FRCA Curriculum – Anaesthesia for neurosurgery, neuroradiology and neuro critical care

Competence Source Curriculum Description
NA_IK_01 Intermediate Recalls/describes the relevance of the anatomy of the skull, skull base, vertebral column and central nervous system to neuroanaesthetic practice [Cross ref applied sciences]
NA_IK_02 Intermediate Recalls/explains the relevance of applied physiology and pathophysiology related to the central nervous system to neuroanaesthetic practice [Cross ref applied sciences]
NA_IK_03 Intermediate Describes techniques for decreasing the intra-cranial pressure
NA_IK_04 Intermediate Explains the indications for using neurophysiological monitoring [including EEG, evoked potentials and ICP measurement] to benefit patients requiring neurosurgery/neuro-critical care
NA_IK_05 Intermediate Recalls how drugs can impact on neurophysiological monitoring
NA_IK_06 Intermediate Recalls/explains the pharmacology of drugs which act on the central nervous system [Cross ref applied basic sciences]
NA_IK_07 Intermediate Explains the complications of positioning for neurosurgical procedures: prone, sitting, lateral, park bench
NA_IK_08 Intermediate Demonstrates understanding of the perioperative anaesthetic management of patients for neurosurgery and neuroradiology.

This includes:

  • Preoperative assessment and optimization of patients with neurological disease
  • Induction and maintenance and reversal of anaesthesia
  • Early postoperative care including the specific areas of fluid management and the control of pain
NA_IK_09 Intermediate Demonstrates understanding of anaesthesia for neurosurgical procedures including but not exclusively:

  • Shunt surgery
  • Evacuation of intracranial haematoma
  • Planned supratentorial and posterior fossa surgery [including vascular disease and tumours]
  • Emergency surgery for traumatic brain injury
  • Spinal column surgery
NA_IK_10 Intermediate Discusses the principles of anaesthesia for neuroradiology including but not exclusively:

  • Emergency and elective imaging of the central nervous system [including the principles of stereotactic surgery]
  • interventional procedures [including coiling of intracranial aneurysms] 

[Cross reference anaesthesia in the non-theatre environment]
NA_IK_11 Intermediate Explains the anaesthetic implications of pituitary disease including endocrine effects and trans-sphenoidal surgery
NA_IK_12 Intermediate Describes anaesthesia for trigeminal neuralgia including thermocoagulation
NA_IK_13 Intermediate Explains the anaesthetic implications of spinal cord trauma
NA_IK_14 Intermediate Describes how to recognize an unstable cervical spine and explains how it should be managed
NA_IK_15 Intermediate Discusses the indications for postoperative ventilation
NA_IK_16 Intermediate Explains the techniques used for recognition and management of air embolism
NA_IK_17 Intermediate Describes the special risk associated with prion diseases during neurosurgery
NA_IK_18 Intermediate Demonstrates understanding of the principles of anaesthesia for patients with neurological disease [including but not exclusively]:

  • Guillain-Barre
  • Myasthenia gravis
  • Myasthenic syndrome
  • Dystrophia myotonica
  • Muscular dystrophy
  • Paraplegia and long term spinal cord damage
NA_IK_19 Intermediate Discusses the specific risks of venous thromboembolic disease in neurosurgical patients and how these are managed
NA_IK_20 Intermediate Demonstrates understanding of the neurocritical care management of traumatic brain injury [including but not exclusively]:

  • indications for ventilation
  • recognition and management of raised ICP
  • cerebral protection strategies 
  • fluid and electrolyte balance in the head injured patient
  • systemic effects of traumatic brain injury
  • The principles of management of acute spinal cord injury
NA_IK_21 Intermediate Describes the control of status epilepticus
NA_IK_22 Intermediate Describes the requirements for safe transfer of patients with brain injury
NA_IK_23 Intermediate Explains the issues related to the management of organ donation in neuro-critical care [Cross reference intensive care]