The provision of anaesthesia for children by nonsubspecialists: expectations of newly qualified consultant anaesthetists and their prospective employers in Victoria.

Damian Castanelli, Kushlani Stevenson, John Patrick Monagle

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We surveyed newly qualified consultant anaesthetists and their prospective employers in Victoria, regarding their
expectations for the provision of paediatric anaesthesia by anaesthetists who have not completed subspecialty training
in paediatric anaesthesia (generally-trained anaesthetists).
Responses were received from 15 of 19 (79%) eligible Directors and 26 of 37 (70%) newly qualified Australian
and New Zealand College of Anaesthetists (ANZCA) Fellows. Of those responding, 80% of Directors and 82% of
Fellows would expect a generally-trained anaesthetist to anaesthetise children two years of age or older. Regional
Directors expected generally-trained anaesthetists to anaesthetise younger children than metropolitan Directors, and
Directors’ expectations were not influenced by their own practice.
Testing these age limits with a series of simple case descriptions showed there is recognition from both Directors
and Fellows that the stated age limits would be modified in both directions by case complexity and comorbidities.
The new consultants who responded were significantly less confident than Directors in their ability to resuscitate
and stabilise a critically ill child prior to transfer if required. Only 50% agreed they still met all the requirements of
the ANZCA paediatric module and only 37.5% had the level of confidence they achieved during their paediatric
We suggest that current training provides capacity to routinely anaesthetise well children two years of age or older.
However, it appears more training would be required for most anaesthetists undertaking anaesthesia for younger
patients or more complex paediatric cases. This raises the question of subspecialty endorsements within ANZCA
Original languageEnglish
Pages (from-to)911-919
JournalAnaesthesia and Intensive Care
Issue number5
Publication statusPublished - Sep 2010

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