The Thoracic Anesthesia team provides services for all the intrathoracic non-cardiac surgery and for procedures involving the airway. The volume of interventional pulmonary medical procedures including rigid bronchoscopies and stent placements has increased dramatically over the past few years. The addition of a tracheal reconstruction surgeon was accompanied by a rise in reconstructive procedures, making BIDMC a national referral center for tracheobronchioplasties. Residents complete a one-month rotation as a CA-2, and may return for further experience as a CA-3.
This is a great rotation for CA-2 and CA-3's. Many of the patients will need arterial lines, thoracic epidurals, double lumen tubes, bronchoscopy, and central lines - all of which are done by the resident.
There is usually one-on-one attending coverage, offering residents a wonderful learning opportunity in the clinical setting. Cases can range from VATS to esophegectomies to trancheobronchioplasties.
A Day in the Life
"Thoracic surgery cases often need extra preparation/procedures, so our days start a bit earlier to make sure all necessary equipment is available and lines can be placed in a timely manner. Typical procedures include lung resections via open thoracotomy or video-assisted thoracoscopy and mediastinoscopies. Communication with the surgical team the evening before is ideal, especially if there are any issues/concerns about the patient’s co-morbidities or pulmonary status.
You will also have the experience of learning to perform anesthetics on extremely sick, pulmonary cripples that may not be candidates for other surgical procedures. We have a very active interventional pulmonary team that gives us an opportunity to learn how to share the airway. It is imperative to have close and clear communication with the interventionalists before and during the procedure. Typical procedures include flexible or rigid bronchoscopies and thoracoscopies." - Susie Jang, CA-3