International Education Elective at - PowerPoint Presentation

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International Education Elective at Siriraj Hospital in Bangkok, Thailand

MS-4

Yasser Hassan

The University of Kansas SOM

January 29

to February 23, 2018

Bangkok, Thailand

Capital and largest city in ThailandCity population over 8 millionMetro population over 14 millionHistorical roots are a small trading post during the Ayutthaya Kingdom in the 15th century

Grand Palace

View of downtown from Sky Bar

Siriraj Hospital

The largest and oldest hospital in ThailandFounded by King Chulalongkorn in 1888 in response to the cholera epidemicThe hospital was named after his son who died of dysenteryThe former King Bhumibol Adulyadej (Rama IX) was cared for at Siriraj before passing away in October 2016

Department of Anesthesiology

1 week in General 1 week in ENT and Cardio1 week in Ortho1 week in OB/GYN

First thing I noticed, all the sandals!

Intraop

TEE during cardiac surgery

(Picture taken from their website)

Topic of Interest

The similarities and differences of

A

nesthesiology between The University of Kansas Medical Center and Siriraj Hospital.

I selected this topic because I am interested in anesthesiology and am going into anesthesiology residency (at UMKC

this year

).

I wanted to expand my perspective on admi

nisteri

ng anesthesia beca

use the field is very personal, variable, and dynamic.

Interview With Faculty Member

Dr. Pichaya Waitayawinyu, MD, AnesthesiologistNeuro Anesthesia fellowship training at Harborview Medical Center, University of WashingtonPediatric Anesthesia fellowship training at Children’s National Health System, Washington D.C.

Some key points during the interview:Anesthesiology at Siriraj is actually quite similar to KUMC!Not as much funding so expensive medications such as Sugammadex not used muchReusable drapes, sheets, gowns used in the ORPaper records in the OR30 Baht programMD requires 6 years of medical school, 1 year internship, 4 years residencyCRNA only 1 year training! 1 year ICU experience is not required

Pre-OpIntra-OpPost-OpKUMCPatient comes in morning of surgeryEither CRNA or Resident present in the roomAnesthesiologist responsible for post-op painSirirajPatient comes in day before surgery and stays overnightSRNA, CRNA, Resident all could be in the roomSurgeon responsible for post-op pain (Anesthesiologist can give guidelines)Only 30 PCAs available

Some of the differences in Anesthesiology at KUMC vs

Siriraj

Adductor Canal Nerve Block

Dr. Nantthasorn Zinboonyahgoon, MD, Pain fellowship training at Brigham and Women’s HospitalAssisted several of these nerve blocks one of the days of my ortho week – favorite clinical experiencePure sensory nerve block (saphenous nerve) for postoperative analgesia after knee surgeryAvoids quadriceps weakness in femoral nerve block

Elephants near Chiang Mai

Favorite cultural experience Activities included feeding elephants, making vitamins for them, mud bath, and river bathFacts about elephants:Largest living land mammalLife span similar to humansWeigh 2.25-5.5 tonsEat up to 300 lbs/dayDiet consists of roots, grasses, fruit, and barkOnly sleep 2 hours per day

Mud bath

Faddy (fellow KU MS4) feeding an elephant

Making vitamins for the elephants, ingredients included bananas, tamarind, and sugar, wrapped in bamboo leaves

Our fellow Thai medical students took us out for dinner, dessert, and out on the town!

References

https://en.wikipedia.org/wiki/Bangkok

https://en.wikipedia.org/wiki/Siriraj_Hospital

http://www.si.mahidol.ac.th/department/Anesthesiology/home/

http://www.pictaram.net/user/259476182/1589986287137590814_259476182

https://www.nysora.com/ultrasound-guided-saphenous-subsartoriusadductor-canal-nerve-block

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466855/

https://www.nationalgeographic.com/animals/mammals/a/asian-elephant/