Reflections- ICPNT Fellows’ Perspectives

Reflections of my ICPNT Morrisey Educational Award Supported Experience at SNACC 2023

Amy Mitchell BMBS, BMedSci, FRCA
Neuroanesthesia Fellow
Vancouver General Hospital, BC, Canada

As a UK Trainee, working in Canada on a fellowship for a year, I was excited to experience my first annual SNACC conference, taking place in Alexandria, Virginia. As part of this, I was lucky enough to receive sponsorship to attend both the ICPNT Neuroanesthesia Skills Bootcamp and one of the several problem-based learning sessions on offer.

First up on the weekend agenda was the bootcamp session – a morning dedicated to teaching attendees an array of important clinical skills that can be utilized throughout our fellowship and beyond. On arriving and seeing a variety of patient volunteers sitting next to ultrasound machines with echo probes attached I thought maybe I had walked into the wrong room – was there a cardiac conference ongoing in the same venue? However, it seemed our bootcamp would be split into two parts – a Cardiac Point of Care Ultrasound (POCUS) for the Neuro-anesthesiologist, followed by whistle stop tour of a variety of neuroanesthesia related clinical skills and concepts.

Starting the POCUS session, it quickly became clear why such an interesting skill had been chosen for this bootcamp. With discussions including Takotsubo Cardiomyopathy and evaluation of right heart status with its importance in the management of venous air embolism, you can glean a lot of useful information from placing a probe on a patient.

The session was very much focused on interactive hands-on experience and I’m thankful to the patients who gave up their time to allow us to learn from them (including a very interesting case of dextrocardia). Switching between a number of patients and faculty meant we got an excellent variety of expertise, tips, tricks and troubleshooting techniques. Although it is impossible to gain mastery of a skill in a 1.5-hour session, overall this was a good taster into the importance of cardiac POCUS, and would likely empower people to seek more learning opportunity and experience with this skill within their own institution.

The next section placed us back into slightly more familiar territory with small group sessions on the use of Transcranial Doppler Sonography, Near-Infrared Spectroscopy, Scalp Blocks, Airway management for the awake craniotomy patient and regional anesthesia for spinal surgery.

In keeping with the theme of interactivity there was a variety of equipment to use throughout the sessions. Having not yet used a transcranial doppler in my own clinical practice it was incredibly useful to be shown the different acoustic windows and deduce flow velocities from these. Another nod of thanks goes to the medical student who allowed a multitude of participants to practice scanning their thoracic and lumbar spine to help us improve our understanding of ultrasound guided Erector Spinae Plane (ESP) and Thoracolumbar Interfacsical plane (TLIP) blocks for use in our multimodal analgesia regimes for spinal surgery patients.

Having a personal interest in awake craniotomies and how they are managed in different institutions made the refresher in scalp block anatomy invaluable and the discussion of different forms of airway management in these cases a highlight for me. The novel technique of using bilateral nasopharyngeal airways attached to a double lumen tube connector in patients during times of sedation to allow for adequate gas exchange without airway manipulation was certainly interesting to discuss.

I finished the bootcamp session with a lot of new and refreshed knowledge as well as a springboard to many different ideas and concepts that I will look into and think about incorporating into my own clinical practice at home.

Finally, the Problem Based Learning Discussion I attended on management of Complex Spinal Surgery in the Poly-Trauma Patient I would say was another highlight of my conference experience. Having an hour-long small group session from colleagues with experience from all over the world led to an absolutely fascinating discussion and exchange of ideas, and I would recommend to anyone who attends SNACC in the future to attend one of these stimulating sessions.

In summary, I am very thankful for the opportunity to be supported to attend these sessions. Not only did I get to learn some new skills and update my knowledge of old ones, but it was also a great experience to network and exchange ideas with highly skilled clinicians in their fields as well as discovering how other bootcamp attendees make the most out of their fellowship time at their respective institutions. Thank you to SNACC for the fun and informative weekend.

A Letter of Gratitude from a Seattle Neuroanesthesia Fellow

Shuhong Guo, MD, PhD
University of Washington, Seattle

It was an honor for me to receive the ICPNT/SNACC Morrisey educational award and to have the opportunity to attend the ICPNT Neuroanesthesia Skills Bootcamp, intraoperative frontal EEG workshop, Problem-based Learning Discussions, and the Networking Celebration.

This year the Neuroanesthesia Skills Bootcamp focused on clinical skills to improve patient care. It was an excellent experience to practice cardiac point of care ultrasound on different volunteer patients, especially a patient with dextrocardia (incidence: 1 in 12000 pregnancies). I also learned how to do scalp blocks to decrease post-operative pain, and I am hoping that I can begin to include this procedure in my practice and in educating residents during their neuroanesthesia rotations at the University of Washington (UW). The intraoperative frontal EEG workshop helped me to interpret EEG patterns and identify the artifacts. The Problem-based Learning Discussions sessions had excellent cases. I enrolled in the Craniotomy for a Patient with a Cardiac Assist Device and learned the perioperative management of anticoagulation, hemodynamic goals, and choice of monitoring techniques in these patients.

As a new faculty in the neuroanesthesia division at UW, I am excited to begin contributing as a clinical educator. I would love to see the PBLDs, and answers posted on SNACC’s website so that we can continue to learn well after the annual meeting and incorporate in educating residents and fellows. Additionally, I think early sharing with our membership insights into the Bootcamp offerings will generate even more interest from learners in this fantastic aspect of the annual meeting.

For me, the highlight of the meeting was the Networking Celebration. It was great to meet esteemed clinicians, researchers, and educators and learn about their career trajectories and a little about their roles at their institutions. Thank you to the sponsors who helped support a delicious menu as well as a platform for people who love neuroanesthesia! Thank you again for the award! Hoping this award will benefit more neuroanesthesia fellows in the future!

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