Ambulatory & Outpatient Anesthesiology
Section Head and Medical Director – Timothy Harwood, MD
The Section on Outpatient and
Ambulatory Anesthesiology provides service to over 10,000 patients per year in
an 8 operating room suite at the main campus, and a 3 room suite at Davie Medical Center in Advance, NC. The section is composed of 5
primary faculty members with others contributing from the Regional Anesthesia
section helping to provide care at Davie Medical Center.
We employ a variety of regional
blocks using ultrasound and nerve stimulator techniques to provide a wide
breadth of regional anesthesia techniques to provide longer periods of pain
relief after our orthopedic surgical procedures. In addition, our use of
short-acting anesthetics and non-narcotic pain medicines helps ensure more
rapid recovery and quality of the postoperative experience.
Section Head – Thomas Slaughter, MD
The Section on Cardiothoracic Anesthesiology provides care for patients requiring cardiac (heart), thoracic (lung), or vascular (blood vessel) surgery at Wake Forest Baptist Medical Center. The faculty within the Cardiothoracic Anesthesiology Section are highly experienced in providing care for both adult and pediatric patients requiring these types of surgeries. After college, each of our physician faculty has completed 4 years of medical school, 4 years of residency training in anesthesiology, and an additional 1-2 years specializing in Cardiothoracic Anesthesiology. In addition, our faculty are nationally recognized for their efforts to improve the care for patients undergoing cardiothoracic and vascular surgery through research and education endeavors.
Although the risk associated with receiving anesthesia remains low, cardiothoracic surgery carries greater risks than many other surgeries. Our faculty will employ state-of-the art monitoring technology to minimize any risk associated with your surgery. For example, during surgery on the heart, our faculty use echocardiography (imaging using sound waves) to monitor the function of the heart and heart valves. One activity that you, as a patient, can do to improve your chances of doing well with surgery is to quit smoking. Chemicals within cigarette and cigar products constrict (squeeze smaller) blood vessels in the heart and may even lead to a heart attack. Stopping smoking before your surgery will improve your health – even if you have smoked for many years. Should you have any specific concerns regarding the anesthesia for your upcoming surgery, please do not hesitate to contact our faculty within the Department of Anesthesiology.
Critical Care Medicine
Section Head and Medical Director, Adult ICUs - David Bowton, MD
The Section on Critical Care provides critical-care-specialist (Intensivist) care to all patients in our Neuro-Intensive Care and Cardiothoracic Intensive Care Units. There are 11 faculty members in the Section. We work closely with our Neurologists, Neurosurgeons, and Cardiothoracic surgeons to ensure the delivery of the highest quality care to each of our patients. The exemplary quality of care provided has been recognized externally by receipt of the Beacon Award for Critical Care Excellence from the AACN. There is an attending Intensivist available 24 hours, 7 days a week in these ICUs. Each of our Intensivists is board certified or eligible in Critical Care and/or Neurocritical Care. Our Intensivists have varied training backgrounds and expertise and bring a wealth of experience to the bedside. The areas in which our Intensivists have primary training and board certifications include Internal Medicine, Anesthesiology, Emergency Medicine and Neurology, and Pulmonary Medicine. For our residents and fellows, this cross-training gives a range of experience not available any where else in the region.
Inpatient General Anesthesiology
Needing surgery for any reason is anxiety-provoking for most of us. We understand this concept exceedingly well because our profession, universally, is primarily dedicated to bringing people safely and comfortably through this experience. Providing anesthesia is our privilege and the dozens of anesthesiologists in our department have dedicated their lives to its proper performance. Your anesthetic will always be performed by a team headed by an anesthesiologist. All anesthesiologists are doctors of medicine who have completed four yours of medical school, 3 to 4 years of anesthesia residency, and many have done extra years of training in particular subspecialties to include neuroanesthesia, cardiac anesthesia, obstetric, pediatric, and regional anesthesia.
Our primary concern is patient safety, always. We are continuously assessing and monitoring every patient in our care to make certain everything that proceeds in the safest manner possible. From this foundation of safety ensures our other primary objectives: patient education and preparation for procedures, prevention, and treatment of pain and nausea, and assurance of a complete lack of awareness for procedures requiring complete or “general” anesthesia.
All anesthetics performed here will have a preoperative assessment completed before proceeding that includes a thorough review of all pertinent medical history, the explanation of all anesthetic options and the acquisition of your informed consent to proceed once all of your questions are answered. Upon completion of the procedure, patients are followed in a recovery area to ensure a safe emergence, optimize any nausea relief and transition pain treatment from surgery through to your next destination.
Section Head – John Reynolds, MD
Should you require a neurosurgical procedure, our anesthesia department has an entire section dedicated to providing care in this unique arena. This includes any procedure on your head, neck, brain, spine, or spinal cord. We are comfortable with the considerations required for these cases because we focus on them every day. The most unique aspect of neuroanesthesia is the requirement to emerge quickly regardless of case duration. We accomplish this by altering the ratios of intranevous pain medications and inhalational gases. Our sole purpose is to make the procudure as safe and comfortable as possible.
Should you have any questions regarding neuroanesthesia, you may contact me at 336-716-4498.
Section Head – Robert D’Angelo, MD (Forsyth Medical Center)
The 14 members of
the Section on Obstetric and Gynecologic Anesthesiology provide anesthesia
coverage for 7,000 obstetric deliveries and 3,000 gynecologic surgeries per
year. Approximately 80% of vaginal deliveries utilize regional analgesia, and
over 90% of patients receive spinal or epidural anesthesia for cesarean
section. In-house call by faculty and resident physicians ensures top-level
service 24-hours a day. The section is internationally known for its research
on spinal and epidural anesthesia and analgesia. Faculty members are board
certified by the American Board of Anesthesiology and have completed
fellowships in obstetric anesthesia. Physicians come from all over the country
to train within the Section on Obstetric and Gynecologic Anesthesiology.
Section Head - Douglas Ririe
The section on
pediatric anesthesia provides care for children requiring anesthesia and
sedation for surgery and non-surgical procedures in the Brenner Children’s
Hospital at Wake Forest Baptist Medical Center. The Brenner Children’s Hospital
(located within the Medical Center) provides outstanding pediatric care and
facilities and functions as an independent pediatric hospital within a large
general hospital environment. More than 4,500 children are admitted
to Brenner Children's Hospital each year. In addition, more than 21,000
pediatric subspecialty visits occur annually at the hospital-based outpatient
clinics. Over 6000 cases each
year are managed by eight Board Certified pediatric anesthesiologists. Pediatric anesthesiologists are physicians
with a minimum of one year of specialized fellowship training and advanced
certification in the perioperative care of children. This ensures the safest
care for infants and children undergoing anesthesia and the optimal emphasis on
the impact of the different psychological, physical, and physiological needs of
children from newborns to teenagers. Surgical cases are comprised of all forms of general, urologic, orthopedic,
ophthalmologic, plastic and reconstructive, otolaryngologic, cardiothoracic,
and neurosurgical procedures. Services are also provided for children requiring
specialized cardiology, pulmonary, gastroenterology and radiology services, to
name a few. Our objectives are
to keep children safe and to make the hospital experience as pleasant as
possible and minimize the stress of surgery and procedures for children and
families requiring our services. This involves helping manage your child’s
anxiety before surgery as well as his or her pain after surgery. In addition,
this involves addressing questions you have about your child’s procedure and
keeping you informed about your child's condition. Our pediatric
anesthesiologists are available 24 hours a day providing optimal pediatric care
for children whenever needed. Brenner Children's Hospital Pediatric Anesthesiology
Pediatric Critical Care
Section Head and Medical Director, Pediatric Intensive Care Unit
and Respiratory Care – Thomas Nakagawa, MD
The pediatric intensive care unit (PICU) at Brenner’s Children’s
Hospital is a state-of-the-art, high-level, 11-bed unit with a separate 7-bed
intermediate care unit. The PICU has 9 full-time board-certified pediatric
intensive care specialists who provide 24-hour in house coverage caring for
critically ill and injured children ranging in age from birth to 21 years of
age. The PICU averages 530 admissions per year. Additionally, over 1000
children are admitted to the intermediate care unit. The intensivists provide
consultation and care for surgical patients and manage medical patients
collaborating with pediatric surgical and medical sub-specialists. The
intensivists are actively involved in the cardiac surgery program caring for
infants and children with congenital heart disease. Additionally, the intensive
care team is involved in the management of medical emergencies, neurosurgical
diseases, pediatric trauma, airway management, mechanical ventilation, vascular
access, and ECMO. A pediatric sedation service run by the pediatric
intensivists provides IV anesthesia for more than 1,000 children each year who
require sedation for various procedures such as burn debridement, diagnostic
and therapeutic lumbar punctures, endoscopy and colonoscopy, wound closures,
hearing and ocular exams, and central line placement. A pediatric mobile
intensive care team is available 24 hours a day to provide transport of
critically ill and injured children to Brenner Children’s hospital.
Section Head, Perioperative Medicine - Angela F. Edwards, MD (below left)
Medical Director, Preoperative Assessment Clinic, Daniel Forest, MD (below right)
The Preoperative Assessment Clinic (PAC) is an innovative, efficient, and newly remodeled, patient-friendly clinic. The PAC provides preoperative preparation and evaluation for over 16,000 ambulatory surgery patients each year. Evidence-based testing is utilized to choose tests wisely and avoid unnecessary "routine" testing. The Anesthesiology Department has an attending anesthesiologist, physician assistants, nurse practitioners, and residents ensuring patients are ready for surgery. Anesthesia and Internal Medicine services work together to ensure patients receive complete perioperative care. While we routinely obtain our own testing, including noninvasive cardiac and pulmonary tests, a variety of consultants are available for more complex patients. An electronic Preoperative Assessment system is currently in use with electronic consents and signatures in the clinic.
Regional Anesthesia and Acute Pain Management
Section Head - Robert Weller, MD
The Section on Regional Anesthesia and Acute Pain Management (RAAPM) has 2 complementary focuses to its provision of patient care, resident education, and clinical research. The first is the application of regional anesthetic techniques for surgery with an emphasis on peripheral nerve blockade and continuous catheter techniques. The faculty in this section work closely with residents during a dedicated month-long RAAPM rotation to provide patients with 2000-3000 peripheral nerve block procedures a year. Each resident places and manages 60-100 regional anesthetics during this month of intensive training which also includes the management of continuous thoracic and lumbar epidural regional anesthetics.
The Acute Pain Service (APS) is a division of the Section of Regional Anesthesia and Acute Pain Management, which manages all inpatient pain management problems and conditions ranging from perioperative pain management, trauma-related pain, chronic pain, and cancer-related pain. The APS cares for both adult and pediatric patients, with 24 hour a day, 365 days a year management and consultation service. Over 150 new patient consultations are seen per month. Continuous epidural analgesia, continuous peripheral neural blockade, IV patient-controlled analgesia, and opioid and non-opioid analgesic therapies are widely used with an emphasis on multimodal analgesic regimens and preventative patient care facilitating postoperative and post-injury rehabilitation. Resident and fellowship level education through twice daily attending rounds, didactic discussions, and case presentations, as well as clinical research are integral components of the APS. Choosing Regional Anesthesia at Wake Forest Medical Center