Sleep Study

[SoonerTexan]

What's the difference between the two types?

[alotofyarn]

What's the difference between the two types?

Cardiac anesthesiologists just have additional training. I think it's an additional fellowship year after the pediatric anesthesia fellowship, but I'm not 100% sure.

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[scrub-jay]

Peds Anesthesia and Cardiac Anesthesia are their own 1-yr fellowships. Peds Cardiac anesthesia do exist, but it’s not a separate accredited fellowship, it’s a sub-sub specialty that can be achieved different ways.

Anesthesiology choices aren’t really cardiology’s call, you should discuss with your surgeon AND with the anesthesiologist themselves. Anesthesiology is its own speciality for a reason and someone should probably ask them what they say about what kind of anesthesia is needed. Do they do a pre-anesthesia clinic at the hospital? That’s where cardiology’s recommendations, health history, pertinent labs are all reviewed and a detailed anesthetic plan is outlined. Part of the plan would be the anesthesia team deciding who the best anesthesiologist for the case would be.

[MrsC]

^^I agree with this^^
You may get the same answer because it's not a cardiac surgery but I would definitely ok this with anesthesia first.

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[alotofyarn]

Peds Anesthesia and Cardiac Anesthesia are their own 1-yr fellowships. Peds Cardiac anesthesia do exist, but it’s not a separate accredited fellowship, it’s a sub-sub specialty that can be achieved different ways.

Anesthesiology choices aren’t really cardiology’s call, you should discuss with your surgeon AND with the anesthesiologist themselves. Anesthesiology is its own speciality for a reason and someone should probably ask them what they say about what kind of anesthesia is needed. Do they do a pre-anesthesia clinic at the hospital? That’s where cardiology’s recommendations, health history, pertinent labs are all reviewed and a detailed anesthetic plan is outlined. Part of the plan would be the anesthesia team deciding who the best anesthesiologist for the case would be.

Thanks for clarifying! We did discuss with both - we first discussed with ENT, and she thought cardiac anesthesia was appropriate, but the anesthesia NP we met with afterward in the preop clinic did not. All hospitals have different protocols, and our previous hospital used cardiac anesthesia for all single ventricle kids until their Fontan (3rd surgery, which C hasn't had), and then use general pediatric anesthesia afterward as long as they are healthy/stable. So, when C had his surgery for tubes/circumcision, he had cardiac anesthesia, even though it wasn't a cardiac case. The protocol here is to use cardiac anesthesia until after the Glenn (2nd surgery, which C has had). I wasn't aware of that going into the appointment, so I was surprised by it. But, now that I've talked to anesthesia and his cardiologist, I feel more comfortable with it.

[scrub-jay]

Sleep Study

Eh, nm.

[alotofyarn]

Did you get to chat with a physician anesthesiologist or just the CRNA? In your shoes, I’d be pushing for a physician anesthesiologist in the room.

ETA: Yes, there is a big rivalry between CRNAs and physician anesthesiologists. CRNA programs have renamed themselves as “doctoral” programs, so some introduce themselves as Dr. So and so. With complicated cases, I highly recommend pushing for an anesthesiologist, not an anesthetist.

She told me she was a NP with anesthesia, I think? Definitely not a doctor, although she seemed knowledgeable enough about his history. C's cardiologist did talk to the cardiac anesthesia team about it afterward as well and confirmed that the pedi general anesthesiologists are familiar with his single ventricle physiology, plus the cardiac anesthesiologists will be available in case anything does come up.

[scrub-jay]

She told me she was a NP with anesthesia, I think? Definitely not a doctor, although she seemed knowledgeable enough about his history. C's cardiologist did talk to the cardiac anesthesia team about it afterward as well and confirmed that the pedi general anesthesiologists are familiar with his single ventricle physiology, plus the cardiac anesthesiologists will be available in case anything does come up.

This sounds good. I’d also be comfortable knowing that cardiac and Peds anesthesia have been looped in on C’s case. I suspect the Peds anesthesiologist they have in mind is probably the best choice.

[alotofyarn]

Surgery is tomorrow!

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[Meenah]

Thinking of you and your family.

[OrionGrad]

Thinking of you guys!

[scrub-jay]

Good luck!

[alotofyarn]

Everything went well! He's resting comfortably and will spend the night in the hospital for monitoring because of his heart.

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[SoonerTexan]

Glad it was uneventful. Hope the little dude starts feeling better soon

[scrub-jay]

Great news!