Identification of Professional Gaps Survey

Question Title

* 1. Do you routinely place pulmonary artery catheters in cardiac surgical patients with low risk of hemodynamic complications?

Always

Always even if I use a TEE

Not if I use TEE

Never

I don't do cardiac anesthesia

Question Title

* 2. Do you use TEE to monitor fluid/cardiac status in patients for non-cardiac surgery?

Yes

If I need to use TEE, I can call for help

We have no TEE available

Question Title

* 3. If a patient with coronary stents placed more than one year ago stopped their aspirin and clopidogrel 5 days ago, prior to the start of anesthesia and surgery you would:

Postpone surgery

Proceed with surgery

Give them aspirin 81 mg to swallow

Give them aspirin 81 mg to chew

Give them aspirin 325 mg to swallow

Give them aspirin 325 mg to chew

Give them aspirin to swallow or chew, the patient's preference

Question Title

* 4. If a patient has an implantable cardiac rhythm device (e.g., pacemaker, ICD), the device is interrogated preoperatively by:

EPS service

Cardiac anesthesiologist

It is not interrogated

Other (please specify)

Question Title

* 5. If a patient has an implantable cardiac rhythm device (e.g., pacemaker, ICD) and you placed a magnet during the procedure, the device is interrogated postoperatively by:

EPS service

Cardiac anesthesiologist

It is not interrogated

Other (please specify)

Question Title

* 6. What tidal volumes do you routinely set in the OR?

4 mL/kg

5 mL/kg

7 mL/kg

10 mL/kg

Question Title

* 7. Do you routinely use PEEP in the OR for ventilated patients?

Yes

Question Title

* 8. Are OSA patients instructed to bring their CPAP machine to the ambulatory surgery center (ASC)?

Yes

I don't know

I don't work in an ASC

Question Title

* 9. Does your organization have a protocol for postoperative disposition (e.g., ward, step-down) of OSA patients?

Yes

We decide on a case-by-case basis

I don't know

Question Title

* 10. Do you routinely do toxicology testing in your preoperative clinic?

Yes

We don't have a preoperative clinic

Question Title

* 11. If you do toxicology testing, do you cancel an elective case if your patient tests cocaine positive and has stable hemodynamics and no prolongation of QT interval on 12-lead ECG?

Yes

We don't test

Question Title

* 12. I administer multimodal antiemetic prophylaxis to:

All my patients

Patients at high risk only

Never

Question Title

* 13. You induce general anesthesia for an emergency cesarean delivery and despite multiple attempts with multiple devices intubation is unsuccessful. At this time you:

Continue trying before allowing the surgeon start

Continue trying but allow the surgeon to start

Place a LMA and allow the surgeon to start

Wake-up the patient and do awake fiberoptic intubation

Wake-up the patient and perform neuraxial anesthesia

Question Title

* 14. Does your organization have a protocol for obstetrical hemorrhage?

Yes

I don't know

We don't do obstetrics

Question Title

* 15. Do you use depth of anesthesia monitoring for TIVA?

Yes

I don't do TIVA

I would but don't have a monitor

Question Title

* 16. Do you ask your patient if they use herbal medications?

Always

Sometimes, if I remember

Never

Question Title

* 17. Are you aware of current recommendation regarding safe injection practices?

Yes

I don't know there are recommendations

Question Title

* 18. Do you routinely replace fluid deficits?

Yes, by calculating maintenance fluid x hours NPO

Yes, using an approximation (e.g., 1 liter)

Yes, I have my own formula

No, it is not necessary

Question Title

* 19. Do you use sterile technique for arterial catheter placement?

Yes

Question Title

* 20. Do you use gown, mask, and hat for epidural catheter placement outside the OR?

Yes

I don't place epidural catheters

Question Title

* 21. While placing an epidural catheter you get a wet tap, do you:

Go to another level

Place the epidural catheter intrathecal

Abandon the procedure

Question Title

* 22. Do you order opioids as first line treatment for postoperative pain in the PACU?

Always

Yes, my surgeon doesn't let me order NSAIDs

I order multiple types of medications and I let the nurse decide which to give

Question Title

* 23. Is elective surgery postponed in patients with elevated Hgb A1C?

> 8

> 9

> 10

Never

We don't check

Question Title

* 24. Does your organization have a massive transfusion protocol?

Yes

I don't know

Question Title

* 25. During massive transfusion, how do you determine the type of blood product (e.g., PRBC, FFP, Platelets) to transfuse?

Use a ratio of 1:1:1

Use a different ratio

Results of point-of-care testing

Question Title

* 26. Do you routinely use antifibrinolytics for complex spine cases?

Yes

My organization has a protocol that I follow

I don't do these cases

Question Title

* 27. When the patient is positioned with their head above the heart and an arterial catheter is placed, where do you place the transducer?

Level with the heart

Level with the external auditory canal

Question Title

* 28. What product do you use to sterilize the skin prior to placement of neuraxial anesthesia?

Chlorhexidine/alcohol preparation

Iodine/alcohol preparation

Povidone iodine

Whatever is available

Question Title

* 29. Do you routinely use ultrasound to place central venous catheters?

Always

Sometimes

Never

Don't have ultrasound available

Question Title

* 30. Do you know what the surgical home is?

Yes

I heard of it but I don't know what it is

I never heard of it

Question Title

* 31. Do you think that anesthesiologists should be involved in the perioperative medical management of surgical patients?

Yes

I am not sure

Question Title

* 32. At your organization, criteria for postoperative admission of pediatric patients with OSA after T&A are consistent with the American Academy of Pediatrics guidelines?

Yes

I am not familiar with these guidelines

Question Title

* 33. Do you perform hand hygiene before and after donning gloves?

Always

Sometimes

When I remember

It isn't necessary

Question Title

* 34. Do you make sure you know where the fire extinguishers are in every location that you provide anesthesia?

Always

Sometimes

Never

Question Title

* 35. Does your organization provide training on OR fires and use of fire extinguishers?

Yes

I don't know

Question Title

* 36. Are DNR orders automatically rescinded during surgery?

Yes

I don't know

Question Title

* 37. Do you routinely monitor neuromuscular blockade if administering muscle relaxants?

Yes

Don't have monitors

Question Title

* 38. What train-of-four ratio do you require prior to extubation?

0.5

0.7

0.9

I don't use train-of-four monitoring

Question Title

* 39. If a patient can stick out their tongue at the end of the procedure, that is sufficient evidence of adequate reversal of neuromuscular blockade.

True

False

I don't know

Question Title

* 40. When do you perform the time out?

Prior to entering the OR

Prior to induction of general anesthesia

Prior to surgical incision

No predetermined time (varies all the time)

Question Title

* 41. Who should care for post-Fontan adolescent and adult patients undergoing non-cardiac surgery?

Pediatric cardiac anesthesiologist

Cardiac anesthesiologist

Pediatric anesthesiologist

General anesthesiologist

Question Title

* 42. Do you routinely use ultrasound to place regional blocks (consider only those blocks amenable to ultrasound use)?

Always

If the ultrasound machine is available

Depends on the type of block

It is not necessary

I don't know how to use it

Don't have an ultrasound machine

Question Title

* 43. In your OBA/ASC practice, there are specific criteria that delineate acceptable surgical candidates (e.g., OSA, BMI, ASA classification)?

Yes

Decided on a case-by-case basis

I don't know

Don't work in these areas

Question Title

* 44. I know how to perform a cricothyrotomy and do jet ventilation when I can't ventilate and can't intubate.

Yes

Question Title

* 45. My department/organization educates us on crisis resource management.

Yes

I am not familiar with crisis resource management

Question Title

* 46. A 2 year old for strabismus repair presents with a 3 day history of runny nose and productive cough. You would:

Postpone surgery for 3-4 weeks

Postpone surgery until the symptoms are resolved

Proceed with surgery

Proceed with surgery after informed consent from parents regarding increased risk of anesthesia

Question Title

* 47. An ex-premie (32 weeks gestation) presents for hernia repair at 12 weeks of age. Postoperatively, the patient should be:

Discharged home

Admitted to hospital ward

Admitted to monitored setting

Disposition depends on PACU course