What is an Anesthesiologist?
An anesthesiologist is a medical doctor who specializes in the administration of anesthesia and related issues. Anesthesiologists most famously work in the operating room, keeping patients unconscious and monitoring their vital signs during surgery, but these professionals can also be seen in other environments. For example, anesthesiologists can administer nerve blocks, epidurals, and other forms of pain management which are used outside the operating room.
Anesthesiologists have several responsibilities. They are involved in pain management, and any situation in which a patient must be unconscious for a procedure, using anesthetic agents to induce and maintain unconsciousness. These medical professionals also participate in life support, including monitoring vital signs, managing the patient's airway, and staging prompt interventions if necessary. Anesthesiologists are often treated as the patient's advocate in the operating room, keeping the patient stable during the procedure and informing the surgeon if the patient develops problems which could influence the procedure.
In the case of a surgery, the anesthesiologist meets with the patient before the procedure takes place to perform an interview and discuss the procedure with the patient. The anesthesiologist must determine whether or not the patient will be safe in surgery, and he or she will develop an anesthesia plan which is designed to keep the patient sedated and comfortable. Anesthesiology can include general anesthesia, in which the patient is totally unconscious, along with conscious sedation, regional anesthesia, and local anesthesia.
Postoperative pain management is also important for anesthesiologists, and these professionals also have to address concerns like awareness under anesthesia. Pain management is critical not only for quality of life, but also in healing, as patients who are not suffering from pain tend to heal more quickly. An anesthesiologist is also usually involved in the management of pain such as that associated with labor and delivery.
These care providers have to be very careful with the drugs they use. An anesthesiologist administers paralytic agents which prevent patients from breathing on their own, for example, along with drugs which can cause brain damage and severe medical complications if they are not administered properly. Anesthesiologists tend to have a very keen eye for detail and precision, and they are also extremely good at math and very calm under stress.
Anesthesia can be practiced by nurse anesthetists, anesthesia technicians, and anesthesia assistants. These care providers have various levels of training, and are sometimes able to act independently, while others must work under the supervision of a doctor. In all cases, the training includes extensive education in anatomy, physiology, chemistry, and biology.
Should the anesthesiologist know if you will be breathing on your own before he takes you off the ventilator?
BIS monitors have never been shown to decrease intraop recall, in any study ever performed. In theory they should, but they don't. Weird huh?
@ Alisha: Anesthesiologists need to go to school for 12 to 13 years after high school. A four year college degree, four years of medical school, and then four to five years of residency and specialization. Medical school is about 50K a year, plus living expenses. Expect to make 30 to 40K a year as a resident, and be on 24 hour call with sleep disruption and high stress during residency.
Finally, when you are near 30 years old, begin to practice your specialty. Also, Anesthesiology is relatively competitive to get into, so plan on being in the top 50 percent or third of your medical school class when you apply to anesthesia, as they pick and choose their trainees. You'd better really want it.
Also, prepare to fight for your job opportunities with Nurse anesthetists, who believe they should be able to do an anesthesiologist's job without supervision, and due to Obamacare, this is becoming more and more of a reality.
I am an anesthesiologist. Nobody wants anyone to have recall during surgery -- not the patient, anesthesiologist, surgeon, family, nurse, etc. BIS monitors, which are essentially pared down EEG units, show brain activity. In theory, they should help enable appropriate levels of sedation or unconsciousness to prevent recall. The reality is that no study -- except the studies performed by the BIS manufacturing companies -- has ever shown BIS monitors to reduce the rate of recall during surgery. Read that again!
This may be because some people create memories (like those who remember past lives), or insert your own reason. However, the good news is that most memory recall is of noise, not pain. Pain causes the heart rate and blood pressure to race up, usually long before consciousness is possible. Even small amounts of anesthesia gas cause amnesia in almost all people. Therefore, a patient having both consciousness and pain is extremely unlikely, since the heart rate and BP will shoot up, alerting the anesthesiologist that the body is reacting to pain. Hope this helps.
I have read that more people than we think wake up during surgery every day. They can't move or talk, so they just have to lie there in pain, or if they are not feeling pain, they still have to deal with the fact that they can see the surgeons working inside their bodies.
A few hospitals use BIS monitors, which let anesthesiologists know if someone is about to become conscious. The monitor reads brain waves, and the anesthesiologist watches it so that he can act accordingly if a change occurs.
What disturbs me is that only a fraction of hospitals in the United States even use these monitors. Anesthesiologists think they know when to administer more anesthesia, but apparently, they don't always know, and if these monitors were used at every hospital, we might never hear about people becoming alert during surgery.
@lighth0se33 – It really does make a patient more at ease. I had to have a kidney transplant eight years ago, and both my donor and I had to receive anesthesia beforehand.
The anesthesiologist seemed completely at home in this environment. He explained what would happen and what he was about to do to each of us, and he did so in a tone of voice that was both confident and reassuring.
He smiled a lot and just seemed very capable in general. I had been extremely nervous before he entered the room, but as he was administering the anesthesia, I felt much better about the whole procedure. He had managed to set my mind at ease.
I am a naturally nervous person, and when I feel like others are relying on me for something important, I become suddenly unable to function at my best. So, I am the type of person that a hospital would not want on its staff as an anesthesiologist.
It must take someone with a natural calm and a real confidence in their ability to do this job. I know that patients would feel a lot better before surgery if the person administering their anesthesia seemed very capable and relaxed.
An anesthesiologist career can be extremely rewarding financially. My cousin went through all the years of training to become one, and even though she is only in her late twenties, she now owns a nice home and a very nice car.
I always knew that finding a career that paid well would be important to her, because her family had been so well off. She had become accustomed to having nice things and being able to afford vacations to tropical paradise.
So, even though her work schedule involves long hours and she sometimes works six days a week, she can really enjoy the time that she does have off. I suppose the tradeoff is worth it.
@alisha-- A physician anesthesiologist who is a doctor has to go to school longer than a nurse or an assistant.
If you want to become a nurse anesthesiologist, you need to get a bachelors of science in nursing, followed by a masters degree. You also need a couple of years of experience at a hospital before you can start practicing. So I think that's like nine or ten years all in all after high school. For physicians it's even longer because they have to do a residency too.
In my opinion, the only true anesthesiologist is the physician anesthesiologist. Nurse anesthesiologists can administer anesthesia too, but they are not as knowledgeable as physician anesthesiologists. Physicians can also respond better to emergency situations during surgeries. If you are really interested in this field, I recommend that you become a physician anesthesiologist.
I'm interested in going to school for a medical profession. I haven't completely made up my mind yet, but I think I want to be an anesthesiologist.
Does the kind of classes I take in high school matter for this college degree and profession at all?
And in total, how long do anesthesiologists have to go to school for? Is it easier to be an anesthesiologist assistant or a nurse instead of a doctor? Which requires the least amount of education and/or training?
My mom used to be an anesthesiologist, an anesthesiology technician to be precise. She worked for close to twenty years before she switched to teaching.
My mom always tells me that the anesthesiologist is as important as the operating surgeon during a surgery. It's a difficult and stressful job because a small mistake on the part of the anesthesiologist could cost the patient his or her life.
My mom says that the most important part about being an anesthesiologist is calculating the amount of sedation to be given. It has to be calculated correctly because the patient should not wake up too soon or too late. Patients are supposed to wake up in a couple of hours after a surgery under general anesthesia is completed. That entire responsibility rests on the shoulders of the anesthesiologist.
I'm really proud of my mom in this regard. I don't think I could ever be an anesthesiologist because I don't do well in stressful environments.
I think it's important for patients to be aware of all the different levels in the medical profession. Nurse anesthetists are wonderful and well-trained, but they are not doctors.
When I was in labor with my first child, I requested an epidural. The first person who came in was a nurse anesthetist and she was training someone else and clearly very nervous about it! She kept explaining everything she was doing, but not with much confidence.
Well, I was not surprised when it turned out that the epidural had not been placed correctly and I got no relief at all! So then they sent in the anesthesiologist. I guess that's one of their roles -- to be the "buck stops here" person.
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