CURRIULUM

FOR
2 YEARS POST MATRIC
DIPLOMA OF
ANESTHESIA TECHNICIAN

2021

PUNJAB MEDICAL FACULTY

1
 LAHORE, PAKISTAN
TABLE OF CONTENTS
Sr. # Description Page No.
1. Preface 3
2. General Outline 4
3. Section I: (Paper I) 11
(i) Unit 1: Operation Theater Management 12
(ii) Unit 2: Equipment & Devices 14
(iii) Unit 3: Sterilization & Disinfection 16
4. Section II: (Paper II) 18
(i) Unit 1: General Principles of Anesthesia 19
(ii) Unit 2: Equipment 21
(iii) Unit 3: Procedures 23
5. Section II: (Paper II) 25
(i) Unit 1: Patient Care 26
(ii) Unit 2: Anesthesia Assistance 28
6. Practical Attachment 30
7. Recommended Reading for Teachers 35
8. Acknowledgements 36

2
 Preface
At the national and international level, Anesthesia has been recognized as a critical part of essential
surgical care in dire need of dedicated and organized training. Development of a two years
Anesthesia Diploma is a part of ongoing efforts to train multifaceted AHPs to assist in all aspects
of anesthesia care in Pakistan and also provide training and employment opportunities to our youth.

Focus of the new curricula would be on integration of tasks and multi-skilling of students. Thus
there would be a common knowledge base for all courses in the form of a Core Course which
would provide insight into essential technical knowledge besides providing base for development
of the education for Allied Health Sciences up to post graduate level.

The goal of this document has been to outline a common body of knowledge that is essential for
entry-level surgical technicians. Combined with the Core Course it will provide a broad knowledge
base for the technicians and provide opportunities for practical skill development in the relevant
field. This needs based curriculum places practical skills development at high priority. Content
and apprenticeship experiences is designed to sequentially develop, apply, critically analyze,
integrate, synthesize and evaluate concepts and theories in the performance of surgical procedures.

There will be two papers to assess the knowledge gained and two practical / viva examination to
assess the concepts and skills. The papers are:

1. Paper-I: Operation Theater Management; Equipment & Devices; Sterilization &

Disinfection.
2. Paper-II: Anesthesia

3
 GENERAL OUTLINE
Aim of this curriculum is to develop students with the relevant professional knowledge, skills and
techniques to enable them to apply their acquired expertise for efficient health service delivery. At
the end of training the student should be able exhibit the following general and specific
competencies:

A. General Learning Objectives

1. Act upon his/her job description ethically keeping in mind the requirements of
community and people at large.
2. Demonstrate empathy and humane approach towards communities and exhibit
interpersonal behavior in accordance with the societal norms and expectations.
3. Demonstrate sufficient understanding of basic sciences related to the technology and
be able to integrate such knowledge in his/her work.
B. Specific Learning Objectives
The job of Anesthesia is preparation, maintenance, and provision of anesthesia related
equipment and supplies, assistance to anesthetist during surgical procedure. Upon
completion they will be able to:

BASICS:
1. Introduction of basic human anatomy and physiology as per matriculation standards.
2. Knowledge in detail of asepsis, infection, disinfection.
3. Use of different anti-septic chemotherapeutic agents (which material is to be used for
sterilization).
4. Anesthesia and use of anesthetic agents, machines.
5. Pre & postoperative care management in theatre transportation and on arrival to recovery
area.
6. Cardiopulmonary resuscitation
7. Intravenous fluids, infusion set up.
8. Setting up pressure transducer
9. Vasopressor, anesthesia related drugs
10. Forced air warmer, fluid warmer
11. Indications of blood transfusion, checking blood products
12. Duties of Anesthesia technician
13. Fluids, infusions, transfusions (Chemistry, indication & complications)
14. Pain Control techniques, drugs
15. Consent; patient rights
16. Ethics; Professionalism

4
SPECIAL (SECTION-II)
1. Perform Safety checklist of anesthesia equipment and ventilators.
2. Use & care of electronic equipment.
i. Anesthesia machine/workstation
ii. Suction machines
iii. Cardiac monitors
iv. Pulse oximeter
3. Awareness & handling of surgical and anesthesia instruments, rubber goods and how to
sterilize them.
4. Instrument identification and care (introduction, sterilization, cleanliness after use, how to
pack them again) e.g.
i. Bronchoscope (Flexible)
ii. Video Laryngoscope
5. Patient positioning
6. Preparation & organization of anesthesia drug and airway trolleys
7. Assisting difficult airway
8. Difficult airway algorithm
9. Recognizing Respiratory distress
10. Recognizing Local Anesthesia toxicity
11. Epidural trolley set up
12. Crisis management in Anesthesia, team approach
13. Cardiac/Transplant

5
 PRACTIAL
I. Identification and proper use of Equipment
a. Oral & Nasal Airways, face mask
b. ETT types, indications, choosing appropriate size
c. Laryngoscope types, choosing appropriate size
d. LMA, various supraglottic devices, indications
e. Proper use of Stylet, bougie, tube exchanger, Video Laryngoscope
f. Fiberoptic bronchoscope, parts, sterilization
g. Check O2 cylinder and flow meter
h. Check Ambu bag
i. Check Suction Machine
j. Check laryngoscope change battery
k. Check recovery room airway & drug trolley
l. Other:
i. Maggill’s forceps
ii. Nasogastric Tube
iii. Foley’s catheter
iv. Intra-venous cannulae
v. Nelaton’s Catheter
vi. Tracheostomy tube
vii. Surgical Gloves
viii. BP Cuff
I. Organize and maintain Medication Trolley
1. Organize drawers
2. Maintain inventory
II. Intra-venous Fluids
A. Various types, appropriate fluid, Fluids-5% D/W
o NaCl
o D/S
o Ringers
B. Setting up infusion set

6
C. Assist in IV placement and secure IV
III. Infusion
A. Vasoactive infusion preparation
B. Use of infusion pumps
IV. Time out/ WHO Surgical Checklist
V. STERILIZATION & Disinfection
1. Identification + use of different Antiseptic Solutions, e.g Pyodine, Spirit, Cidex, Savalon
etc.
2. Sterilization of anesthesia related equipment including fiberoptic bronchoscope
3. Principles of sterile technique, purpose
VI. Procedure
1. Sterile Technique, gown glove; Setting up sterile tray
2. Central venous line sizes, assist placement
3. Check correct placement of endotracheal tube
4. Setting up for Radial & femoral arterial lines
5. Pressure transducer setup
6. Assist in Difficult airway
7. Assist Fiberoptic Nasal & Oral intubation & Video Laryngoscope

7
 C. Distribution of Training Time:
The two years’ program would be divided in three distinct parts (Papers). There will be a “Core
Course” which would be common for all technologies. The examination for this component will
be taken at the end of first academic year. The teaching for specific aspect of this technology will
be divided in two sections; examination for these will be held at the end of second academic year-
however, teaching for specific techniques will start from the first year.

A typical training day for students at training institutions routinely comprises of five hours.
Keeping a generous allowance of holidays and weekends, an academic year for students would be
200 days. Therefore, 1000 teaching hours would be available in 12 months. In the new scheme of
studies, for the Core Course the proportion of classroom teaching and practical training (applied
learning activities) would be 60:40; whereas this proportion for the specific techniques would be
40:60 and the time allocations for dividing teaching time between various topics, units and sub-
units will be done accordingly as depicted below:

Core Course 500 Hours

Section I (Paper-I) 750 Hours
Section II (Paper-II) 750 Hours
Total 2000 Hours

The marks distribution for this diploma would be:

Subject Marks
First Year
Core Course 100
Viva 100
Second Year
Section-I 100
Section-II 100
Practical/Viva Section I 100
Practical/Viva Section II 100
Total 600

8
D. Essential Teaching Requirements:

I. Training requirements/instructional methodologies (Process)

a. Teaching staff will give in-service training as recommended by PMF from time to time.
b. Teachers will use a combination of interactive programmed instructions (non-IT), class
teaching with exercises using audiovisual aids, mini-lectures, group discussions,
simulations and case studies as instructional/teaching methodologies.\
c. IT will be employed for teaching where necessary.
d. A combination of English and Urdu languages will be used as medium of instruction.
e. Teachers will encourage students to ask questions; they will encourage debate and
discussion in class to inspire and hone thinking skills of students. Students will be given
the opportunity to engage in activities that promote divergent thinking skills. Students will
be encouraged to work independently, as well as in small groups and as a whole class, to
form creative associations of ideas across discipline lines.

II. Practical learning component:

As prime objective of the training program is to develop practical skills, an extended clinical
attachment is its essential part. The student will rotate amongst various sections including
different operation theaters and his/her attendance will be recorded on a logbook to be signed
by supervisors. Teachers will ensure that students are given chance to practice activities under
supervision that are relevant to the topic being taught in class in order for them to develop
relevant practical skills.

The detail of specifications for the institution imparting education according to the new scheme
of studies. Including the facilities for practical attachment, is available in “New Affiliation
Criteria” for such institutions.

E. Organization of Units of Curriculum:

The different units presented in the subsequent sections would comprise of the following
components, not essentially in the sequence depicted below:

a. Learning Focus (contents, hours, weight & age for assessment)

b. Rationale
c. Scope
d. Learning Objectives (aims and learning outcomes)
e. Practical Learning Component (where applicable)

9
F. Revisions and Updating of Curriculum:
The curricula are ever evolving organic documents. Regular reviews and revisions are,
therefore, essentially required to keep them in pace with modern need, topics that are required
now might outlive their utility in a few years. Updating curricula therefore forms the basis for
quality teaching as well as professional competence of technicians. This would be ensured by
technology-wise panels of experts notified by the Health Department.

10
 SECTION I

(Paper I)

UNIT 1: OPERATION THEATER

UNIT 2: MANAGEMENT EQUIPMENT & DEVICES

UNIT 3: STERILIZATION AND DISINFECTION

11
 Unit I
Operation Theater Management
1. Rationale:
The Anesthesia Technician has a very significant role in management of operation room.
He should have knowledge of various administrative procedures for smooth functioning of
operation department.

2. Scope:
The content will prepare student in the issues related to care of OT before, during and after
a surgical procedure. The focus would also be on development of correct attitudes in OT
and on economizing OT resources.

3. Learning Objectives:
After completing this section, the students will be able to:
i. Understand the organization and functioning of Operation Theater.
ii. Appropriately administer Operation Theater and manage its resources.

12
 OPERATION THEATER MANAGEMENT
LEARNING FOCUS
i. Introduction to Operating Department 10 hours
Organization and design: the operation room suite, single and multiple 08 hours
ii.
theatre units
iii. The surgical team: required attributes; OT etiquette and protocols 08 hours
iv. Duties of Anesthesia Technician 10 hours
v. Admission & transfer procedure 10 hours
vi. Essential documentation: informed consent forms 06 hours
vii AGS 10 hours
viii Humidity and heating requirements 06 hours
ix Electrical and fire safety 08 hours
x Prevention of physical, electrical, chemical injuries/hazards to patient 08 hours
xi Tissue Disposal 08 hours
xii Economizing theater resources 08 hours
xiii Class room Teaching 100 hours
xiv Practical Attachments 150 hours
xv Total Teaching 250 hours
xvi Weightage for assessment 35%

13
 Unit 2
Equipment and Devices
1. Rationale
The Anesthesia Technician has the responsibility of handling and maintaining various
equipment available in the operation theater. He must, therefore, possess knowledge and
skills to manage such equipment and devices.

2. Scope:
The content will provide a thorough understanding of the machinery employed in OT;
this will also include maintenance and minor repairs of this machinery.

3. Learning Objectives:
After completing this section, the students will be able to:
i. Conduct a comprehensive and appropriate equipment check.
ii. Identify and take appropriate action when confronted with equipment-related
malfunctions and maintain service records.

14
 Equipment and Devices
Learning Focus

Electro-medical/electrosurgical equipment used in O.T. Use and care of

i. 12 hours
electronic equipment – grounding system
ii. Monitoring equipment: cardiac monitors, pulse of oximeter 10 hours
iii. Defibrillators + AED 12 hours
Fiber-optic endoscopy: introduction, types, procedures and care of
iv. 10 hours
instruments
v. Operating microscopes: principle, parts, use and care 06 hours
vi. Gas cylinders, medical gas pipeline system & manifold room 10 hours
vii Suction machines 05 hours
viii Handling, fixing and troubleshooting of equipment. 10 hours
Class Room Teaching 75 hours
Practical Attachments 125 hours
Total Teaching 200 hours
Weightage for assessment 25%

15
 UNIT 3
STERILIZATION AND DISINFECTION
1. Rationale:
Maintaining utmost asepsis is the foundation of modern surgery. The Anesthesia Technician
should be well versed with different techniques for maintaining an infection free OT environment
and ensuring sterilization of instruments used during the surgical processes.

2. Scope:
The content will cover the concepts of infection, cross-infection and asepsis. The student will build
upon the knowledge gained during the core course and will be enabled to employ different
sterilization and asepsis techniques in appropriate manners.

3. Learning Objectives:
After completing this subsection, the students will be able to:

i. Taking precautions to prevent the spread of infection

ii. Ensuring the cleaning of the Operation Theatre prior to operations
iii. Cleaning, packing, sterilization, maintenance and storage of instruments and other
equipment used in Operation Theatre.
iv. Manage sterile stock.

16
 Sterilization and Disinfection
Learning Focus
i. Definition of cross infection; modes and types 10 hours
ii. Principles of microbial control: prevention of cross infection to the 12 hours
patient and surgical team
iii. Definition of sterilization, disinfection, antiseptic, aseptic, carrier 10 hours
iv. Environmental disinfection: cleaning and disinfection of Operating 12 hours
Room
v. Detergents, types and uses 10 hours
vi. Scrubbing and its methods 12 hours
vii. Handling of infectious hospital waste 16 hours
viii. Self-protection; gown, gloves, shoes, dress 18 hours
Class Room Teaching 100 hours
Practical Attachments 200 hours
Total Teaching 300 hours
Weightage for assessment 40%

17
 SECTION 2

(Paper-II)

Unit 1 General Principles of Anesthesia

Unit 2 Equipment
Unit 3 Procedures

18
UNIT 1: General Principles of Anesthesia
1. Introduction of basic human anatomy and physiology as per matriculation standards.
2. Knowledge in detail of asepsis, infection, disinfection.
3. Methods of sterilization of different materials used in surgery and anesthesia.
4. Use of different anti-septic chemotherapeutic agents (which material is to be used for
sterilization)
5. Anesthesia and use of anesthetic agent’s machines.
6. Pre and postoperative care management in theatre transportation and on arrival to
recovery area.
7. Cardiopulmonary resuscitation
8. Intra-venous fluids, infusion set up.
9. Setting up pressure transducer
10. Vasopressor, anesthesia related drugs
11. Forced air warmer, fluid warmer
12. Indications for blood transfusion, checking blood products
13. Duties of Anesthesia Technician
14. Fluids, infusions, transfusions (Chemistry, indication and complications)
15. Pain Control techniques, drugs
16. Consent; patient rights
17. Ethics; Professionalism

Special (Section II)

1. Perform safety checklist of anesthesia equipment and ventilators.
2. Use and care of electronic equipment
3. Anesthesia machine/workstation
4. Suction machines
5. Cardiac monitors
6. Pulse oximeter
7. Awareness & handling of surgical and anesthesia instruments, rubber goods and how
to sterilizer them.
8. Bronchoscope (Flexible)
9. Video laryngoscope
10. Different operative positions on the operating tables and positioning of light.
11. Patient positioning
12. Preparation & organization of anesthesia drug and airway trolleys
13. Assisting difficult airway
14. Difficult airway algorithm
15. Recognizing Respiratory distress
16. Recognizing local anesthetic toxicity
17. Epidural trolley set up

19
 18. Crisis management in anesthesia, team approach
19. Cardiac/Transplant
20. Drug Cart Management
21. Use and maintain for control drugs
22. Sterilization of Anesthesia Equipment

CLASS ROOM TEACHING: 90 hours

PRACTICAL TEACHING: 165 hours
TOTAL: 250 hours
WEIGHT AGE: 35%

20
UNIT 2 EQUIPMEN T
I. IDENTIFICATION AND PROPER USE OF EQUIPMENT

(a) Oral & Nasal airways, face mask

(b) ETT types, indications, choosing appropriate size
(c) Laryngoscope types, choosing appropriate size
(d) LMA, various supraglottic devices, indications
(e) Proper use of Stylet, bougie, tube exchanger, Video Laryngoscope
(f) Fiberoptic bronchoscope, parts, sterilization
(g) Check O2 cylinder and flow meter
(h) Check Ambu Bag
(i) Check Suction Machine
(j) Check laryngoscope, change battery
(k) Check recovery room airway & drug trolley
(l) Other:
(i) Maggill’s Forceps
(ii) Nasogastric Tube
(iii) Foley’s Catheter
(iv) Intra-venous cannulae
(v) Nelalton Catheter
(vi) Tracheostomy Tube
(vii) Surgical Gloves
(viii) BP Cuff

II. Organize & maintain Medication Trolley

1. Organize drawers
2. Maintain inventory

III. Intra-venous Fluids

A. Various types, appropriate fluid, Fluids -5% D/W
 NaCl
 D/S
 Ringers
B. Setting up infusion set
C. Assist in IV placement & secure IV

21
 IV. Infusion
a) Vasoactive infusion preparation
b) Use of infusion pumps

V. Time out/WHO Surgical Checklist

VI. STERILIZATION & Disinfection:

1. Identification + use of different Antiseptic Solutions e.g Pyodine, Spirit, Cidex, Savalon
etc.
2. Sterilization of anesthesia related equipment including fiberoptic bronchoscope.
3. Principles of sterile technique, purpose.

CLASS ROOM TEACHING: 100 hours

PRACTICAL TEACHING: 200 hours
TOTAL: 300 hours
WEIGHTAGE: 45%

22
 UNIT 3: Procedure

1. Sterile Technique, gown glove: Setting up sterile tray

2. Central venous line sizes, assist placement
3. Check correct placement of endotracheal tube
4. Setting up for Radial & femoral arterial lines
5. Pressure transducer setup
6. Assist in Difficult airway
7. Assist Fiberoptic Nasal & Oral intubation & Video Laryngoscope

CLASS ROOM TEACHING: 70 hours

PRACTICAL TEACHING: 130 hours
TOTAL: 200 hours
WEIGHTAGE: 20%

23
 PRACTICAL ATTACHMENT
The extensive internship will reinforce the classroom learning and enable the student to understand
how to handle the workload in different disciplines of surgical technology.

It is this aspect of the course that will determine the level of professionalism students will display
after employment. This period will be interspersed with learning of theory.

During the two year of this program the students will be placed in different operation theaters and
related sections on a roster basis to gain practical experience in relevant areas under supervision
of tutor technicians and the surgical instructors. If a particular specially is not available in the
hospital, collaboration with other hospitals will be sought to provide adequate experience to
students.

RECOMMENDED REFERENCE BOOKS

1. Morgan and Mikhail’s Clinical Anesthesiology
2. MGH Textbook of Anesthetic Equipment
By Sandberg, Urman and Ehrenfeld

24
 SECTION 2

(Paper-II)

Unit 1 Patient Care

Unit 2 Anesthesia Assistance

25
 Unit 1
Patient Care

1. Scope
The content provides basic knowledge of common surgical conditions. It also gives
understanding of care of patient before, during and after the procedure. Special emphasis
would be on first aid management and emergency lifesaving procedures.

2. Learning Objectives:
After completing this unit, the students will be able to:

i. Understanding the common surgical conditions

ii. Manage wounds and apply dressings
iii. Provide first aid and emergency basic life care

26
 Patient Care
Learning Focus
Introduction, sign, symptoms and first aid management of:
 Hemorrhage
i. 15 hours
 Burns
 Shock
Special precautions in handling patients with sepsis, blood borne
ii. 15 hours
infection – Hep. B, HCV, HIV etc.
Post-op care of patient
 Position
 Monitoring
iii. 15 hours
 Recovery
 Transportation
 IV line & drain care
Blood Transfusion: Blood storage, grouping, cross matching, blood
iv. 15 hours
products etc; common blood reactions
v. Fluids, infusions (chemistry, indication and complications) 15 hours
Basic Lift Support Protection and maintenance of patient airway
 Natural or artificial respiration
 Assisted by emergency oxygen
vi. 15 hours
 The movement of blood through the beating of heart
 The emergency measure of CPR
 Automated external defibrillator or AED
Class Room Teaching 90 hours
Practical Attachments 160 hours
Total Teaching 250 hours
Weightage for assessment 35%

27
 Unit 2

Anesthesia Assistance

1. Rationale:
Being a member of multi-disciplinary anesthesia team, the technician is to provide
assistance to the anesthetist.

2. Scope:
Content will cover the basics of anesthesia techniques. Students will be acclimatized with
anesthesia related gadgetry and their skills will be developed for assisting the anesthetist.
However, the actual administration of anesthesia will be out of bond for the technicians.

3. Learning Objectives:
After completing this unit, the students will be able to:
i. Identify and understand the use of anesthetic equipment
ii. Be aware of various types of agents and drugs used during anesthesia
iii. Caring for patient and assisting the anesthetist during procedures.

28
 Anesthesia Assistance
Learning Focus
i Introduction of Anesthesia Technology-types of anesthesia 10 hours
ii Role of Anesthesia Care Team- specific duties of Anesthesia Technician 04 hours
iii Anesthetic agents, types and uses 12 hours
Types & use of sedative, hypnotic, pre-anesthetic and other groups of
iv 06 hours
drugs??
v Patient preparation before anesthesia 06 hours
vi Stages of anesthesia; patient management during anesthesia 08 hours
vii Anesthesia machine- parts, block diagram etc. 08 hours
viii Emergency intubation equipment and techniques 05 hours
ix Set-up and use of complex anesthesia equipment 05 hours
x Maintenance of anesthesia equipment for proper functioning 06 hours
Class Room Teaching 70 hours
Practical Attachments 130 hours
Total Teaching 200 hours
Weightage for assessment 25%

29
 PRACTICAL ATTACHMENT
The extensive internship will reinforce the classroom learning and enable the student to understand
how to handle the workload in different disciplines of anesthesia and surgery. It is this aspect of
the course that will determine the level of professionalism students will display after employment.
This period will be interspersed with learning of theory.

During the two year of this program the students will be placed in different operation theaters and
related sections on a roster basis to gain practical experience in relevant areas under supervision
of tutor technicians and surgical instructors. If a particular specially is not available in the hospital,
collaboration with other hospitals will be sought to provide adequate experience to students.
On the availability of the following sections, the student will get a rotation amongst them.

 General Surgery
 Minor OT
 Emergency
 Obstetrics & Gynecology
 ENT/ Ophthalmology
 Orthopedics
 Anesthesia
 ICU
 Sub-specialties
Students will maintain a record of their attachment in the “Practical Note Books” (one for each
section), the last portion of which would be designed as a “Log Book” which shall be a work dairy
and record. Special mention shall be made of the procedures, if any, conducted by the candidate.
This dairy shall be scrutinized and certified by the Head of the Department and Head of the
Institution, and presented in the practical/viva examination.
The scope of practical attachment would be:

30
A. IDENTIFICATION OF INSTRUMENTS AND PREPARATIONS OF TROLLEYS
i. Emergency:
1. Laparotomy Set
2. Thoracotomy Set
3. Suprapubic Cystostomy
4. Chest Intubation
5. Venesection
6. Appendectomy
7. Fracture
8. Burr Hole
9. Wound Debridement
ii. Elective
1. Cholecystectomy
2. Thyroidectomy
3. Herniotomy + Herniorraphy
4. Mastectomy
5. Nephrectomy
6. Vesicolithotomy
7. Prostatectomy
8. S.M.R
9. Tonsillectomy
10. Mastoidectomy
11. Cataract Surgery
12. Retinal Surgery
13. Orbital Surgery
14. Caesarian Section
15. Hysterectomy
16. Dilation and Curettage
17. Haemorrhoidectomy
18. Fistulectomy
19. Joint Replacement
20. Spinal + Epidural Block
21. Laparoscopic Surgery (Trolley)
B. IDENTIFICATION OF MATERIALS
1. Identification of different suture material
 Plain and chronic catgut
 Prolene
 Vicryl
 Pollydioxanone
 Silk

31
  Nylon
2. Different Type of Fluids
o Isotonic Fluids -5% D/W
 NaCl
 D/S
 Ringers
o Plasma Expander
 Haemaccel
 Getatundin
 Albumin
3. Hypodermic needles, syringes and cannulas
4. Appliances
 Endotracheal Tubes
 Airway
 Ambu Bag
 Maggil’s Forceps
 Nasogastric Tube
 Foley’s Catheter
 Intra-venous cannulae
 Nelaton’s Catheter
 Tracheostomy Tube
 Surgical Gloves
 Proctoscope
 Sigmoidoscope
C. STERILIZATION & ANTI SEPSIS:
Identification + use of different antiseptic solutions e.g pyodine, spirit, cidex, savalon etc.
D. BASIC HANDLING OF MACHINES INSTRUMENTS
Anesthesia Instruments
 Ventilator
 Diathermy
 Suction
 Monitors

Delicate Instruments

 Procotoscope
 Sigmoid scope
 Gastro scope
 Colonoscopy
 Bronchoscope

32
  Cystoscope
 Laparoscope
E. (I) Identification and proper use of equipment
(a) Oral & Nasal Airway’s face mask
(b) ETT types indications, choosing appropriate size
(c) Laryngoscope types, choosing appropriate size
(d) LMA, various supraglottic devices, indicators
(e) Proper use of Stylet, bougie, tube exchanger, Video Laryngoscope
(f) Fiberoptic bronchoscope, parts, sterilization
(g) Check O2 cylinder and flow meter
(h) Check Ambu bag
(i) Check Suction machine
(j) Check laryngoscope, change battery
(k) Check recovery room airways & drug trolley
(l) Other:
(i) Maggill’s Forceps
(ii) Nasogastric Tube
(iii) Foley’s Catheter
(iv) Intra-venous cannulae
(v) Nelaton’s Catheter
(vi) Tracheostomy Tube
(vii) Surgical Gloves
(viii) BP Cuff

(II) Organize and maintain medication trolley

1. Organize drawers
2. Maintain inventory

(III) Intra-venous fluids

(a) Various types, appropriate fluid, fluids -5% D/W
 NaCl
 D/S
 Ringers
(b) Setting up infusion set
(c) Assist in IV placement and secure IV
(IV) Vasoactive infusion preparation

(a) Vasoactive infusion preparation

(b) Use of infusion pumps
(V) Time out/WHO surgical Checklist

33
(VI) STERILIZATION & Disinfection
1. Sterilization of anesthesia related equipment including fiberoptic
bronchoscope.
2. Principles of sterile technique, purpose.

(VII) Procedure:
1. Sterile technique, gown glove; setting up sterile tray.
2. Central venous line sizes, assist placement
3. Check correct placement of endotracheal tube
4. Setting up for radial & femoral arterial lines
5. Pressure transducer setup
6. Assist in difficult airway & assist fiberoptic nasal & oral intubation; video
laryngoscope.

34
 RECOMMENDED BOOKS
1. Handbook of Operation Theatre Techniques: Publisher, Jaypee
2. Operating Room Technique – Berry and Kohn’s Publisher: Mosby Elsevier Health Science
3. Operating Room Technique – Raymond John Brigden
4. The Operating Room Aide; Publisher: Career Pub
5. Surgical Nursing and Technique: A book for nurses, dressers, house Surgeons-Charles
Plumley: Childe
6. Morgan & Mikhail’s Clinical Anesthesiology
7. MGH Textbook of Anesthetic Equipment by Sandberg, Urman & Ehrenfeld
8. Standards for Perioperative Autologous
Blood Collection by AABB -5th Edition (2013)

35
 ACKNOWLEDGMENTS
Preparations of this new curriculum was indeed a gigantic task, especially in the very limited time
available for this assignment. Its accomplishment would not have been possible without concerted
efforts of many professional colleagues.

Grateful acknowledgement is hereby made to the following members of Panel of Experts for
Operation Theatre/ Anesthesia Technology for their contributions and feedback:
1. Prof. Masood Rashid Prof. of Surgery AIMC
(Convenor)
2. Prof. Mujeeb Ahmad Prof. of ENT SIMS
3. Dr. Sikandar Gondal Assistant Professor PGMI
4. Dr. Fawad Karim Senior Registrar AIMC/JHL

I am also indebted to Dr. Ahsan Mahmood Gondal, Registrar PMF for providing assistance in
completion of this task.

Dr. Arshad Usmani

Secretary
Punjab Medical Faculty
August -2013

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