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TABLE OF CONTENTS

1.0 Departmental Overview

1.1 Purpose and use of manual

1.2 Mission Statement

1.3 Philosophy and Objectives

1.4 Organizational Chart

1.5 Scope of care and services

1.6 Standards of Care

2.0 Personnel

2.1 Job Descriptions

2.2 Orientation Plan

2.3 Recruitment/Selection

2.4 Performance Assessment

3.0 Administrative

3.1 Administrative Meetings

3.2 Operations

3.2.1 Equipment

3.2.2 Medical Gases

3.2.3 Electrical Safety

3.2.4 Supplies and Equipment

4.0 Education

4.1 Non-Employee Training Guidelines

4.1.1 Rotations

4.1.2 Medical students

4.1.3 Internships

4.1.4 Fellowships

4.1.5 Residencies

4.1.6 Guidelines for research

5.0 UTMB Policies and Procedures

5.1 Promotion/Reclassification

5.2 Appeal/Grievance

5.3 Corrective/Disciplinary Action

5.4 Employee Scheduling

5.5 Times and Attendance

5.6 Safety

5.7 Security

5.8 Employee Breaks

5.9 Smoking

5.10 TDCJ Guidelines

5.11 Quality Management Program

5.12 Conscious Sedation

5.13 Universal Precautions

5.14 Emergency Operations

5.15 Epidemiology Policies

1.0 DEPARTMENTAL OVERVIEW

1.1 PURPOSES AND USE OF THIS MANUAL

It is the purpose of this manual to set forth the minimum requirements for safe, modern, and ethical

provision of anesthesia, whether it be for diagnostic, therapeutic, invasive, or surgical procedures.

1.2 MISSION STATEMENT

The mission of the Anesthesiology Department at the University of Texas Medical Branch at Galveston is

to ensure accessible, comprehensive, high-quality anesthesiology services in a safe and supportive

environment, while simultaneously promoting excellence in research and education.

Specifically, the Anesthesiology Department is dedicated to:

Providing state-of-the-art anesthesiology and critical care services to all patients who are eligible

to receive them.

Providing premier educational and research programs in conjunction with our affiliated

institutions.

Serving as a major tertiary referral center for anesthesiology and critical care services.

1.3 PHILOSOPHY AND OBJECTIVES

1. Anesthesiology is a discipline within the practice of medicine specializing in the medical

management of patients who are rendered unconscious and/or insensible to pain and

emotional stress during surgical, obstetrical, and certain other medical procedures. The

practice of Anesthesiology includes preoperative, intraoperative, and postoperative

evaluation and treatment of these patients. This includes the protection of life functions and

vital organs (e.g., brain, heart, lung, kidney, liver) under the stress of these same procedures.

2. A competent anesthesiologist is a physician from whom one can expect:

Medical Judgment – availability of mature medical decision making applicable to

solutions of medical problems associated with patient care as related to the practice of the

specialty;

Technical Ability – facility in providing all technical services likely to be required in the

practice of the specialty;

Scholarship – the talent, training, and habits of study necessary for evaluating and

appropriately applying knowledge;

1.4 ORGANIZATION CHART

Organizational ChartDepartment of Anesthesiology, University of Texas Medical Branch, Galveston, Texas

Chairman

Vice ChairClinical Affairs

Subspecialty Divisions

Administrative Associate

Vice ChairEducation

Departmental Administrator

Anesthesiology Specialists Editorial Office Director

Secretarial Support

Educational Support

Technical Support

Resident Coordinator

Administrative Manager(Office Manager)

Medical School Training

Resident Education Programs

Surgical Intensive Care Unit

Cardio thoracic Anesthesiology

Obstetrical Anesthesiology

Pain Management

Shriners’ Burns Hospital

Medical Director Operating Rooms

Pediatric Anesthesiology

Pre-Screening Clinic

1.5 SCOPE OF CARE FOR ANESTHESIOLOGY DEPARTMENT

The scope of care in the Anesthesiology Department is the preoperative evaluation,

intraoperative management, and postoperative recovery of patients undergoing anesthesia

and surgery. Additionally, the Anesthesiology Department maintains a major role in the

direction of the Surgical Intensive Care Unit (SICU) and Ambulatory Surgery Services.

The department also operates a Pain Management Clinic, provides anesthesia and

analgesia for obstetrical patients, and serves as a consultant in airway management. The

department advises UTMB on the provision of moderate sedation at various locations

throughout its hospitals.

1.6 STANDARDS OF CARE

The following standards apply to all anesthesia care although, in emergency situations, appropriate life

support measures take precedence. These standards may be exceeded at any time based on the judgment of

the responsible anesthesiologist. They are intended to encourage high quality patient care, but observing

them cannot guarantee any specific patient outcome. They are subject to revision from time to time, as

warranted by ongoing developments in practice and technology.

1.6.1 Pre-operative Testing

Preanesthetic laboratory and diagnostic testing are often essential; however, no routine laboratory or

screening test is necessary for the preanesthetic evaluation of patients. Appropriate indications for ordering

tests includes the identification of specific clinical indicators or risk factors (e.g., age, pre-existing disease,

surgical procedure). Individual surgeons and anesthesiologists should order test(s) when, in their judgment,

the results may influence decisions regarding risks and management of the anesthesia and surgery.

1.6.2 Basic Standards for Preanesthesia Care

1. An anesthesiologist shall be responsible for determining the medical status of the patient,

developing a plan of anesthesia care, and acquainting the patient or responsible adult with the

proposed plan.

2. The development of an appropriate plan of anesthesia care is based upon:

a. Reviewing the medical record.

b. Interviewing and examining the patient to:

i. Discuss the medical history, previous anesthetic experience and drug therapy.

ii. Assess those aspects of the physical condition and concurrent health problems,

which might affect decisions regarding perioperative risk and management.

c. Obtaining and/or reviewing tests and consultations necessary to the conduct of

anesthesia.

d. Determining the appropriate prescription of perioperative medications necessary to the

conduct of anesthesia.

e. Discuss with each patient the appropriate anesthesia options and risks.

The responsible anesthesiologist shall verify that the above has been properly performed and documented

in the patient’s record.

1.6.3 STANDARDS FOR BASIC ANESTHETIC MONITORING

1. Qualified anesthesia personnel shall be present in the room throughout the conduct

of all general anesthetics, regional anesthetics, and monitored anesthesia care.

a. Patient status can change rapidly during anesthesia and necessitates the need for

continuous monitoring of the patient. In the event there is a direct known hazard,

e.g., radiation, to the anesthesia personnel, which might require intermittent remote

observation of the patient, some provision for monitoring the patient must be made.

In the event that an emergency requires the temporary absence of the person

primarily responsible for the anesthetic, the best judgment of the anesthesiologist

will be exercised in comparing the emergency with the anesthetized patient’s

condition and in the selection of the person left for the anesthetic during the

temporary absence.

2. During all anesthetics, the patient’s oxygenation, ventilation, circulation, and

temperature shall be continually evaluated.

3.

a. Oxygenation

Inspired gas: During every administration of general anesthesia, the

concentration of oxygen in the patient breathing system shall be measured

by an oxygen analyzer with low oxygen concentration limit alarm in use.

Blood Oxygenation: During all anesthetics a quantitative method of

assessing oxygenation such as pulse oximetry shall be employed.

b. Ventilation

Every patient receiving a general anesthetic shall have the adequacy of

ventilation continually evaluated. While qualitative clinical signs such as

auscultation of breath sounds, observation of the reservoir breathing bag and

chest excursions may be adequate, quantitative monitoring of the CO2 content

and/or volume of expired gas is encouraged.

When an endotracheal tube is inserted, its presence in the trachea must be

confirmed by clinical assessment and by identification of carbon dioxide in the

expired gas. Continual end-tidal carbon dioxide analysis, in use from the time

of endotracheal tube placement, until extubation or initiating transfer to a

postoperative care location, shall be performed using a quantitative method such

as capnography, capnometry, or mass spectroscopy.

When ventilation is controlled by a mechanical ventilator, there shall be

continuous use of a device that is capable of detecting disconnection of

components of the breathing system. The device must give an audible signal

when its alarm threshold is exceeded.

During regional anesthesia and monitored anesthesia care, the adequacy of

ventilation shall be evaluated, at least, by continual observation of qualitative

clinical signs.

c. Circulation

Every patient receiving anesthesia shall have the electrocardiogram continuously

displayed from the beginning of anesthesia until preparing to depart the

anesthetizing location.

Every patient receiving anesthesia shall have arterial blood pressure and heart

rate determined and evaluated at a minimum of every five minutes.

Every patient receiving general anesthesia shall have, in addition to the above,

circulatory function continually evaluated by at least one of the following:

palpation of the pulse, auscultation of heart sounds, monitoring of intra-arterial

pressure, ultrasound peripheral pulse monitoring, or pulse plethysmography or

oximetry.

d. Body Temperature

There shall be a readily available means to continuously measure the patient’s

temperature. When changes in body temperature are intended, anticipated or

suspected, the temperature shall be measured.

e. Anesthesia for Electroconvulsive Therapy (ECT)

In accordance with the Texas Administrative Code (TAC), Title 25, Part II, Chapter

405E, in addition to routine anesthetic monitoring as described in 1.6.3, all patients

for ECT shall have a serum pseudocholinesterase level documented if there is no

record of previous testing or no documentation of prior successful use of muscle

relaxants (succinylcholine).

1.6.4 BASIC STANDARDS FOR POST ANESTHESIA CARE

1. All patients who receive general or regional anesthesia, or monitored anesthesia care shall

receive appropriate post anesthesia management.

a. A Post anesthesia Care Unit (PACU) or an area, which provides equivalent

postanesthesia care, shall be available to receive patients after surgery and

anesthesia. All patients who receive anesthesia will be admitted to the PACU except

by specific order of the anesthesiologist responsible for the patient’s care.

b. The medical aspects of care in the PACU shall be governed by policies and

procedures, which have been reviewed and approved by the Department of

Anesthesiology.

c. The design, equipment and staffing of the PACU shall meet requirements of the

facility’s accrediting and licensing bodies.

d. The nursing standards of practice shall be consistent with those approved by the

American Society of Post Anesthesia Nurses (ASPAN).

2. A patient transported to the PACU shall be accompanied by a member of the anesthesia

care team who is knowledgeable about the patient’s condition. The patient shall be

continually evaluated and treated during transport with monitoring and support

appropriate to the patient’s condition.

3. Upon arrival in the PACU, the patient shall be re-evaluated and a verbal report

provided to the responsible PACU nurse by the member of the anesthesia care team who

accompanied the patient.

a. The patient’s status on arrival in the PACU shall be documented.

b. Information concerning the preoperative condition and the surgical/anesthetic course

shall be transmitted to the PACU nurse.

c. The member of the anesthesia care team will remain in the PACU until the PACU

nurse accepts responsibility for the nursing care of the patient.

4. The patient’s condition shall be evaluated continually in the PACU.

a. The patient shall be observed and monitored by methods appropriate to the patient’s

medical condition. Particular attention should be given to monitoring oxygenation,

ventilation, circulation, and temperature. Pulse oximetry shall be employed in the

initial phase of recovery.

b. An accurate written report of the PACU period shall be maintained. Use of an

appropriate PACU scoring system is encouraged for each patient on admission, at

appropriate intervals prior to discharge, and at the time of discharge.

c. General medical supervision and coordination of patient care in the PACU shall be

the responsibility of the anesthesiologist in charge of the daily schedule in

consultation with the faculty anesthesiologist who supervised the anesthetic.

d. There shall be a policy to assure the availability in the facility of a physician capable

of managing complications and providing cardio-pulmonary resuscitation for

patients in the PACU.

5. A physician is responsible for the discharge of the patient from the post anesthesia care

unit.

a. When discharge criteria are used they must be approved by the Department of

Anesthesiology and the medical staff. They may vary depending upon whether the

patient is discharged to a hospital room, to an intensive care unit (ICU), or home.

b. In the absence of a physician responsible for the discharge, the PACU nurse shall

determine that the patient meets the discharge criteria. The name of the physician

accepting responsibility for the discharge shall be noted on the record.

1.6.5 INFORMED CONSENT

1. As a general rule, patient consent must be obtained prior to the performance of any anesthetic

or the administration of blood products. Informed consent should include:

The general nature of the contemplated anesthetic.

Discussion of anesthetic options available for the patient.

The benefits, risks, discomforts, and potential complications related to the anesthetic that

may be reasonably expected.

Signature of the patient or the person authorized to sign on the patient’s behalf, the

signature of the practitioner who obtains the consent, and the signature of the person

witnessing the consent.

2. Cross reference IHOP 9.3.17 for complete overview of informed consent policies and

application in special or unusual circumstances.

2.0 PERSONNEL

2.1 JOB DESCRIPTIONS

2.1.1 DEPARTMENT CHAIR

1. Primary Function

The Chair of the Department of Anesthesiology will be selected and appointed by the Dean of

Medical School in accordance with the Bylaws of the Medical Staff. The Chair’s responsibilities

shall include, but are not necessarily limited to:

a. Integration of the Department into the primary function of the hospital

b. Recommendation privileges for all individuals with primary anesthesia

responsibility. These privileges shall be processed through established

medical staff channels.

c. Recommending the availability of a sufficient number of qualified

personnel to provide the services needed for the daily surgical schedule

and 24-hour, 7-day-a-week availability of anesthesia care.

d. Recommending the amount of space and other resources needed by the

department.

e. Continuing evaluation of the professional performance of all individuals

who have delineated clinical privileges in the department.

f. Recommending to the administration and medical staff the type and

amount of equipment necessary for administering anesthesia and related

resuscitative efforts, ensuring through at least annual review that such

equipment is available.

g. Development of regulations concerning anesthetic safety.

h. Ensuring that important internal processes and activities (those that most

affect patient outcomes) throughout the organization are systematically

assessed and improved.

i. Participation in the development of policies relating to the functioning of

anesthetists and administration of anesthesia in various departments or

services of the hospital, including participating in the hospital’s program

of cardiopulmonary resuscitation.

2. Specific Duties

a. Reporting as required to the Credentials Committee, Quality

Improvement committee, Safety Committee, Infection Control

Committee, and Operating Room Committee.

b. Establishing quality standards for the anesthesia department.

c. Specific duties as provided in the Bylaws.

In the absence of the Chair, the Vice-Chair for Clinical Affairs shall assume all the responsibilities of the

Chair as provided by the Bylaws

2.1.2 PHYSICIAN ANESTHESIOLOGISTS

Staffing for the delivery of anesthesia care shall be related to the scope and complexity of the services

offered. Anesthesia care shall be provided by anesthesiologists or supervised trainees in an approved

educational program. A qualified anesthesiologist shall be available to provide anesthesia care for patients

whenever it is required in the hospital. Except for specific emergency situations, the administration of

anesthesia shall be limited to areas where it can be given safely, in accordance with the policies and

procedures of the Anesthesiology Department.

1. Primary Function

a. Perform accepted procedures commonly used to render patients insensible to pain during

the performance of surgical, obstetrical, and other pain-producing clinical maneuvers,

and to relieve pain-associated medical syndromes.

b. Support life functions during the period in which anesthesia is administered

c. Provide consultation relating to various other forms of patient care, such as respiratory

therapy and problems in pain relief.

2. Specific Duties

a. Preoperative evaluation and reasonable explanation to the patient of the proposed

anesthetic procedure.

b. Pre-medication of the patient if needed.

c. Administration of anesthesia to the patient on the basis of the ASA standards and

guidelines: i.e., the anesthesiologist will be personally responsible for the conduct of the

selected anesthetic and will be immediately available at all times to fulfill this

responsibility.

d. Will make a documented postoperative visit or visits as indicated.

2.1.3 CERTIFIED REGISTERED NURSE ANESTHETISTS AND ANESTHESIA

ASSISTANTS

Delegation of functions to non-physician personnel should be based on specific criteria (i.e., the

individual’s education, training, and demonstrated skills) approved by the medical staff on the

recommendation of the physician responsible for anesthesia care. Such criteria should include competence

to follow the anesthesia plan prescribed by the anesthesiologist and the technical ability to:

1. Induce anesthesia under the direction on an anesthesiologist.

2. Maintain anesthesia at prescribed levels.

3. Monitor and support life functions during the perioperative period.

4. Recognize and report to the anesthesiologist any abnormal patient responses during

anesthesia.

2.2 ORIENTATION PLAN

All new hires in the Department of Anesthesiology are required to attend the UTMB orientation program as

outlined by the University. New faculty are oriented to the Department, and the Operating Room Suites by

the Vice -Chairman for Clinical Affairs or his designee. Additionally, the Administrator of the department

meets with all new hires to review administrative policies, and responsibilities of the faculty, and the

departmental benefits.

2.3 RECRUITMENT AND SELECTION

The Department of Anesthesiology complies with the Policies and Procedures of the University of Texas

Medical Branch at Galveston for the recruitment and selection of all employees. Faculty members are

recruited via word of mouth, or through advertisements in appropriate publications.

2.4 EMPLOYEE PERFORMANCE ASSESSMENT

2.4.1 Classified personnel have their performance appraised in accordance with the UTMB

Human Resources policies and procedures for classified personnel.

2.4.2 Administrative and Professional personnel have their performance appraised in

accordance with the UTMB Human resources policies and procedures for Administrative

and professional personnel.

2.4.3 Residents and fellows, as well as CRNA’s and Anesthesiology Assistant P.A.’s, are

evaluated daily by the faculty. Resident and Fellow evaluations are reviewed and acted

upon by the Clinical Competence Committee.

2.4.4 Each member of the faculty has their performance appraised on an annual basis. They

are evaluated on their performance as it relates to their leadership, effectiveness, clinical

effectiveness, clinical effectiveness, educational effectiveness, and research effectiveness.

Each member of the faculty is anonymously evaluated by the residents for their

educational skills, us of sound medical judgment, clinical knowledge, etc. Self-

evaluations, and peer evaluations are part of the overall assessments process.

3.0 ADMINISTRATIVE

3.1 ADMINISTRATIVE MEETINGS

The Department of Anesthesiology conducts several regularly scheduled meetings to discuss matters of

administrative concern, these include:

3.1.1 Faculty Meetings are held each month. The purpose of this meeting is to keep the faculty

informed regarding all areas of departmental and institutional importance, administrative, clinical,

education, and research. These meetings also provide an opportunity for the faculty to have input

regarding matters that concern them.

3.1.2 Chairman’s Advisory Committee meetings are held weekly. Their purpose is to discuss those

issues affecting the department and the institution to develop and approve plans, and implement

actions necessary to carry out those plans.

3.1.3 Education Committee meets monthly to coordinate the resident education programs in the

Department of Anesthesiology.

3.1.4 Quality Management Committee meets monthly to review all mortality, critical incidents and

complaints occurring on patients directly under the care of our department.

3.1.5 Other committees: Various members of the faculty and staff of the Department of Anesthesiology

serve as active members of several Medical School, Hospital, Practice Plan, and/or Institutional

Committees including but not limited to the following:

Operating Room Committee

Transfusion Committee (Hospital)

Executive Committee of the Medical Staff

CPI Committee (Hospital)

Quality of Care Committee (Hospital)

3.2 OPERATIONS3.2.1 Equipment

1. Anesthesia apparatus must be inspected and tested by anesthesia provider prior

to being put into use. If a defect is discovered, the equipment must be replaced

or not put into use until the defect is corrected.

2. Oxygen and nitrous oxide cylinders will be maintained on each anesthesia

machine and be ready for use in case of emergency.

3. Lubrication of regulators and fittings will be avoided. Oil, grease or flammable

liquids will not be permitted to come into contact with oxygen cylinder valves,

regulators and gauges.

4. Cylinder valves will remain closed except when in use, then opened fully.

5. Empty cylinders will not remain on anesthesia machines. Cylinders will be

replaced immediately will full tanks suitably marked.

6. Unapproved or equipment without prior inspection will not be permitted in

patient care anesthesia areas.

7. Each anesthetic gas machine will have a pin-index safety system to prevent the

cross connecting of gasses.

a. All piped-in gasses will have a pin-index system with appropriate alarm

system.

8. All anesthesia machines and piped-in gas pin-indexing systems will be equipped

with an audible alarm sounding if oxygen is not flowing in addition to

anesthetizing gases.

9. All anesthesia machines will have a gas-scavenger system connected to suction

that is not vented into the air conditioning system.

3.2.2 Medical Gases

1. All anesthesia personnel will familiarize themselves with the rate, volume, and

mechanism of air exchange within the surgical, recover, and intensive care unit

areas.

2. Only non-flammable anesthetic agents will be used for anesthesia or for the

preoperative preparation of the surgical field.

3. All freestanding cylinders, whether empty or full, shall be chained or supported

in a cylinder cart.

a. Small cylinders of oxygen or other non-flammable gas required during

patient transport may be used when safely affixed to the patient’s bed or

gurney.

4. Full tanks will be stored separately from empty tanks and each storage area will

be appropriately marked.

5. All cylinder storage areas will have controlled access to be protected from

extreme heat and cold.

6. Personnel concerned with the use and transport of cylinders shall be instructed

in the proper handling of gas cylinders.

7. All cylinders and associated equipment intended for use in an anesthetizing area

must be properly labeled by the manufacturer.

3.2.3 Electrical Safety

1. All electrical equipment will be tested by the Department of Engineering prior to

being put into use and then at regular intervals, not to exceed six (6) months,

unless an indicated inspection is justified by previous experience or

manufacturer’s recommendation.

2. All equipment will be fitted with three-prong grounding plugs, and cords will be

standardized according to current National Fire Protection Agency regulations.

3. With the exception of certain radiological equipment and fixed lighting more

than five (5) feet above the floor, all electrical equipment in the operating room

suite shall be on an audio-visual line isolation monitor.

a. When this device indicates a hazard, the use of any electrical equipment

will be avoided if at all possible, particularly the last electrical item put into

use, as well as any item not required for patient monitoring or life support.

b. Following the completion of the procedure, the area from which the signal

emanated will not be used until the defect is remedied.

c. All personnel working in these areas will be familiar with the procedure to

be followed.

3.2.4 Supplies and Equipment

1. The minimum supplies and equipment necessary for the administration of

anesthesia and for related resuscitative efforts include, but not necessarily

limited to:

a. Sphygmomanometers and stethoscopes – regular and esophageal;

b. Gas machines with oxygen supply, alarm and scavenger system;

c. Anesthesia machines will be inspected on a semi-annual basis by the

contracted biomedical corporation representative.

3.2.5 Controlled Substances

1. All personnel in the Department will adhere to the Pharmacy's policies and

procedures regarding the dispensing, administration, wasting, and return of

controlled substances.

2. Controlled substances are never to leave the hospital premises.

3. Controlled substances cannot be stored in lockers or offices.

4. Before leaving the hospital, each individual must reconcile the records for all

controlled substances for which they are responsible. All drugs must have been

administered, wasted, or returned before a member of the Anesthesiology

Department leaves the hospital premises. Controlled substances cannot be

transferred to another member of the department.

4.0 Education4.1 Non-Employee Training GuidelinesRotations

I. General

Rotations are structured in accordance with the guidelines of the

Accreditation Council for Graduate Medical Education (ACGME) and

the Residency Review Committee (RRC) for Anesthesiology. (1996

revision). All rotations within the Department of Anesthesiology are

reviewed by the Education Committee on a yearly basis. The

performance of individual residents is monitored by the Clinical

Competency Committee (CCC) who review all unsatisfactory evaluations

give by rotation directors. The timing of required rotations and their

content is reviewed by the Education Committee on a yearly basis.

II. Required Rotations

Day Surgery Unit/ Outpatient evaluation

Cardio thoracic anesthesia

Obstetrical anesthesia

Neuroanesthesia

Pediatric Anesthesia (UTMB; Shriners’ Burn Institute – Galveston TX,

Driscoll Children’s Hospital – Corpus Christi, TX)

Pain management

Post-Anesthesia Care Unit

Critical Care Medicine

III. Elective Rotations

Advanced clinical experience is available in all subspecialties at UTMB as

recommended in the ACGME guidelines. Additional external rotations include:

Pediatric Anesthesia (Shriners’ Burn Institute – Galveston TX, Driscoll Children’s

Hospital – Corpus Christi, TX, Texas Children’s Hospital – Houston, Texas)

Pain Management (MD Anderson Hospital – Houston, TX)

Cardio thoracic anesthesia (Texas Heart Institute – Houston, TX)

Thoracic Anesthesia (MD Anderson Hospital – Houston, TX)

Medical Students

1.First and Second year curriculum. The faculty of the department of anesthesia are

responsible for participating in the first and second year curriculum to the extent required

by the Medical school. This includes but is not limited to facilitating Practice of Medicine

(POM) and Problem Based learning discussion (PBLD) courses

1. Core Curriculum lectures. The faculty of the department of anesthesia are

responsible for the series of lectures covering preoperative evaluation,

intraoperative physiology and postoperative management of the surgical patient.

These lectures are given to 3rd year medical students during their surgical

clerkship.

2. 1st year Anesthesia rotations. The following rotations are available to 1st year

medical students as electives:

One month elective in Clinical Anesthesia

Two month elective in Research in Anesthesia

3. 4th year Anesthesia rotations: The following rotations are available to 4th year

medical students as electives:

Research in anesthesiology

Surgical Intensive Care Unit

Pain Management

Obstetrical Anesthesia

Cardiovascular Anesthesia

Clerkship in Anesthesia

Acting Internship in Anesthesia

Internships. The internship for residents entering the four year residency is under the supervision of the

director of the residency. Interns complete twelve months of clinical rotations outside the department of

anesthesia during their PGY-1 and PGY-2 years. The residents receive evaluations from the supervising

faculty at the conclusion of each rotation. All unsatisfactory evaluations are reviewed by the CCC in

addition to the director of resident education. Rotations are scheduled with the following departments or

sections:

Medicine (ward, cardiology, pulmonary, outpatient clinics, consults)

Surgery (ward)

Pediatrics (Pediatric ER, Infant Special Care Unit)

Emergency Medicine

Oral Surgery

Fellowships

The department, from time to time, may offer fellowship in Pedi, Cardiovascular, Pain,

and ICU.

Residencies. The Department of Anesthesia is an ACGME accredited residency program.

Guidelines for research. Research opportunities are available to senior residents. All projects are subject

to the guidelines of the Institutional Review Board (IRB).

5.0 UTMB Policies and Procedures (All sites accessed08/03)

5.1 Promotion/Reclassification

http://www.utmb.edu/policy/ihop/search/03%2D06%2D05.pdf


5.2 Appeal

http://www.utmb.edu/policy/ihop/search/03-10-02.pdf

5.3 Grievance


5.4 Corrective/Disciplinary Action


5.4 Employee Scheduling

http://wahoo.utmb.edu/policy/nursing/search/03-57.pdf

5.5 Time and Attendance


5.6 Safety


5.7 Security


5.8 Employee Breaks


5.9 Smoking


5.10 TDCJ Guidelines


5.11 Quality Management Program


http://www.utmb.edu/policy/social/search/03%2D04.pdf


5.12 Moderate Sedation




http://www.utmb.edu/policy/social/search/03-04.pdf








http://wahoo.utmb.edu/policy/nursing/search/03-57.pdf






5.13 Universal Precautions

http://wahoo.utmb.edu/ERC/student/isolatio.htm

5.14 Emergency Operations

http://www.utmb.edu/emergency_plan/plan/default.htm

5.15 Epidemiology Policies

http://www.utmb.edu/policy/hcepidem/search/02%2D01.pdf

http://www.utmb.edu/policy/hcepidem/search/02-01.pdf

http://www.utmb.edu/emergency_plan/plan/default.htm

http://wahoo.utmb.edu/ERC/student/isolatio.htm

Documents

TABLE OF CONTENTS - Home Page | Department of ...anesth.utmb.edu/Residents/Joint_Commission/Policy and... · Web viewOil, grease or flammable liquids will not be permitted to come