiveness.
    4. Perform airway management maneuvers:
    • Head-tilt chin lift
    • Jaw-thrust
    • Chin-lift
    5. Reassess airway patency after any maneuver.
    6. Maintain cervical alignment in patients with known or
    suspected cervical spine injury.
    7. Demonstrate correct sizing and insertion of oral
    airway
    8. Ventilate patient adequately using the bag-valve
    mask without evidence of stomach insufflation.( 1 & 2
    handed technique)
    9. Assess ventilation adequacy: visual chest rise, pulse
    oximetry
    10. Report significant patient reactions during and after
    procedure.

    Evaluator (Attending or CRNA) Name (print): ________________________


    Evaluator (Attending or CRNA) Signature: __________________________ Date: ______________________
    Overall Result: Satisfactory/ Unsatisfactory (circle one)
    Submit: Email checklist (scan/photo) to [email protected]

    Updated February 2020 Page 1 of 4


    Moderate Sedation Training Program. Airway Management Supervised Experience.
    Skills Checklist
    MD/ARNP/PA (circle one) Attending/Fellow/Senior Resident (circle one)
    Name: ___________________________________________
    Skill S U NP Comments
    S = Satisfactory
    U = Unsatisfactory
    NP = Not Performed
    1. Assess baseline vitals, LOC, O2 saturation, pain level.
    2. Assess airway- look externally (beard, obesity short
    neck, edentulous), Mallampati,
    Upper Lip Bite Test, mouth opening,
    Thyromental distance
    3. Monitor HR, O2 saturation and ETCO2 continuously;
    visually monitor LOC & level of responsiveness.
    5. Perform airway management maneuvers:
    • Head-tilt chin lift
    • Jaw-thrust
    • Chin-lift
    5. Reassess airway patency after any maneuver.
    6. Maintain cervical alignment in patients with known or
    suspected cervical spine injury.
    7. Demonstrate correct sizing and insertion of oral
    airway.
    8. Ventilate patient adequately using the bag-valve mask
    without evidence of stomach insufflation.( 1 & 2 handed
    technique)
    9. Assess ventilation adequacy: visual chest rise, pulse
    oximetry
    10. Report significant patient reactions during and after
    procedure.

    Evaluator (Attending or CRNA) Name (print): _______________________


    Evaluator (Attending or CRNA) Signature: __________________________ Date: ______________________
    Overall Result: Satisfactory/ Unsatisfactory (circle one)
    Submit: Email (scan/photo) to [email protected]

    Updated February 2020 Page 2 of 4


    Moderate Sedation Training Program. Airway Management Supervised Experience.
    Important Instructions
    Location options:

    During this session, you will be assessed performing basic airway skills, including bag/mask ventilation, on two (2)
    patients. This can be done one of the following places:

    1. Procedural unit
    - If you work in a procedural unit where anesthesia providers cover cases, you may be evaluated by
    these providers during the course of a normal day.
    - Please let the CRNA or Anesthesia Attending know at the beginning of the day that you are to be
    evaluated on your two (2) cases. If they have any concerns regarding the suitability of a certain
    patient, they will arrange an alternative patient.
    2. In the OR (HMC or UWMC – Montlake or UWMC - Northwest)
    You will be assigned to a specific anesthesia attending who will check you off during the induction
    phase of two (2) “first-Start” cases at the beginning of the day.
    3. In the PACU at HMC
    You may be assigned to patients having ECT in the PACU at Harborview instead of patients in the OR.

    Instructions applicable to all locations:


    - Make sure to print two (2) copies of the Skills Checklist to take to your hands-on airway session.
    - Read it ahead of time so you know what to expect.
    - Upon successful completion, send your 2 (two) signed checklists to [email protected].

    Location-specific instructions:

    UWMC - Montlake Campus


    Contact [email protected].
    On the scheduled day, go to the OR by 7:00 am in scrubs (8:00am on Weds), with your two (2) checklists, and make
    contact with the Anesthesiologist in Charge (AIC) on 89607. They will assign you to a specific Anesthesia Attending in
    either the Main OR or Pavilion OR and give you the Attending’s spectralink number for you to call. You will be evaluated
    during the induction phase of two (2) “first start” cases.

    UWMC – Northwest Campus


    Contact Alex Pang: [email protected]
    Dr. Pang will schedule you for a convenient day (Tuesdays & Thursdays are best). On the scheduled day, go to the OR
    front desk, located on the second floor in the B/C wing. If coming from outside it is best to park in the F Lot and enter
    via the North Entrance. There are double doors outside the operating room that require a badge to enter but you can
    pick up the telephone outside the double doors to enter the surgical area. The OR front desk is located next to the white
    board inside the secured area. Contact the Anesthesiologist-in-Charge (AIC) on 206 668 4821. They will assign you to a
    specific Anesthesia Attending, who is working with 2 CRNAs, and give you the Attending’s number for you to call. You
    will be evaluated during the induction phase of two (2) “first start” cases.

    Updated February 2020 Page 3 of 4


    Moderate Sedation Training Program. Airway Management Supervised Experience.
    Important Instructions

    HMC
    Contact Raquel Hivera in the 6th Floor Anesthesia Office (6EC-21) [email protected]
    Tel: 206.744.4371
    They will schedule you for a convenient day (Monday, Tuesday, Thursday or Friday only) and give you the code for the
    locker room so that you can change into scrubs on the day. On the day, go to the OR by 7:00 am in scrubs, with your
    two (2) checklists, and check in with the front desk (48800), asking for the Anesthesiologist in Charge (AIC).

    The AIC will assign you to a specific anesthesia attending in either the Main OR or Maleng OR, and give you that
    attending’s number to call. You will be evaluated during the induction phase of two (2) first start cases or two (2) ECT
    cases – depending on your original scheduling. If you get allocated to the ECT patients there may be a 30 minute delay.
    This is rather difficult to predict, as allocation to suitable patients can only happen on that particular day.

    VAMC
    Contact Stephen Clark in the 3rd floor OR office (3D 104 – Bldg. 100)
    [email protected]
    Tel: 206.716.5958
    They will schedule you for a convenient day (likely M, W, or F). He will arrange for you to have access to the locker room
    so that you can change into scrubs that day. You should plan to park in the Visitors’ lot and enter the VA through the
    main entrance near the Emergency Department. This is building 100. You will then go to the 3rd floor and find the OR.
    On the day, go to the OR by 7:00 am in scrubs, with your two (2) checklists, and make contact with the
    Anesthesiologist in Charge (AIC). Ask the nursing staff at the front desk who that is for the day. The
    Anesthesiologist in Charge will then assign you to a specific Anesthesia Attending and tell you how to get a hold of
    them. Your airway skills will then be evaluated during the induction phase of two (2) “first start” cases.

    SCCA
    Charge Nurse
    Tel: 206.606.1329
    Tuesdays and Thursdays will be available for airway skills assessment at SCCA, and only ONE (1) person will be able to
    complete the training per Thursday. Check the procedure suite schedule (206.288.1329 or in ORCA) to be sure a case is
    scheduled. Spaces are limited so if you also work at another hospital in the UW system, please book your session there
    instead. Be sure to bring two (2) checklists with you.

    Updated February 2020 Page 4 of 4

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