What does an anesthesiologist do?

What is an Anesthesiologist?

If you think that you'd like the operating room environment versus doing rounds, and would be ok handling the occasional emergency, anesthesiology might be for you.

An anesthesiologist is a medical doctor who keeps a patient comfortable, safe and pain-free during surgery by administering local or general anesthetic. Once the patient enters the operating room, an anesthesiologist will be by their side throughout the surgery, making sure they are stable right through to the post-anesthesia care unit.

Anesthesiology is a prestigious and lucrative field of medicine, but requires a great deal of education and expertise.

What does an Anesthesiologist do?

An anesthesiologist will meet with the patient prior to surgery to make sure they are suitably prepared and medically fit to endure the proposed surgery as well as the related anesthetic. Once they have done this, just before the surgery, the anesthesiologist will administer either a general or local anesthetic to the patient.

During the surgery, the anesthesiologist will monitor the patient's blood pressure, heart rhythm, temperature, level of consciousness, and amount of oxygen in the blood. For a general anesthetic, the anesthesiologist will monitor each breath. This is done by measuring the volume of breath exhaled and the amount of carbon dioxide in each breath. They may also measure the amount of blood the heart is pumping and blood pressure inside the lung vessels.

After putting the patient to sleep, the anesthesiologist will adjust the patient's position if necessary, depending on the surgery being performed. For example, a back operation will require a different position than a stomach operation. Also checking to make sure a patient doesn't have his legs crossed is important, as the patient can potentially sustain nerve damage if the legs are crossed for the duration of a long operation.

Some of the anesthesiologist's duties during surgery include:
- Continuous monitoring of vital signs
- Monitoring of the level and depth of anesthesia
- Making adjustments if necessary
- Recognition of any potentially life threatening emergencies and timely intervention
- Ensuring the safety of the patient at all times

They may also work with patients who need pain management for other issues outside of the operating room and delivery room. They provide after care for patients who have had surgery and still require some sort of pain management. They may also work in emergency rooms, and help with patients who need immediate pain relief or sedation.

Anesthesiology, like all medical disciplines, is sufficiently complex that it is divided into several subspecialties. While initially trained in anesthesiology as a whole, as they move through residency training, anesthesiologists choose to specialize in a particular area.

The following are some subspecialties within anesthesiology and a brief outline of the responsibilities involved for each:

Cardiothoracic Anesthesiologist
This type of anesthesiologist has advanced training specifically dedicated to cardiac and thoracic anesthesia involving the heart and lungs, and whose responsibility it is to make the perioperative period both safe and comfortable for the patient.

Cardiothoracic anesthesiologists provide anesthesia for operations of the human chest, which may include bypass surgery (includes supervision of the bypass heart-lung machine), robotic surgery, minimally invasive surgery, and complex aortic surgery. They also keep an eye on the patient's bodily reactions to drugs during surgery.

Cardiothoracic anesthesiologists may also work with non-cardiac procedures, like performing ultrasound assessments for cardiac health, electrophysiology consulting for the reprogramming of pacemakers and implantable cardioverter-defibrillators (ICD), esophageal resection, and various types of video-assisted thoracoscopic surgery.

They often conduct research to help improve anesthesia and patient care during surgery and study medicines and ways for caring for heart patients before, during, and after an operation.

Critical Care Anesthesiologist
Some anesthesiologists pursue advanced training to subspecialize in critical care medicine in both adult and pediatric hospitals. Because of their comprehensive training in resuscitation and in clinical physiology and pharmacology, anesthesiologists are particularly suited to administering to patients in the intensive care unit.

Critical care anesthesiologists are able to coordinate the medical assessment, diagnosis, respiratory/cardiovascular support, and pain control needed by ICU patients - as well as provide airway management, advanced life support, and cardiac and pulmonary resuscitation in many emergency and trauma situations. They also play a vital role in stabilizing and preparing patients for emergency surgery.

Neurosurgical Anesthesiologist
Like other anesthesiologists, neurosurgical anesthesiologists provide anesthesia in the operating room, but specialize in the anesthetic management of patients with various conditions of the central nervous system, the brain, and the spine.

Anesthetic management is needed for aneurysms, head injuries, pediatric neurosurgery, spine surgery, arteriovenous malformations, intracranial tumors, stereotactic procedures, and neuroradiological procedures.

These types of procedures not only require having a solid understanding of neuroanatomy and neurophysiology, but require the knowledge base to measure intracranial pressure, cerebral blood flow, and cerebral metabolic rate.

Obstetric Anesthesiologist
An obstetric anesthesiologist works closely with obstetricians, perinatologists, midwives, neonatologists and labor and delivery nurses in order to give quality care for pregnant women and their babies.

Obstetric anesthesiologists serve in labor and delivery, ready to assist in the management of pain of labor and delivery, to administer anesthesia for cesarean section, and to manage emergencies that may arise.

They discuss pain management options with the mother, and administer an epidural anesthetic if the mother decides that she wants it. They watch over the mother and if the labor is long, or the epidural wears off, they provide another dose.

Pediatric Anesthesiologist
Children are not small adults and no child is exactly the same. Pediatric anesthesiologists focus on providing an individualized experience for each child, based on his or her needs. After surgery, pediatric anesthesiologists are involved in prescribing pain medication or recommending pain-relieving techniques for each child that is best for providing comfort and rest for optimal recuperation.

Pediatric anesthesiologists are also involved in caring for children during radiological imaging or scanning procedures, gastrointestinal procedures, and other non-surgical treatments that require a cooperative and motionless patient.

Other careers within anesthesiology (not physicians):

Nurse Anesthetist
A nurse anesthetist (or a certified registered nurse anesthetist (CRNA)), is someone who has completed graduate-level education and has been board certified in anesthesia.

They are capable of administering anesthesia under the oversight of an anesthesiologist, surgeon, dentist, podiatrist or other qualified healthcare professional. Some nurse anesthetists hold credentials in fields such as respiratory care or critical care nursing, and some choose to specialize in obstetric, neurosurgical, pediatric, dental or cardiovascular anesthesia services.

They are independently licensed health professionals, and are often the sole providers of anesthesia services that offer surgical, obstetrical, and trauma stabilization services in rural hospitals and areas where it would otherwise not be possible.

Anesthesiologist Assistant
An anesthesiologist assistant (not to be confused with a nurse anesthetist) is a non-physician anesthesia provider who practices anesthesia under the medical direction of an anesthesiologist.

The assistant will operate anesthesia equipment, monitor patients, and provide quality anesthesia care. Anesthesiologist assistants accompany the patient before, during and after anesthesia to ensure quality and continued care. They are trained to assist in life-saving measures, such as CPR, and life support.

What is the workplace of an Anesthesiologist like?

Anesthesiologists often work in high stress situations, where a great deal of concentration and alertness is necessary, such as in the operating room. They also work in many outpatient facilities, and they will often have to work with people who are recovering from an operation, or those who need pain management treatment.