is the practice of medicine dedicated to the relief of pain
and total care of the surgical patient before, during and
of today's anesthesiologists has kept pace with their expanding
role in offering the highest quality health care available
anywhere in the world. After completing a four-year college
program and four years of medical school, they enter a four-year
anesthesiology residency training program. Fellowships in
an anesthesia subspecialty and in education or research
may also be taken for an additional year.
More than 90
percent of the active membership of the American Society
of Anesthesiologists have been certified as diplomates of
the American Board of Anesthesiology.
responsibilities to patients include:
evaluation and treatment;
B. Medical management of patients and their anesthetic
C. Postanesthetic evaluation and treatment;
D. On-site medical direction of any nonphysician who assists
in the technical aspects of anesthesia care to the patient.
expertise of this specialist has caused a dramatic expansion
of the role of the anesthesiologist. Although historically,
anesthesiologists have been known primarily as physicians
who administer anesthesia to alleviate pain and suppress
consciousness of the patient undergoing surgery, they also
provide medical care and consultations in many other settings
and situations in addition to the operating room. In recent
years, many anesthesiologists have dedicated their careers
to the treatment of acute, chronic or cancer pain.
anesthesiologist is the perioperative physician ("peri-"
meaning "all-around") who provides medical care
to each patient throughout his or her surgical experience.
This includes medically evaluating the patient before surgery
(preoperative), consulting with the surgical team, providing
pain control and support of life functions during surgery
(intraoperative), supervising care after surgery (postoperative)
and medically discharging the patient from the recovery
Care Team Approach
has the reputation for delivering the highest quality of
anesthesia services for all types: elective and emergency
surgery. The main purpose for the establishment of AAFL
was that this level of service be provided at any time.
The implementation of the team care concept, we feel, is
the means of providing each patient with the best coordinated,
idividual care. We then can concentrate particular resources,
both personnel and equipment, wherever and whenever necessary.
The members of AAFL consist of both Anesthesiologists and
Certified Nurse Anesthetists.
40 million anesthetics are administered each year in this
country. Anesthesiologists provide or participate in more
than 90 percent of these anesthetics. In the operating room,
they are responsible for the medical management and anesthetic
care of the patient throughout the duration of the surgery.
The anesthesiologist must carefully match the anesthetic
needs of each patient to that patient's medical condition,
responses to anesthesia and the requirements of the surgery.
Within the confines
of the operating room suite, which is often comprised of
several separate operating rooms, the activities of the
anesthesiologist are seen by few people outside of the surgical
and nursing team. Even the patients themselves are unable
to recall much of their involvement with this vital specialist
because most of the anesthesiologist's critical work is
done while the patient is anesthetized! The role of the
anesthesiologist in the operating room is to:
continual medical assessment of the patient;
and control the patient's vital life functions -- heart
rate and rhythm, breathing, blood pressure, body temperature
and body fluid balance; and
the patient's pain and level of unconsciousness to make
conditions ideal for a safe and successful surgery.
to direct patient care, the anesthesiologist is often responsible
for managing the resources of the operating suite, including
the efficient use of operating rooms, supplies, equipment
In the postanesthesia care unit (recovery room):
This is where
patients are transferred after surgery, allowing them to
emerge fully from the effects of the anesthesia under the
watchful eyes of skilled nursing personnel with anesthesiologist
consultation immediately available. While safety is of course
the foremost priority during surgery, it is also of utmost
concern that the patient be monitored and continually assessed
while fully recovering from the anesthesia. In most cases,
the anesthesiologist decides when the patient has recovered
enough to be sent home following outpatient surgery, has
been stabilized sufficiently to be moved to a regular room
in the medical facility or should be transferred to an intensive
to the patient's pain being relieved or blocked entirely
during a surgical procedure, it is equally important to
provide adequate pain relief postoperatively for the patient's
comfort and well-being. After surgery, the anesthesiologist
is involved in prescribing pain-relieving medication and
techniques that are best for each individual patient to
maintain a level of comfort and to allow proper rest.
their specialty training, anesthesiologists are uniquely
qualified to prescribe and administer drug therapies for
acute, chronic, cancer and childbirth pain. In childbirth,
the anesthesiologist manages the care of two people, providing
pain relief with epidural or spinal blocks for the mother
while managing the life functions of both the mother and
the baby. Anesthesiologists also have been in the vanguard
of those developing new therapies for chronic and cancer
care and trauma medicine:
As an outgrowth
of the postanesthesia care unit, critical care units are
now found in all major medical facilities throughout the
country. The role of the anesthesiologist in this setting
is to provide medical assessment and diagnosis, respiratory
and cardiovascular support, and infection control.
also have the medical background to deal with many emergency
situations. They provide airway management, cardiac and
pulmonary resuscitation, advanced life support and pain
control. As consultants, they play an active role in stabilizing
and preparing the patient for emergency surgery.
During cardiac laboratory procedures:
In most institutions, anesthesiologists are available during
cardiac catheterizations and angioplasty procedures for
emergency airway management or resuscitation if necessary.
diagnostic procedures and nonsurgical treatments:
As medical technologies
have advanced, so has the need for anesthesiologists to
become involved in caring for patients during radiological
imaging or scanning procedures, endoscopies, in vitro fertilization,
lithotripsy procedures, electroshock treatment, nutritional
support and respiratory therapy.
AND CLINICAL STUDIES
Some of the
most significant strides in medicine and surgery have been
directly attributable to anesthesiology's advances in patient
monitoring, improved anesthetic agents and new drug therapy.
Anesthesia research at the clinical and basic science levels
has been done almost exclusively by anesthesiologists or
Ph.D. scientists with the goal of continually improving
patient care and safety.
conducted in each of the subspecialties of pediatric, geriatric,
obstetric, critical care, cardiovascular, neurosurgical
and ambulatory anesthesia. Other areas of study include:
blood transfusions and fluid therapy, infection control,
difficult airway management, cardiopulmonary resuscitation,
complications, new devices and methods of monitoring, pharmacology,
pain therapy and organ transplant.
from anesthesia have declined dramatically over the last
25 years. Since 1970, the number of anesthesiologists has
more than doubled and, at the same time and at virtually
the same rate, patient outcomes have improved. In just the
last decade, estimates for the number of deaths attributed
to anesthesia have dropped 25-fold from 1 in 10,000 anesthetics
to less than 1 in 250,000 today.
All this has
occurred during a time when the youngest of premature infants
in neonatal units survives intricate, lifesaving procedures
and 100-year-old patients undergo and recover from major
surgeries that were once thought to be impossible.
AND LEGISLATIVE ACTIVITIES
through their national professional organization, the American
Society of Anesthesiologists (ASA), participate in many
continuing medical education programs and legislative activities.
largest international educational program for anesthesiologists
-- a five-day ASA Annual Meeting with an attendance of more
refresher courses for continuing medical education during
the ASA Annual Meeting and regional courses and workshops
throughout the year.
and applications of new knowledge in the areas of patient
safety, standards of care, practice guidelines and quality
programs and materials about the current and emerging technologies
in anesthesiology to help the public make educated choices
about their anesthesia or pain management care.
and regulatory activities at the state and national levels
through the ASA Washington Office.