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The meeting was called to order at 0715
hrs.
PRESENT
Drs. R. Preston, D. Campbell, R. Nunn, J. Douglas, J. Kronberg, P. Angle, B. Ong, R. Elliott, R. Shukla, J. Littleford, M.
Srebrynak.
1. Minutes of the previous meeting were approved, with the exception of 6.1: Dr. Peter, not Dr. MacArthur, will speak on post C/S analgesia.
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2. BUSINESS ARISING
2.1 Obstetric Anesthesia Guidelines - The Guidelines for Practice of Obstetric Anesthesia were accepted. It was suggested that they be reviewed every three years.
2.2 Neonatal Resuscitation Program - This program has been resurrected. NRP guidelines are to be redone by 2000. Dr. Littleford has agreed to rejoin this committee as the anesthesiologist member. The question of CAS funding support was discussed, and Dr. Littleford will let us know her expenses this year so we can petition the CAS for funding.
2.3 CAS Head Office Changes - It was noted that there have been many significant changes at CAS Head Office lately. These have impacted negatively on the operations of the sections.
2.4 Section Sponsorship - Dr. Breen received $2500 in industry sponsorship for the meeting. Astra will be approached re: sponsorship opportunities for our section website.
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3. REPORTS
3.1 Scientific Affairs (Dr. Campbell) - Obstetric topics were well represented at the resident discussion sessions (1 of 9) and poster displays (7 of 9).
3.2 GP Anesthetist Discussions (Dr. Preston for Dr. Breen) - These discussions arose over the controversy of whether or not a GP anesthetist could bill for provision of obstetric care and anesthesia care in the same delivering patient. There are presently no guidelines for this situation. The SOGC and the SRPC (Society for Rural Physicians of Canada) are meeting to discuss such things as definitions of low risk patients where this scenario may be permitted. Our CAS OB Section has decided to avoid issuing a statement which condones this clinical practice of dual service.
3.3 Section Chair Teleconference - Deferred
3.4 Executive Meeting - Deferred
3.5 Financial Report (Dr. Preston) - Dr. Preston presented our section financial report. We have broken even for the past year. There will be no CAS meeting in 2000 (World Congress) so we anticipate less operating costs as a result.
3.6 Section Website (Dr. Preston) - This is managed by Dr. Preston. The address is www.obanaesthesia.org. The group commended her on its success. She would like members to supply her with suggestions for 1) OB links 2) discussion topics or general thoughts and comments 3) meetings (dates, etc) 4) Fellowship information from your institution.
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4. NEW BUSINESS
4.1 SOGC (Dr. Preston) - Dr. Preston had very fruitful discussions with the SOGC during meetings in the fall. It was decided that our groups should, in the future, work on cooperative guidelines for issues that affect us both. We are presently giving input into guidelines for management of labour pain. We will soon do the same for management of PDPH.
4.2 Guidelines for Management of Fetal Bradycardia after Regional Anesthesia (Dr. Nunn) - Dr. Nunn presented a brief literature search on this topic. Input from the group was sought on what to include or exclude. They will be circulated to a small group for further refinement, then on to the CAS Committee for approval. They will then be sent on to the
SOGC.
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5. CORRESPONDENCE
5.1 National Midwifery Guidelines - Provincial guidelines for midwifery vary greatly. We concluded simply that the aim should be that all women should receive optimum analgesia during childbirth. We hope that we will be able to make a joint statement to this end in the future. Dr. Kronberg will supply Dr. Preston with more information in the meantime for posting on the website. There is to be an article in the CMAJ on anesthesiologists and midwives including midwifery training for labour epidural analgesia.
5.2 SOGC Guidelines - the SOGC wants the CAS and OB Section to review their standards for anesthesiologist attendance at complicated vaginal deliveries.
5.3 see 3.2
5.4 Back up Anesthetists for OB Services in Small Hospitals - deferred
6. FUTURE MEETINGS
6.1 2000 World Congress (Montreal) - There will be no CAS OB lectures or luncheon meetings. However, an OB section business meeting will be scheduled.
6.2 CAS 2001 (Halifax) - Dr. Nunn will be the local OB host. He will liaise with Dr. Campbell (Scientific Affairs) by November 2000 to set the itinery/speakers for the lunch and symposium. Dr. Campbell will confirm to the CAS by Fall 99 the OB Scientific Program.
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7. OTHER BUSINESS
7.1 CAS Newsletter - this section will take advantage of these for various PR items
7.2 1998 Section Luncheon - this session received a low rating via the CAS questionnaire. The reasons were unclear. We will look at the 99 questionnaire results closely.
7.3 International Journal of OB Anesthesia - We are attempting to get special subscription rates for Section members
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8. SECTION EXECUTIVE AND SCIENTIFIC AFFAIRS REP
Presently, they consist of:
Dr. Roanne Preston, Chairperson - 3rd year
Dr. David Campbell, Vice-Chair and Scientific Affairs - 2nd year
Dr. Rob Nunn, secretary - 2nd year
These positions will remain in effect until the 2000 Meeting, at which time new blood will be welcomed.
There being no further business, the meeting was adjourned at 0900 hr.
Respectfully submitted:
R. Nunn, MD, FRCPC
Secretary, OB Section, CAS
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