IAPA Fellowship

IAPA Fellowship

Paediatric Anaesthesia Fellowship of IAPA

  • Name of the Fellowship : Paediatric Anaesthesia Fellowship
  • Duration of Course : 12 months.
  • Target Group : Anaesthetists with M.D.(Anaesth)/D.N.B.(Aneasth)
  • Curriculum :
    1. Programme Goals :  To enable Anaesthesiologists to recognize the anatomical, physiological and psychological differences in the sub-set of Paediatric patients. To train anaesthesiologists adequately to ensure safe delivery of anaesthesia to this vulnerable group of patients.
    2. Medical Knowledge and Cirriculum :
      1. Physiology of the neonate, the premature and childdren.
      2. Anatomic variations in neonates and children.
      3. Pharmocology and variations in neonates and children
      4. Difficult airway management and devices used
      5. High risk pregnancies: Pre-eclampsia, gestational diabetes, jaundice, thyroid deficiency etc.
      6. High risk children: Those on ventilators, those with heart diseases, severe asthma etc.
      7. Neonatal and pediatric emergencies: NEC (necrotizing enterocolitis), Diaphragmatic hernia, trachea-esophageal fistula, volvulus, torsion testis, appendicitis etc.
      8. Bronchoscopy for foreign body
      9. Fluid management in neonates, children and high risk patients.
      10. Local Anaesthetic Pharmacology as applied to children and neonates
      11. Neuraxial & systemic opioids, NSAID's, and non-opioid adjuncts for analgesia in children and neonates.
      12. Spinal, Epidural, Caudal and Combined spinal epidural (CSE) Anaesthesia for pediatric and neonatal usage.
      13. Complications of anaesthesia and regional blocks in children : Recognition & Treatment
    3. Anaesthesia for following Surgeries: All surgeries in children and neonates including various sub-specialties. Paediatric surgery including neonatal surgeries, laparoscopic surgeries both in children and neonates; Plastic surgery including burns and cleft lip/palate; Dental surgery; ENT surgery including trachesotomies and bronchoscopy; Neurosurgery including VP shunts, trauma etc.; Orthopaedic surgery including congenital malformations and trauma
    4. Skills to be achieved during the course: Placement of peripheral IV lines, placement of central lines, spinals, epidurals, caudals, peripheral nerve blocks. Management of difficult airway and use of alternative devices.
    5. Academics : Active participation in weekly classes, monthly perinatal meetings with obstetricians, weekly pediatric meetings along with paediatricians, annual paediatric anaesthesia meeting and other CMEs
    6. Evaluation Process : Six monthly examinations (written and viva-voce) and maintenance of log book. Exit exam to be evaluated by IAPA
    7. Research: One study and/or one case report to be published (or submitted for publication), by the end of the course
    8. Log Book: A detailed log of all cases and procedures done to be documented
    9. Stipend: A stipend of not less than what a DNB candidate is paid in that city for a fellowship. Though individual hospitals are free to pay above the minimum.
    10. Selection Process: Eventually by a centralized process, through IAPA, but now each accredited institution can select on its own.
    11. Rotation: Rotation to PICU and NICU for 2 weeks each.
  • Institution framework : The hospital should have a full fledged paediatric and neonatal departments including NICU and PICU. There should be round the clock availability of paediatrician and Anaesthesthesiologist. A minimum of 75 paediatric surgeries should be done per month (including all sub-specialties like ENT, Dental etc). There should be reasonable equipment and monitoring available for safety of the anaesthesia process. (a list of essential equipment and monitoring can be compiled)
  • Utility: On completion of course, fellows should be able to incorporate the latest advances in anaesthesia in the sub-specialty of paediatrics and perform safe surgeries in children and neonates, thus help reduce Child Mortality.

Essential Equipment to be available:

  • Each patient Monitoring: NIBP, ECG, SaO2, ETCO2, Temperature and availability of invasive monitoring
  • Transport monitor and incubator.
  • Defibrillator (one for the OT complex)
  • Warming devices: Blowers, OT temperature adjustment, radiant warmers, fluid warmers etc.
  • Difficult airway equipment: LMA, other supra-glottic airway devices, nasopharyngeal and oral airways of all sizes
  • Desirable equipment: Portable ultrasound, Stimuplex (for nerve blocks), PNS (for twitch monitoring of relaxant reversal), fibre-optic bronchoscope (size 2.2, 2.7 etc)
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