Department of Anesthesiology

A Day in the Life: Texas Heart Institute

Master
Terms
Andrew

Item Term
Andrew Nguyen, M.D., CA-3

Item Definition

The Texas Heart Institute is one of the hospital sites that we rotate at as a CA-2 and CA-3 (and sometimes for a month as a CA-1).

I arrive at the hospital around 5:30-6:30 a.m. depending on the case I'll be doing. I double check the case assignments and head to the room I'll be in for that day.

I normally look at the patient's chart the night ahead of time, but I review the chart again for any major updates or new labs/studies.

I run through my typical MSMAIDS checklist. The pyxis machine and anesthesia cabinets are very well stocked. In addition, the anesthesia techs are very knowledgeable of the types of cases that we do here and the specific equipment that we need: ranging from simple set-ups for something like a small vascular case to larger set-ups for bigger cases you'll see as a resident, like a liver transplant or ACB (aka CABG). Frequently, they'll have these things (cold bolus line, hot line, pressure lines -art, CVP, PA, etc., TEE) already set up - sometimes before you even get there.

Given that we take care of a lot of sick cardiac patients here, I'll commonly put together an arterial line placement kit, central line supplies and/or infusions that we'll likely need. I'll meet with my attending or text them to go over the plan and clarify any questions I have, and then go see the patient to preop and consent them, in anticipation of a 7:30 a.m. case start normally. I'll proceed through the cases until I get relieved or finish out the room and take over another case.

At the end of the day, I head home based on my order in the release schedule - but reliably one of the first to leave if I'm first- or second-call the next day. Later that evening, the on-call resident lets us know the case assignments for the next day and that gives us a chance to read up on the patients and the cases.

At THI, we typically take care of patients for cardiac, vascular, and intrathoracic non-cardiac procedures (VATS, esophageal resection, etc.). We also take care of sick cardiac patients undergoing other procedures as well (e.g., tracheostomies) as well as kidney and liver transplants. The anesthesia attendings here are some of our most capable and clinically adaptable staff as they are all CV or CV/ICU-trained and also used to doing cases solo if need be. It's also a unique rotation site as a resident because it has a more private practice atmosphere and pace.

The rotation really complements our other sites well and acts as a great immersion into the cardiac world. The experience I had here is one of the major reasons I decided to pursue a cardiac fellowship after residency.