1. ANAESTHESIOLOGY MODULE
FF4412
Head of Department: Assoc. Prof. Datin Dr. Norsidah Abdul Manap
Module Heads: Dr. Azarinah Izaham
Dr. Aliza Mohamad Yusof
Department’s PPD Coordinator: Dr. Rufinah Teo
1.DIRECTORY OF TEACHING STAFF
NO. LECTURERS EXT. E-MAIL ADDRESS
1 Assoc. Prof. Dr. Adnan Dan 5786 adnan@ppukm.ukm.my
2 Assoc. Prof. Datin Dr.
Norsidah A. Manap
5788 nmanap@ppukm.ukm.my
3 Prof. Dr. Lee Choon Yee 5789 lee@ppukm.ukm.my
4 Prof. Dr. Jaafar
Md. Zain
5790 jaafar@ppukm.ukm.my
5 Assoc. Prof. Dr. Choy
Yin Choy
5791 choy@ppukm.ukm.my
6 Dr. Nurlia Yahya 5794 nurlia@ppukm.ukm.my
7 Prof. Dr. Joanna Ooi Su Min 5852 joanna@ppukm.ukm.my
8 Assoc. Prof. Dr. Raha Abdul
Rahman
5849 raha@ppukm.ukm.my
9 Dr. Muhammad Maaya 5865 mm0427@gmail.com
10 Dr. Nadia Md. Nor 5621 nadiamn@ppukm.ukm.my
11 Dr. Khairulamir Zainuddin 5796 z_amir72@hotmail.com
12 Dr. Azmil Farid Zabir 5792 azmil@ppukm.ukm.my
13 Dr. Wan Rahiza Wan Mat 5785 docaweng@yahoo.com
14 Dr. Azarinah Izaham 5797 azaizaham@yahoo.com
15 Dr. Esa Kamaruzaman 6751 ek4776@hotmail.com
16 Dr. Liu Chian Yong 5865 chianyong@yahoo.com
17 Dr. Kamal Bashar Abu Bakar tengku_k@hotmail.com
18 Dr. Aliza Mohamad Yusof synctium_x@yahoo.com
19 Dr. Rufinah Teo finah77@yahoo.com
20 Dr. Shereen Tang Suet Ping shereen_tang@yahoo.com
21 Dr. Azlina Masdar 5864 azlinamasdar@yahoo.com
SYNOPSIS:
In this 2- week posting students will be exposed to the basic principles of general and
regional anaesthesia, skills of airway maintenance and basic life support. They will be
introduced to the management of the critically ill. Prerequisites to this module include
sound knowledge in the clinical and biomedical sciences. The teaching learning
methodology includes lectures, skill lab, computer assisted learning, pre-operative
assessment, practical procedures in the operation theatre, small group tutorials and
discussion, and basic life support hands-on and exam sessions. Assessment is based
on the continuous assessment and end-of-semester theory and OSCE examination.

2. OBJECTIVES:
On completion of this module students should be familiar with various airway
equipment, anaesthesia techniques and common drugs; be able to maintain an
airway and perform basic life support, manage patients perioperatively, and
communicate well with patients, their families and the multidisciplinary team.
PREREQUISITES
The students should have the following relevant knowledge and skills:
1. Good knowledge of clinical sciences
2. Good knowledge of biomedical sciences
II. MODULE LEARNING OUTCOMES
On completion of this module, the student should be able to:
1. identify and use different airway equipment and adjuncts.
2. perform different modes of maintaining an airway.
3. perform basic life support (BLS).
4. know the assessment and preoperative preparation of patients.
5. recognize various techniques of anaesthesia.
6. identify and describe common drugs used for anaesthesia and resuscitation.
7. identify the various methods of post operative pain management
8. demonstrate skills in breaking bad news with regards to anaesthetic related
complications, and death and dying.
9. discuss the consequences of their clinical decision upon the patient, patient’s
relatives, and other medical personnel.
10. understand the importance of team work and communication.
III. COURSE CONTENTS
Subjects Topics
Airway • Airway assessment
• Airway maintenance
• Intubation/Airway devices
Anaesthesia • Peri-operative management
• General anaesthesia
• Regional anaesthesia
• Emergency anaesthesia
Drugs in anaesthesia • Drugs for premedication
• Intravenous anaesthetic agents
• Inhalational anaesthetic agents
• Muscle relaxants and reversal agents
• Opioids and non-opioids
• Local anaesthetic agents
• Resuscitation drugs
Resuscitation • Basic Life Support

4. IV. TEACHING LEARNING METHODOLOGY
1. Lectures
a. Four one-hour sessions are given in the beginning of this module
i. Airway management and airway adjuncts.
• The methods of maintaining an airway during anaesthesia
o head tilt, chin lift
o the correct technique of intubation
• Various airway adjuncts
ii. Types of anaesthesia.
• The operative management of general anaesthesia
• The operative management of regional anaesthesia
o spinal and epidural
o indications, side-effects and contra-indications
o peripheral nerve block
• The conduct of emergency anaesthesia
iii. Preoperative preparation of patient and postoperative pain relief.
• Pre-operative patient assessment and management
• Methods of post-operative pain relief
o simple oral analgesics
o opioids
o patient-controlled analgesia
o regional anaesthesia
• Acute pain service
• Anaesthetic clinic
iv. Key elements of intensive care and related issues.
• Overview of intensive care management
• Organization
• Admission criteria
• Organ support
• Sedation
• Monitoring
b. Common Lecture- Breaking Bad News
• 1 hour lecture presented once a year and attended by all the fourth
year students
• proper method of communicating with relatives regarding patient’s
poor prognosis and death
2. Skill lab and computer-assisted learning (CAL)
The students are divided into groups for these two three hour sessions.
a. In the Anaesthetic Skill Lab, a demonstration on airway management by a lecturer
is followed by the students’ practical session.
• Managing a mannequin’s airway with various airway adjuncts
• Intubating a mannequin

5. • Introduction to spinal, epidural and combined spinal-epidural
needles
• Simulation – central and peripheral venous cannulation
b. In the Computer Lab, the students undergo computer-assisted learning, where they
are guided through a scenario whereby they ‘manage’ an anaesthetised patient via
simulation.
3. Pre-operative assessment in the ward
The students follow a lecturer or medical officer on a pre-operative assessment in the
ward, where they learn the process of preparing a patient prior to anaesthesia and
surgery. The students are shown
• how to conduct an anaesthetic assessment
• how to examine a patient’s airway
• how to manage common and simple medical problems prior to
anaesthesia and surgery
During this session, the students also select a patient each to follow through, for a
case write-up.
4. Practical
In the operating theatre (OT), the students are divided into small groups, and
allocated to various operating sessions, where they are shown how general and
regional anaesthesia are conducted.
The medical students are required to perform certain procedures which are recorded
in a logbook. These are
1. Intravenous cannulation
2. Applying monitors on a patient
3. Managing a patient’s airway with a face-mask and oropharyngeal airway
4. Intubating a patient
5. Certifying the correct placement of endotracheal tube
5. Understanding the conduct of anaesthesia
5. Small group tutorial
This takes place in the operating theatre to discuss topics that are covered and not
covered in the lectures. Special attention is given to:
1. Drugs used in general anesthesia.
• Intravenous anaesthetic agents
• Inhalational anaesthetic agents
• Muscle relaxants
• Opioids and non-opioids
• Resuscitation drugs
• Reversal agents
2. Monitoring of patients in OT.
3. General anaesthesia.
4. Regional anaesthesia

6. • spinal
• epidural
• combined spinal-epidural
• Peripheral nerve block
6. Basic Life Support
Upon starting this module, the students are given a Basic Life Support Course Manual
which has been prepared by the Department of Anaesthesiology and Intensive Care.
The BLS session is a one-day course which takes place during the second week of
the module to give ample time for the students to thoroughly read the manual.
The components of the session are
1. Demonstration and practical stations.
• an overview lecture on the basics of BLS
• how to correctly perform a one-person and two-person rescue on an
adult
• how to correctly treat a conscious and unconscious adult choking
patient
• how to correctly perform a one-person BLS on an infant
• how to correctly treat a choking infant
2. Examination.
• 40 objective questions (one best answer format) on the basics of BLS,
which takes place the afternoon before the course
• 5 rotating practical stations assessing the skills mentioned above,
which takes place in the afternoon of the course.
Those who fail the objective paper can resit the exam the following afternoon.
The students who fail the practical assessment can retake the test
immediately afterwards. The students have to repeat the whole exam if they
fail either component of the repeat exam.
The students are awarded with a BLS Course Certificate after passing the exams.
Lecturers & Medical Officers in charge:
Various Lectures and Medical Officers, i.e. a rolling roster of Lectures and
Medical Officers
7. Small Group Discussion (SGD)
The students are divided into small groups, and each group is allocated a topic to
research for discussion during the second week. The four topics to be discussed are:
1. Dealing with death and dying patients
2. Dealing with brain dead patients and the issue of organ donation
3. Consent in Anaesthesia
4. Breaking bad news: Anaesthesia related complications
All groups are also required to demonstrate breaking bad news with regards to simple
clinical circumstances..

8. V. ASSESSMENT
Prerequisites
A student is considered to have satisfactorily completed this module, and allowed to
sit for the end-of-semester exam, when he/she
1. has submitted a completed and signed logbook
2. has submitted an original case write-up
3. has a good record of attendance (at least 80%)
Breakdown of marks
Continuous assessment 30%
End-of-semester theory examination 35%
End-of-semester OSCE 35%
1. Continuous assessment (30%)
The components of the continuous assessment are
Logbook 10%
Case write-up 20%
2. End-of-semester theory examination (35%)
10 Questions (mixture of one best answer and extended matching item)
3. End-of-semester OSCE (35%)
• 4 OSCE stations (1 manned and 3 unmanned)
• 2 PPD stations (rotated between the 3 minor postings each end-of-semester
exam, i.e. Ophthalmology & Otorhinolaryngology, Otorhinolaryngology &
Anaesthesiology, Anaesthesiology & Ophthalmology)
Both the theory and OSCE examinations take place in combination of the 3 minor
postings.
PPD
The components of the continuous assessment are
• Reflective writhing 10%
• Small group discussion 10%
• PPD component of case write-up 30%
Theory consisting KFQ and OSCE 50%

9. Continuous assessment
1. Logbook (30%/3 =10%)
ATTENDANCE (10%)
Lectures Date & Signature
1. Airway management & airway adjuncts
2. Preop preparation and postop pain relief
3. Types of anaesthesia
4. Introduction to care of critically ill patient
Skill lab
Computer assisted learning (CAL)
Pre-operative assessment
Small group discussion (SGD)
On call (5-9pm)
BLS
Pass / Fail
TUTORIAL (5%)
OT Signature Date & Operation
1. Introduction to
a. induction agents
b. opioids
c. muscle relaxants
d. reversal
2. Monitoring in anaesthesia
3. General anaesthesia
4. Regional anaesthesia
a. spinal
b. epidural
c. peripheral nerve block
5. Pre and postoperative
Management

10. PROCEDURES (15%)
Date & Signature
Observed Performed
Apply monitors on patient
IV cannulations (minimum performed 3)
Intubation: patient (minimum performed 1)
Intubation: mannequin (minimum performed 1)
Hold mask on patient (minimum performed 1)
Insert an oropharyngeal airway
Certify correct placement of ETT
Spinal Not required
Epidural Not required
Combined spinal-epidural Not required
Central venous line cannulation Not required
Arterial line cannulation Not required
Hold mask on patient (1 mark/performed procedure) Max. 3%
Intubation (1 mark/performed procedure) Max. 3%
Intravenous cannulation (1 mark/performed procedure) Max. 5%
Others (1 mark/observed or performed procedures) Max. 5%
2. Case write-up (20%)
The student chooses a patient scheduled for an operative procedure and writes an
anaesthetic peri-operative follow-up
• Pre-operative assessment and management
• The conduct of anaesthesia
• Immediate post-operative management
• Discussion which should emphasise the anaesthetic element
3. PPD specific assignment (20%)
- refer PPD Guideline
Passing criteria
In order to pass this module, the student must
1. pass the BLS assessment, and
2. accumulate at least 50% from the continuous assessment and end-of-
semester examinations.

11. APPENDIX I. TWO-WEEK TIMETABLE FOR THE MODULE
Week 1
0800-1000 1000-1300 1300-
1400
1400-1700
Mon 0800-0830
Introduction lecture
from the Module
Head
0830-0930
Lecture: Airway
management and
airway adjuncts
0930-1030
Lecture: Types of
anaesthesia
The students are
divided into 8
groups
Operating Theatre
according to groups
Break 1400-1500
Lecture: Preoperative
preparation of patient
and postoperative
pain relief
1500-1600
Lecture: Introduction
to the care of the
critically ill patient
1600-1700
Pre-operative
assessment
Tue 0800-0900
Departmental CME
0900-1000
All groups
Operating
Theatre/ICU/APS
according to
groups
Groups 1-4
Operating
Theatre/ICU
Groups 5&6
Skill Lab
Groups 7&8
Computer assisted
learning (CAL)
Break 1400-1600
All groups
Operating Theatre
according to groups
1600-1700
Pre-operative
assessment
Wed 0800-0900
CPC
0900-1000
All groups
Operating
Theatre/ICU/APS
according to
groups
Groups 1-4
Operating
Theatre/ICU
Groups 5&6
CAL
Groups 7&8
Skill Lab
Break 1400-1600
All groups
Operating Theatre
according to groups
1600-1700
Pre-operative
assessment
Thu All groups
Operating
Theatre/ICU/APS
according to
groups
Groups 1&2
Skill Lab
Groups 3&4
CAL
Groups 5-8
Operating
Theatre/ICU
Break 1400-1700
Special Study Module
Fri All groups
Operating
Theatre/ICU/APS
according to
groups
Groups 1&2
CAL
Groups 3&4
Skill Lab
Groups 5-8
Operating
Theatre/ICU
Break 1500-1700
Concept lecture

12. Week 2
0800-1300 1300-1400 1400-1700
Mon 0800-0900
Departmental CME
0900-1300
Groups 1-4
BLS Demonstration & Practice
Groups 5-8
Operating Theatre/ICU/APS
according to groups
Break Groups 1-4
BLS MCQ/Practical Exam
Groups 5-8
Small Group Discussion
Tue 0800-0900
Departmental CME
0900-1300
Groups 1-4
Operating Theatre/ICU/APS
according to groups
Groups 5-8
BLS Demonstration & Practice
Break Groups 1-4
Small Group Discussion
Groups 5-8
BLS MCQ/Practical Exam
Wed 0800-0900
CPC
0900-1300
All groups
Operating Theatre/ICU/APS
according to groups
Break 1400-1600
All groups
Operating Theatre according to
groups
1600-1700
Pre-operative assessment
Thu All groups
Operating Theatre/ICU/APS
according to groups
Break 1400-1700
Special Study Module
Fri All groups
Operating Theatre/ICU/APS
according to groups
Break 1500-1700
Concept lecture
This two weeks timetable is subject to change in the event
• the module coinciding with public holidays or departmental activities, e.g.
Masters Students’ Examination
• increasing or decreasing student group size

13. APPENDIX II. RESOURCE MATERIALS
Textbook
Gwinnutt, Carl. 2004. Clinical Anaesthesia (Lecture Notes).
2nd
Edition. Blackwell Publishing Limited.
Manual
Basic Life Support Course Manual (2010)
An Introduction to Cardiopulmonary Resuscitation, Basic Airway Management and
Defibrillation (2nd
Edition 2011) UKMMC