UTSW Dept. of Anesthesiology

2016-2017 First Quarter Resident Newsletter

Words of Wisdom

Dear Residents,

The Dalai Lama was asked what surprised him about humanity: “Man sacrifices his health in order to make money. Then he sacrifices money to recuperate his health. And then he is so anxious about the future that he does not enjoy the present; the results being that he does not live in the present or the future; he lives as if he is never going to die, and then dies never having lived.”

Words cannot fully express how much I appreciate your extraordinary gift - the framing of my father’s portrait and biography – and your comforting sympathy notes, beautifully bound together. Please stop by my office, at your convenience, to view the display. My father takes his place on the wall with the other men who have served as mentors and inspiring leaders to me: Buddy Giesecke and Pepper Jenkins. I can only hope and aspire to be such a man to all of you.

My father’s death has caused me to consider what is important. I believe the greatest realization I have had, in reflecting upon his life, is that he lived life and enjoyed every minute. I want this for each and every one of you.

I realize that being a physician and an anesthesiology resident comes with its own set of external stressors that are not easy to cope or deal with in all the circles of your life. Please be aware that our focus in the coming months is to make sure we are providing you with the supportive environment that you deserve in all aspects of your life so you can be a successful anesthesiologist while you “live life.” We value your feedback on this front and look forward to developing a cutting-edge program that will include educational initiatives and activities within the anesthesia resident houses, as well as small group activities which will foster behaviors that will allow you to live life to its fullest.

My hope is that, by doing the above, this will be my and my father’s greatest gift to you.

It is an honor and privilege to be your Chairman. Thank you for bringing so much joy to my life.

With much gratitude,

Charles W. Whitten, M.D.

Professor and Chair

Celebrating 8 Years as our Chairman

On Friday, September 16th we celebrated Dr. Whitten's 8th year as our Chairman. We are so proud and honored to be under his leadership and wish him many more years to come!
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2017-2018 Resident Recruitment Kick-Off Party

We kicked off the 2017-2018 Resident Recruitment Season Thursday, September 22nd at Dr. Tiffany Moon's home. This year we will be having recruitment lunches at Parkland and CUH instead of Sprague to make your attendance easier - we really rely on you during this time!

We will be conducting interviews on the days below. Please discuss with your Chiefs and arrange time away with your rotation directors if you would like to participate in lunches!

November: 15th, 17th, & 22nd

December: 1st, 6th, 8th, 13th, 20th, 27th, & 29th

January: 3rd, 7th (tentative), 10th, 12th, 17th, 19th, 24th, 26th, & 31st

Global Health Initiative

Alexa Kaminski and Amber Benhardt traveled to China with Dr. Weike Tao in June for a once in a lifetime experience teaching physicians and nurses in the obstetric arena, emphasizing improvement on the safety of mother and baby. We are so proud of all three of them!

The link below will take you to an article on the "No Pain Labor and Delivery Global Health Initiative" and the group's most recent trip.

ASA Monitor - Dr. Koepke

Please take a moment to congratulate Dr. Elena Koepke, MD, MBA on her published article "Why Involvement in Your State Society Is Invaluable: A Resident's Perspective" in the June edition of the ASA Monitor. We are very proud of her!

The link below will take you to a PDF version - take a moment to read her work!

October Resident Meeting - Systems Based Practices (Private Sector)

The October Resident Meeting will be on October 19th from 5:00 - 7:00 PM and will focus on the business of private practice. We will invite members of the private sector to speak to us about the actual business of anesthesiology and how it differs from the academic sector. This meeting will provide you with invaluable information as you plan for the next step in your career as an anesthesiologist

Mock Applied Exam (Oral & OSCE) February 28th

Dr. Bhoja will be hosting Mock Applied Exams for CA-3's preparing to take their ABA Boards this coming July. The day will be broken up into two sessions, 8 participants each, which will include 8 OSCE and Oral Board stations split up by a 10 minute break just as you will experience when taking the real exam. Please be on the lookout for more information forthcoming!

Research & QI/PS Project Opportunities

Below is a minor list of current research and QI/PS projects across the department. Please reach out to the lead PI if you are interested in joining the team.

*complete database of ongoing projects, linked to MedHub, is forthcoming*

Project: The EvK Clinical Trial

Website: www.evktrial.org

PI: G. Matchett

Study Team: The Parkland General Anesthesiology Division in collaboration with Critical Care Medicine, Surgical Critical Care, many others

Pre-Requisites: None. Parkland Chiefs in the Main O.R. are helping to enroll patients, will be briefed during your chief month.

Summary: In this IRB-approved, prospective randomized clinical trial we are randomizing patients to receive either Etomidate versus Ketamine (EvK) immediately prior to emergency endotracheal intubation. The goal of the study is to clarify lingering questions about etomidate-associated morbidity in critical illness. We are making excellent progress with study enrollment, currently enrolling at a rate of about 20 patients per month. We anticipate a mature dataset in the first or second quarter of 2018. Any resident who helps with study enrollment will receive author credit on the study manuscript.

Project: EMR Intraoperative Handoff

PI: T. Bryson

Study Team: Jia Romito

Pre-requisites: None

Summary: Develop a tool to help standardize handoff information in EPIC

Project: Perioperative OSA Recognition

PI: W. Lee (Pulmonary)

Study Team: Trent Bryson

Pre-requisites: None

Summary: Improve identification of, care provided to, and patient education of sleep apnea in the perioperative setting.

Project: Resident Education Calendar

PI: T. Bryson

Study Team: None

Pre-requisites: None

Summary: Improve faculty and resident access to and knowledge of resident education calendar and utilize tools within EPIC to improve daily knowledge of resident learning topics.

Project: Factors of Chronic Pain Interventions (IRB)

PI: H. Rana

Study Team: None

Pre-requisites: None

Summary: Looking at whether certain psychosocial traits or expectations affect response to chronic pain intervention. Will involve giving patients pre and postop a questionnaire and certain validated tools to determine if there are certain factors that result in poor response to pain intervention.

Project: Cocaine and General Anesthesia Study

PI: T. Moon

Study Team: None

Pre-requisites: None

Summary: This study aims to be the largest prospective study evaluating the effects of cocaine use on general anesthesia. In particular, I am looking for hemodynamic instability, levels of inflammatory biomarkers, levels of cardiac biomarkers (troponin), and anesthetic requirements in cocaine positive vs. negative patients. The results of this study will provide guidance for the safe surgical care of this group of patients. It will also provide preliminary clinical insights into activation of the inflammatory cascade and anesthetic requirements in surgical patients who abuse cocaine. We started enrolling patients in June and have almost 50 positive cocaine patients. Our target enrollment is 150 cocaine positive patients.

Project: Obesity Airway Study

PI: T. Moon

Study Team: None

Pre-requisites: None

Summary: Controversy exists in the literature on whether BMI alone is a predictor of difficult intubation. In this study, we measure a number of anatomical parameters (neck circumference, thyromental distance, jaw protrusion, etc.) and use a validated index called the Intubation Difficult Score to grade how difficult intubation is. We plan to use a multivariate regression analysis to see which of the factors, alone or in combination, is most predictive of the patients who are difficult to intubate. We also separate subjects into weight based categories (lean, obese, morbidly obese) to see if BMI is associated with difficult intubation. Our power analysis showed we need an n of 1200-1500 for this study and to date, we have 1050 subjects. I plan to reach target enrollment in early 2017 and will begin statistical analysis and drafting of manuscripts and abstracts after that.

You need to know.....

Dr. Wanat has worked tirelessly over the past 3 months to update all of the rotation specific documents for everyone on MedHub. These include anything from rotation expectations to goals and objectives to reading materials and beyond. All documents can be found under Resources/Documents > Residency Rotations.

We are so pleased to announce the addition of Learnly START and Learnly Foundations to our program beginning October 1st. All CB's, CA-1's, and 2017 CA-1's have received their account login information and will be expected to use this self-paced, BASIC curriculum online education system as the preferred method of learning over Moodle. In the coming weeks please look for more detailed information and a detailed implementation schedule from Dr.'s Barden, Wanat, and Liang.

Access to Anesthesia Toolbox will be sent to all residents when it becomes available within the first few weeks of October.

OpenTempo is now our source of truth for your contact information. Please make sure you have updated your pager and cell phone number in OpenTempo to make it easier to reach you.

June 2016 Vapor Camp Photos

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Motivation Station