Going Under

Nicholas Garberina

English III Standard Pd.3

Mr. Piatak

February 23, 2017

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Anesthesiology deals with patients who need anesthetics for a surgery, procedure or to

administer medicine. Without anesthesiologists, most minor surgeries would cause an extreme

amount of pain, thankfully due to anesthetics, doctors can fully numb a patient during surgery,

preventing pain. Anesthesiology first made an appearance to the United States during the Civil

war and further enhancements occurred during World War I and World War II. Now it has

become a true branch of medicine. Anesthesiologists require many years of schooling before

they can become registered doctors. These doctors have a broad range of knowledge of the drugs

that anesthesia requires, but doctors need to continue to learn about new drugs in the developing

anesthetic field. Anesthesiology has turned into the fastest growing, most comprehensive careers

in the field of medicine.

Since the ancient times, people worked on finding ways to reduce pain for a suffering

person. They used different methods in attempts to control and reduce pain. The Chinese

developed and used acupuncture, Greeks and Romans used alcohol, and Africans smoked or

drank potent mind altering substances (Semiatin 49). Thus, ancient people found many different

ways of reducing pain.

Surgical anesthesiology came to light in the 1840s a doctor by the name of Crawford

Long. Born in Georgia, Long became an educated and skilled doctor, through his adolescence, in

education. Long graduated from Franklin College (now University of Georgia) at only 19 years

of age, earning the nickname of The Baby (Anaya-Prado 182). At 26 years of age, Long

started his practice and quickly gained people's loyalty and affection. His most significant

accomplishment, using ether to perform a painless surgery to remove a neck tumor, making Long

a very successful and well known doctor. On March 30,1842, Long removed a neck tumor
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painlessly, the patient expressed his fear of the surgeries pain, Long offered him surgery with

ether. (183). After putting an ether soaked towel over the patient's nose he fell into a deep sleep

allowing long to remove the neck tumor. After the patient woke up he could not believe that the

surgery had succeeded until he saw it for himself. Dr Long became the first medical doctor to use

ether as a form of anesthetic.

Ether did not prove as an effective anesthetic for dental surgery. Dentist developed

another method that still used today. Dental surgery transformed by using nitrous oxide, which

did not put the patient into a deep coma like sleep. The dentist could still perform the surgery

with a quicker recovery time. In 1844 Horace Wells became the first doctor that used nitrous

oxide during a dental operation (Semiatin 51).

The use of anesthesia gained attention during the Civil War and only evolved during the

World Wars. World War II became the true foundation of the discipline of anesthesiology.

World War II had many casualties that occur. The military medical doctors did not have much

training in anesthesia or how to use it in a combat zone. During the World War II many military

physicians got briefed on the basics of anesthesia techniques with quick but detailed training

(Longnecker 65). Due to the reality of how many soldiers needed medical attention during the

war they could not provide in depth training all of the time. The attack on Pearl Harbor opened

the eyes of many doctors. When the attack happened not enough skilled anesthesiologist could

respond, this lead to many doctors not giving the correct doses and put soldiers into respiratory

arrest. It did not take long for doctors to revert to using a drip ether (Crowhurst 22). Even

though pearl harbor had an amazing amount of skilled doctors on hand they had no training in

anesthesiology, and this lack of training lead many doctors into using the wrong kind of
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treatment, in turn killing the patient. Doctors realized that they needed to start training doctors

the correct way to reduce the risk of killing people. In the years following the war F.J. Halford a

senior surgeon at Pearl Harbor pleaded for appropriate anaesthetic training. These pleas ended up

reaching many different colleges; this started establishing anaesthetist facilities giving the proper

education for this medical career (Crowhurst 23). Doctors heard halford and the they began

teaching in a very thorough way so that patients would not have any risk to worry about.

During the 1880s doctors began developing local anesthetics allowing doctors to numb a

patient in a specific area instead of numbing the entire body of the patient. Doctor Sigmund

Freud used this local anesthetics by dripping a few drops of liquid cocaine into his patient's

eyeball; Sigmund Freud successfully completed the world's first ever eye surgery (Semiatin 51).

Patients got numbed in a specific region and doctors than performed the surgery painlessly. As

wars continued doctors helped anesthesiology develop into the practice that we have today.

During the 20th century anesthesiology advanced in many different and innovative ways.

Due to the fact that chloroform caused many fatalities during surgery doctors banned the use of

the drug. Doctors found that they could use new medicine during surgeries/ procedures (Semiatin

51). Many different drugs came from cocaine for different uses throughout the medical field.

The education process for an anesthesiologist can take more than 10 years. In order to

qualify for medical school a doctor first need a Bachelor of Science degree. A student wanting

the achievement of a Bachelor Degree first must complete all of the educational requirements.

These requirements entail a minimum of 120 hours of class credit towards graduation,

completing a major, standing by the colleges academic standards, and completing the

requirements of the General Education Program. Meeting the college academic standards has a
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big influence of completing a Bachelor's program. All Universities have different requirements

for classes that students must complete to graduate. At the University of Iowa the requirements

for students to remain in class starts with maintaining at least a grade point average of C or

higher, attempt all college class work, students need to complete all work at University of Iowa,

and all work attempted in the major. After a student has completed their four year Bachelor

program they can qualify for medical school (Iowa). University of Iowa likes to see good grade

and a sense of drive from their students that want to take a path in become an anesthesiologist.

College helped provide a foundation on which a lot of my medical knowledge was built.

(Interview Question 12). A doctor needs a solid base to start on when going into this field,

college helps by providing that base to continue the education to a higher level.

Once a student has successfully completed their Bachelor Degree program they still have

a long road ahead of them. After completing a Bachelor Degree program, a student needs to go

to medical school for four years. The first two years of medical school consist of spending time

in a mixed between classroom time and the lab. In the classroom students take classes in basic

sciences. These classes include anatomy, biochemistry, microbiology, pathology, and

pharmacology. Students also take the time learning the basics of examining a patient. During the

3rd and 4th year of the program students rotate in hospitals and clinics affiliated with the college.

As students rotate through the hospital they assist residents with a particular specialty. The kind

of specialty the students will focus on all depends on the hospitals strength. Rotating through

hospitals gives the students a beneficial part of the educational process doing this teaches the

students what the hospital life can entails and what they will have to face. The surgery rotation

differs from school to school, some can have a rotation as short as three weeks, and some can
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take three months it all depends (What to Expect in Medical School). All schools have a different

schedule and own different hospitals so not every program will feel the same way.

If a student thinks that medical school could overwhelm them there many other great jobs

that still have a medical background and good pay. Becoming a nurse anesthetist or a CRNA

takes approximately seven to nine years. First a student takes four years earning their Bachelors

of Science in Nursing degree. Once a student has received their degree they need to get their

registered nursing license by passing the nursing examination. Once one passes the nursing

examination, they start out as a registered nurse or RN, there, a student can branch out and

specialize in a specific area of nursing. Once a student has their RN license they need to

complete a minimum of one year working as a RN before applying for a nurse anesthetist

program. A CRNA program can take anywhere between two to three years before they can

become a certified registered nurse anesthetist (ECareers). Becoming a nurse anesthetist requires

more than taking one course of schooling.

As a nurse anesthetist (CRNA), working with physicians who provide patients with

anesthesia, CRNAs have the option to work alongside surgeons and anesthesiologists in order to

make sure everything runs smoothly. A RN has a completely different jobs than what a CRNA

has; a CRNA has to make important decisions with medicine and more life threatening choices.

These decisions deal with medication and the dosage of very powerful drugs that if administered

incorrectly could end up killing the patient. Also as a CRNA have to master a handful of

technical skills. Just having a smart and a good nurse will not fulfill all of the requirements of a

good CRNA it takes many different qualities become the best CRNA that a person can. A good

CRNA needs a compassionate and hardworking personality, the best kind of CRNAs always
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know where their supplies and drugs exist in case of an emergency (Ruesink). CRNAs have

very stressful jobs, a good CRNA can make it a very easy and good job that people enjoy.

After a student finishes their medical schooling they move into their Residency Program.

Residents have the most stressful jobs they never stop moving and have extremely long work

weeks. A anesthesiology resident can work to a maximum of 80 hours, but most work around 55

hours a week (Interview Question 5). Residents always have a busy schedule, they start the day

by going and seeing what time their procedures include. Each day begins by interviewing and

examining the first patients and discussing their health history with them. (Interview Question

2). T
hey go to each patient's room talking to the patient in the room and coming up with and

talking to the patient about the anesthetic plan. Creating an anesthetic plan need a lot of focus

going over the patient's medical history, allergies, ETC Most days end around 5 P.M. when an

on call doctor comes and relives the other doctor (A Day in the Life). Residents have a very

stressful and busy schedule.

Everyday new innovations develop in the field of anesthesiology to make the

administration of medicine easier and more safe. All doctors end up making a mistake sometime

or another. However human error can not exist, when it comes to anesthesiology just the slightest

miscalculation could kill someone. Records show more than 7,000 deaths due to conventional

methods of injection administration drugs (Merry 385). Death from human error has become to

frequent and doctors have come up with a system to track and record drugs getting used and

administered. All drugs used in the hospital need identification by preprinted labels. Some drugs

come in pre filled syringes called flag labels kept in the operating room. When a doctor has a

needed for a drug the anesthesiologist has the responsibility to read the label and scan the
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barcode before they can administer the drug to the patient. The trays hold the drugs depending on

how complex the anesthesia plan (386). To keep consistency drug drawers need the same lay out

as the drug trays. Using these drawers to help reduce congestion in the hospital. On the top

drawer laid out from left to right reflecting the class of drugs. The bottom drawer contains the

more hazardous and less used drugs. Doctors and hospitals need extra precautions and safety

features that makes sure the drugs stay out of the wrong hands. After unlocking the drug drawer,

the computer tracks what drugs get taken (387). Hospitals put Security measures into place

because of the risk of addictive and theft. Locking and tracking the drugs create an efficient way

of letting the doctors know the drugs location.

Doctor malpractice create very serious problem in the medical field. It becomes most

prevalent in anesthesiologists. Doctors have always had trouble putting patients under and

keeping them under. Malpractice insurance became mandatory for the protection of a doctor

making a mistake. Anesthesiologist must have malpractice coverage protecting themselves from

legal claims from the risks of the job. The cost of this insurance has become low compared to the

cost in the past. Drugs used during surgery can put anesthesiologists at risk of malpractice cases.

The highest risk for a malpractice cases include neurosurgeon and anesthesiologist at the most

risk of malpractice cases because the brain has the most sensitive nerves of the human body.

Anesthesia have approximately 1 out of 200,000 deaths this has a major improvement from

1973, approximately one in 1500 deaths. (Choice) Many different factors determine how much

the insurance will cost. Some of the examples include whether or not a doctor currently has

anesthesia malpractice insurance, doctors that have a full time practice or just part time, whether

the doctor has a membership with a medical group ETC Malpractice has become a very
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serious issue and costs a lot of money for the doctor getting sued. This creates a very large price

for the amount of the insurance. The average cost of malpractice insurance ranges around 35,000

dollars, however this number can change with what state the doctor works in and what kind of

practice a doctor has (Choice). As a doctor, having insurance creates a more relaxed situation

and makes the patient more comfortable patient.

Anesthesiology has turned into the fastest growing, most comprehensive careers in the

field of medicine. The World Wars had a massive impacted to anesthesiology, many doctors

started to pay more attention to taking care of the patients. Anesthesiology has a very long

history and has advanced in the past hundreds of years. Schooling for this medical area takes a

very long time, it takes a lot of dedication and commitment to become a good anesthesiologist.

Doctors must have a broad knowledge of drugs used when dealing with patients during surgery.

Security measures need a place when dealing with these drugs to protect from its addictive

properties. In the medical field malpractice suits happen a lot; malpractice insurance covers these

issues to protect doctors from mistakes they make. The amount of schooling that these doctors

need can take a toll on people, however the paycheck pays off in the long run.
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Work Cited

Anaya-Prado, Roberto, and Daniel Schadegg-Pea. "Crawford Williamson Long: The True

Pioneer Of Surgical Anesthesia." Journal Of Investigative Surgery 28.4 (2015): 181-187.

Academic Search Complete. Web. 3 Feb.

2017.<http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,custuid&custid

=s8455861&db=a9h&AN=108814330&site=ehost-live&scope=site>

Choice, Trusted. "Anesthesiologist Insurance." Anesthesiologist Malpractice Insurance.

Consumer Agent Portal, n.d. Web. 05 Feb.

2017.<https://www.trustedchoice.com/professional-liability-insurance/medical-malpractic

e/anesthesiologist/>

Crowhurst, J. A. "The Historical Significance Of Anaesthesia Events At Pearl Harbor."

Anaesthesia & Intensive Care 42.(2014): 21-24. Academic Search Complete. Web. 2 Feb.

2017.

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5861&db=a9h&AN=97077222&site=ehost-live&scope=site>

ECareers, Health. "How Many Years Does It Take to Become a Certified Registered Nurse

Anesthetist?"How Long Certified Registered Nurse Anesthetist (CRNA). Health Careers,

13 Jan. 2017. Web. 02 Feb.

2017.<https://www.healthecareers.com/article/career/how-many-years-does-it-take-to-be

come-a-nurse-anesthetist>
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Iowa, University. "Requirements for a Bachelor's Degree." College of Liberal Arts & Sciences.

University of Iowa, 30 Dec. 2016. Web. 02 Feb.

2017.<https://clas.uiowa.edu/students/handbook/requirements-bachelors-degree>

Longnecker, David E. "Education In Anesthesiology For The Twenty-First Century." Journal Of

Anesthesia 16.1 (2002): 65. Academic Search Complete. Web. 2 Jan. 2017.

<http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=6079216&site=eds-li

ve&scope=site>

Merry, Alan. "A New, Safety-Oriented, Integrated Drug Administration and A... : Anesthesia &

Analgesia."LWW. International Anesthesia Research Society, Aug. 2001. Web. 03 Feb.

2017.

<http://journals.lww.com/anesthesia-analgesia/Abstract/2001/08000/A_New,_Safety_Ori

ented,_Integrated_Drug.30.aspx>

"A Day in the Life - Resident Life - Anesthesiology Residency Program - Prospective Residents

- Graduate Medical Education - Education - University of Rochester Medical Center." A

Day in the Life. University of Rochester, n.d. Web. 03 Feb.

2017.<https://www.urmc.rochester.edu/education/graduate-medical-education/prospectiv

e-residents/anesthesiology/resident-life/life.aspx>

Ruesink, Megan. "Rasmussen College." Rasmussen College - Regionally Accredited College

Online and on Campus. Rasmussen College Inc, 8 Mar. 2015. Web. 15 Feb.

2017.<http://www.rasmussen.edu/degrees/nursing/blog/what-is-nurse-anesthetist/>

Semiatin, Steven. "The History Of Pain Relief And Anesthesia." History Magazine 13.5 (2012):

49. Science Reference Center. Web. 2 Jan. 2017.

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live&scope=site>

Wegh, Willia. Personal Interview. 31 January 2017

"What to Expect in Medical School." What to Expect in Medical School | About Medical School |

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