title: Training, skills and approach to potentially difficult anaesthesia in general practitioner anaesthetists.
abstract: Seventy-six of the 92 practising South Australian rural general practitioner anaesthetists responded to a questionnaire on anaesthetic training, skills and approach to potentially difficult anaesthesia. The mean training period in anaesthesia was 7.5 months, 24% at registrar level. Eight per cent had no training, and 40% had 3 months or less. Thirty-three per cent trained exclusively overseas and 13% hold a Diploma in Anaesthesia. A total of 11,400 anaesthetics were performed by 76 general practitioners in 1992 at an average of 152 (range 2 to 1500). The mean visual analog "comfort score" in performing anaesthesia was 6.6 and correlated best with the number of procedures per year (r = 0.32, P = 0.03). Forty-six per cent of general practitioners provided anaesthesia for the 0 to 12 month age group, and only 35% had regional skills to use in obstetric anaesthesia. Patients classified as ASA grade 3 to 5, disease states such as unstable angina, severe asthma, and risk factors such as skeletal myopathy, were avoided by most general practitioners. The failed intubation rate was 50/10,000. The conclusion is that South Australian general practitioner anaesthetists exhibit a generally safe approach to selection of patients for anaesthesia, although in some instances the approach to potentially difficult anaesthesia should be more conservative.
authors.affiliation: The Investigator Clinic, Port Lincoln, South Australia.
authors.forename: R W
authors.initials: RW
authors.lastname: Watts
authors.forename: M
authors.initials: M
authors.lastname: Bassham
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D016058:Analgesia, Patient-Controlled / Q000706:statistics & numerical data; D000758:Anesthesia / Q000145:classification / Q000706:statistics & numerical data; D000765:Anesthesia, Conduction / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000706:statistics & numerical data; D000776:Anesthesiology / Q000193:education*; D000789:Angina, Unstable / Q000503:physiopathology; D001249:Asthma / Q000503:physiopathology; D002675:Child, Preschool; D002983:Clinical Competence; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D018482:Muscle, Skeletal / Q000503:physiopathology; D009135:Muscular Diseases / Q000503:physiopathology; D011247:Pregnancy; D012307:Risk Factors; D012423:Rural Health; D013021:South Australia / Q000453:epidemiology