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You are in Home >> Exams >> Syllabus: Primary, Final & FCAI

Primary syllabus: Anaesthesia and resuscitation

Created: 7/9/2004

Candidates should be able to demonstrate a good understanding of the fundamentals of clinical anaesthetic practice, with an ability to discern when more senior assistance will be required.

Anaesthetic equipment and safety

Physical principles underlying the function of the anaesthetic machine, pressure regulators, flowmeters, vaporisers, breathing systems. Absorption of carbon dioxide
Principles of lung ventilators, disconnection monitors
Manufacture and storage of oxygen, nitrous oxide, carbon dioxide, compressed air.
Pipeline and suction systems, gas cylinders
Humidification devices
Minimum monitoring requirements
Environmental control of the operating theatre including scavenging systems for waste
anaesthetic gases and vapours
Pre-use checks of anaesthetic machine, breathing systems and monitoring apparatus
Anaesthetic records and critical incidents
Function and use of related anaesthetic and resuscitation equipment including that used for regional anaesthesia. Airways, tracheal tubes, tracheostomy tubes, laryngeal masks, oxygen therapy equipment, self-inflating bags, spinal and epidural needles, intravenous cannulae and transfusion devices
Sterilisation and cleaning of equipment

Preoperative assessment

Implications for anaesthesia of more common medical conditions. In particular, respiratory
diseases (e.g. asthma, chronic obstructive airway disease), cardiac disease (e.g. angina pectoris, valvular disease, myocardial infarction, pacemakers, arrhythmias), vascular disease (e.g. hypertension), sickle cell disease and anaemias, rheumatoid arthritis, renal dysfunction and insufficiency, plasma electrolyte disturbance (e.g. hyper- and hypokalaemia), diabetes mellitus, liver disease
Implications for anaesthesia of more common surgical conditions, trauma, intestinal obstruction and acute abdominal emergencies
ASA classification and other pre-anaesthetic scoring systems such as Glasgow Coma Scale
Interpretation of relevant preoperative investigations, plasma electrolytes, haematology, disturbances of acid/base status, ECG, X-rays, pulmonary function tests and clotting abnormalities
Preoperative assessment of a patient of any age (excluding neonates) for elective or emergency surgery
Restriction of food and fluid by mouth, cessation of smoking, correction of dehydration
Assessment of difficulty of tracheal intubation
Precautions in the management of the infective patient (e.g. hepatitis B positive or HIV positive)
Anaesthetic implications of current drug therapy such as beta blockers, antihypertensive drugs, tricyclic antidepressant agents and monoamine oxidase inhibitors, insulin, anti-diabetic drugs, anticoagulants, contraceptives
Assessment of postoperative analgesic needs


Rationale for premedicant drugs. Choice of drugs, advantages and disadvantages


Intravenous and inhalational induction of anaesthesia; advantages and disadvantages,
Recognition and management of anaphylactic and anaphylactoid reactions, including follow-up and patient information
Indications for tracheal intubation
Management of difficult intubation and failed intubation
Recognition of correct placement of tracheal tube, oesophageal and endobronchial intubation, complications
Causes of regurgitation and vomiting during induction, prevention and management
Technique of cricoid pressure; pulmonary aspiration
Induction of anaesthesia in special circumstances, head injury, full stomach, upper airway obstruction


Ability to deal with emergencies before, during and after anaesthesia and the ability to stabilise a patient's condition until senior assistance can be obtained.
Techniques of maintenance of anaesthesia. To provide adequate analgesia using opioids and other analgesic drugs. To prevent awareness. Management of appropriate intermittent positive pressure ventilation. Airway control. Intraoperative fluid therapy. Minimal monitoring
Diagnosis and management of important critical incidents during anaesthesia including: cyanosis, hypertension, hypotension, cardiac arrhythmias, bronchospasm, respiratory obstruction, increased peak inspiratory pressure, hyper- and hypocarbia, failed intubation, failed reversal
Management of massive haemorrhage, volume expansion, blood transfusion (hazards including incompatibility reaction), gas embolism, malignant hyperthermia
Correct intraoperative positioning on theatre table - complications, prone position
Diagnosis and treatment of pneumothorax


Causes and treatment of failure to breathe at end of operation, suxamethonium apnoea management
Care of the unconscious patient
Recovery room diagnosis and treatment of inadequate pulmonary ventilation, cyanosis, hypo- and hypertension, shivering, stridor. Oxygen therapy, indications and techniques
Methods of pain management. Assessment of pain and analgesic techniques
Prevention, diagnosis and treatment of postoperative pulmonary atelectasis, deep vein thrombosis and pulmonary embolus
Postoperative fluid therapy
Causes and treatment of postoperative nausea and vomiting
Minor and major adverse sequelae to anaesthesia and their management

Anaesthesia in special circumstances

Principles of obstetric anaesthesia
Principles of the care of children (excluding neonates and infants) undergoing anaesthesia for straightforward surgical procedures, including ENT, eye and dental operations
Principles of general anaesthesia for simple ophthalmic procedures and a penetrating eye injury
Patients with a pacemaker
Advantages and problems associated with day surgery, appropriate anaesthetic techniques
Principles of neurosurgical anaesthesia as applied to the management of the head-injured patient
Problems of anaesthesia in the obese patient
Repeat anaesthesia - hepatic injury
Implications for the anaesthetist of viral hepatitis and HIV infections
Laparoscopic and minimally invasive procedures
Management of patients requiring transfer

Regional anaesthesia

Indications, technique and management of the complications of spinal and epidural (including caudal approach) analgesia. Techniques including intravenous regional anaesthesia, brachial plexus block, femoral nerve block, inguinal field block, ankle block and dorsal nerve of the penis block
Local anaesthesia for awake tracheal intubation


Immediate care and resuscitation in patients of all ages. The guidelines promulgated by the European Resuscitation Council and the Resuscitation Council [UK] will be followed. The syllabus will include:

Patient assessment

The principles and practice of life support
The principles and practice of recognition and management of life-threatening arrhythmias including defibrillation and drug therapy
The techniques of venous access and the intraosseous route
Management of the airway and ventilation in the emergency situation, including care of cervical spine
Specific problems in paediatric resuscitation
Ethical aspects of resuscitation


Pathophysiology of trauma and hypovolaemia
Assessment, immediate care and management of trauma patients of all ages
Performance and interpretation of the primary and secondary survey
Immediate specific treatment of life-threatening illness or injury, with special reference to thoracic and abdominal trauma
Care of cervical spine injury
Emergency airway management and oxygen therapy
Cannulation of major vessels for resuscitation and monitoring
Management of hypovolaemic shock
Chest drain insertion and management
Pain management in trauma victims


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