August 2026 - Hsc-clinicians-anesthesia - University of Manitoba Mailing Lists

Process for Anesthesia Support with High-Risk Procedural Sedation
by Marshall Tenenbein, Dr. 04 Sep '26

04 Sep '26

Hi everyone, There was a recent situation where a patient in the ER resuscitation room required an urgent closed reduction under procedural sedation. Due to a variety of circumstances including unstable hemodynamics, the ER physician felt this patient’s status was beyond the scope of their abilities to sedate the patient in the ER. On this night , the junior orthopedic resident was tasked with coordinating with the evening IHA a plan to safely reduce the patient’s fracture. As a result of this situation, based on my input, a communication was sent out to HSC ER doctors. It is important to remember that the vast majority of procedural sedations are carried out in the ED without our involvement. This provides timely care to patients without using precious OR resources. The majority of these procedures will continue this way and I suspect we will be consulted a few times a year. To make the process a bit easier, I have asked that ERPs to contact us directly, and don’t delegate to a trainee. This way we can get a better picture of the patient’s status and the rationale for our involvement so that we can determine the appropriate location of the reduction. There are times where it may be appropriate for us to go to resuscitation, but if the patient is truly unstable, an OR setting would be the appropriate location and the case would be triaged like any other surgical procedure. I corrected the false impression that the PACU is more appropriate than the resuscitation room for unstable patients. I will leave the decision of where these procedures take place to the discretion of the IHA, as it truly is multifactorial. How many rooms are running, how sick the patients are, seniority of residents +/- ACA availability, time of day, PACU status… It’s impossible to protocolize these rare occurrences. Be sure to send me an email if you are consulted for a procedural sedation from the ED so that I can track the occurrences. In the situation described, the evening IHA assessed the patient as stable and appropriate for out of OR sedation. Once it was appropriate for them to leave the OR complex, they went to resusc to sedate the patient while the ortho residents attempted the closed reduction. Unfortunately, the post procedure x-ray demonstrated the reduction failed requiring the IHA to return for a second time. I believe surgical attending supervision is warranted for closed reductions in hemodynamically unstable patients From: Chau Pham <cpham1(a)hsc.mb.ca<mailto:cpham1@hsc.mb.ca>> Subject: Process for Anesthesia Support with High-Risk Procedural Sedation Hello Team, In the uncommon situation where a patient meets ASA III/IV criteria and you are asked to provide procedural sedation in Resuscitation for a procedure that is not immediately life- or limb-saving—such as an orthopedic reduction—you may consult Anesthesia on call if you determine that the patient’s risk exceeds what can safely be managed in the ED. To support clear, timely communication and an effective workflow, please follow this process: 1. Call the Anesthesia on-call phone directly at 204-583-2509. This phone is staffed 24/7. 2. Speak directly with the staff anesthesiologist on call. Please avoid routing the request through intermediary trainees, such as junior Orthopedic residents. 3. Discuss the safest and most appropriate location for sedation based on the patient’s condition and current capacity. This may be Resuscitation, PACU or the OR. 4. The anesthesiologist will be responsible for intra-procedural monitoring. Phase 1 recovery will be provided by the nursing team in the location where the procedure is performed. If sedation occurs in PACU or the OR, the patient’s ED bed must be held so that they can return for phase 2 recovery while awaiting their final disposition. A few important considerations: * PACU is more comparable to a step-down unit than a critical care environment, generally with a nursing ratio of one nurse to two patients. If a patient is too unstable for Resuscitation, they are unlikely to be appropriate for PACU and may require the OR or ICU. After hours, PACU has fewer nursing resources and no immediately available respiratory therapy or pharmacy support. There may also be fewer physicians present, with much of the support resting on a single anesthesiologist. * During regular daytime hours, Anesthesia generally has more in-house staff available to assist. After hours, the anesthetist on-call may be working alone or scrubbed into an E1 case and unable to leave the OR complex. A senior resident may not always be available to provide relief. A clinical assistant is available until 23:00, and the backup anesthesiologist is approximately one hour from the site and is activated only for emergent situations. These factors should be considered during the discussion about the safest and most practical plan. * If additional Anesthesia resources are engaged, please confirm with Orthopedics that appropriate attending supervision will be available for the reduction. This is important to maximize the likelihood of a successful procedure and avoid requiring Anesthesia to return for a second attempt. * Finally, Anesthesia has asked that we also use the on-call phone number when requesting assistance with a double setup for an anticipated difficult airway. Please do not call “Anesthesia 25”—we would prefer that no one have to run and trip on the way. 😉 Thank you, Chau Disclaimer : This email (including any attachments or enclosed documents) is intended for the addressee(s) only and may contain privileged, proprietary or confidential information. Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited. If you receive this email in error, please notify the sender immediately, return the original (if applicable) and delete the email. Avis : Le présent courriel (y compris toute pièce jointe) est destiné à la personne ou aux personnes à qui il est adressé, et peut contenir des renseignements confidentiels, privés ou protégés par un privilège juridique. Toute utilisation, divulgation, distribution, copie ou diffusion non autorisée est strictement défendue. Si vous avez reçu le présent courriel par erreur, veuillez en informer immédiatement l’expéditeur, retourner l’original (le cas échéant) et supprimer ce courriel.

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HSC & Womens's OR Schedule
by Jashandeep Gill 27 Aug '26

27 Aug '26

Caution! This message was sent from outside the University of Manitoba. Hi, Please find attached the HSC & Women's OR schedule. Thanks, Jashan Jashandeep Gill Secretary III | HSC Winnipeg Shared Health Department of Anesthesiology, Perioperative & Pain Medicine| Harry Medovy House, 2nd Floor AE235 - 671 William Ave, Winnipeg MB R3E 0Z2 Phone: 204-787-7497 Fax: 204- 787-3656 Jgill17(a)sharedhealthmb.ca<mailto:Jgill17@sharedhealthmb.ca> | www.hsc.mb.ca<http://www.hsc.mb.ca/> | www.sharedhealthmb.ca<http://www.sharedhealthmb.ca/> Disclaimer : This email (including any attachments or enclosed documents) is intended for the addressee(s) only and may contain privileged, proprietary or confidential information. Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited. If you receive this email in error, please notify the sender immediately, return the original (if applicable) and delete the email. Avis : Le pr?sent courriel (y compris toute pi?ce jointe) est destin? ? la personne ou aux personnes ? qui il est adress?, et peut contenir des renseignements confidentiels, priv?s ou prot?g?s par un privil?ge juridique. Toute utilisation, divulgation, distribution, copie ou diffusion non autoris?e est strictement d?fendue. Si vous avez re?u le pr?sent courriel par erreur, veuillez en informer imm?diatement l'exp?diteur, retourner l'original (le cas ?ch?ant) et supprimer ce courriel.

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HSC & Women's OR Schedule
by Jashandeep Gill 20 Aug '26

20 Aug '26

Caution! This message was sent from outside the University of Manitoba. Hi, Please find attached the HSC & Women's OR schedule. Thanks, Jashan Jashandeep Gill Secretary III | HSC Winnipeg Shared Health Department of Anesthesiology, Perioperative & Pain Medicine| Harry Medovy House, 2nd Floor AE235 - 671 William Ave, Winnipeg MB R3E 0Z2 Phone: 204-787-7497 Fax: 204- 787-3656 Jgill17(a)sharedhealthmb.ca<mailto:Jgill17@sharedhealthmb.ca> | www.hsc.mb.ca<http://www.hsc.mb.ca/> | www.sharedhealthmb.ca<http://www.sharedhealthmb.ca/> Disclaimer : This email (including any attachments or enclosed documents) is intended for the addressee(s) only and may contain privileged, proprietary or confidential information. Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited. If you receive this email in error, please notify the sender immediately, return the original (if applicable) and delete the email. Avis : Le pr?sent courriel (y compris toute pi?ce jointe) est destin? ? la personne ou aux personnes ? qui il est adress?, et peut contenir des renseignements confidentiels, priv?s ou prot?g?s par un privil?ge juridique. Toute utilisation, divulgation, distribution, copie ou diffusion non autoris?e est strictement d?fendue. Si vous avez re?u le pr?sent courriel par erreur, veuillez en informer imm?diatement l'exp?diteur, retourner l'original (le cas ?ch?ant) et supprimer ce courriel.

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HSC call schedules Sept - Dec 2026
by Genevieve Krahn 14 Aug '26

14 Aug '26

Caution! This message was sent from outside the University of Manitoba. Good morning all, Attached is the HSC-Adult call schedule for September to December. These schedules were based on deadline for requests to be submitted by July 12th (below). We are currently working on the HSC & Pan Am daytime slates. Jashan is ensuring that slates in Women's and those deemed 'desirable' are equitably distributed. Once we have that work completed and gaps filled, all day slates for HSC/Pan Am will be published as well. Available slates will be visible for pick up, per usual. * If we have excess manpower at these 2 sites, you may now see a slate in your schedule called 'Pending Assign-HSC'. [cid:image004.png@01DD2B0D.67F60AD0] This means we are still working with the regional schedulers to try to meet OR requirements at other sites. If, after all OR needs are met and we are still fully staffed, VDOs will be offered regionally. Please ensure that when picking up call shifts that you are on an HSC rotation week. On the home screen, if you click 'My rotations' it will populate your site rotations for each day of the week (see below). Equina is fixing the way the call schedule report looks for PCUS and APS, there is an update scheduled this weekend so I can redistribute the reports with the proper view on Monday. Thanks, Gen [cid:image005.png@01DD2BD5.8B4116B0] From: Genevieve Krahn Sent: Tuesday, June 16, 2026 1:52 PM To: 'Clinicians mail list' <med-anesthesia-clinicians(a)lists.umanitoba.ca<mailto:med-anesthesia-clinicians@lists.umanitoba.ca>>; Cc: June Kaptein <JKAPTEIN(a)vgh.mb.ca<mailto:JKAPTEIN@vgh.mb.ca>>; Charmaine Carlos <ccarlos(a)sbgh.mb.ca<mailto:ccarlos@sbgh.mb.ca>>; Mae Ominga <mominga2(a)sbgh.mb.ca<mailto:mominga2@sbgh.mb.ca>>; Jashandeep Gill <jgill17(a)sharedhealthmb.ca<mailto:jgill17@sharedhealthmb.ca>>; Mira Aird <maird(a)hsc.mb.ca<mailto:maird@hsc.mb.ca>> Subject: Vacation requests Oct - Dec 2026 Good afternoon, all, In our transition to Equina as a scheduling tool, we were targeting getting the schedules out further in advance for our faculty group. Equina has updated their AI tools, and I will be working with a dedicated tech to navigate some new features for the October to December schedules. As such, please have all requests (Vacation, NC, Admin, Teaching, No Call...OR...Available, Day On, On call etc) submitted by Sunday, July 12th for the Oct - Dec months. I am targeting having drafts to your site schedulers of the Call assignments by the end of July, hoping to publish by mid August. Thank you, Genevieve Genevieve Krahn (she/her) Administrative Manager WRHA Anesthesia AE2-21, Harry Medovy House 671 William Avenue R3E 0Z2 Phone: (204)787-8980 Fax: (204)787-4291 Email: Gkrahn2(a)wrha.mb.ca<mailto:Gkrahn2@wrha.mb.ca> The Winnipeg Regional Health Authority acknowledges that it provides health services in facilities located in Treaty 1 and Treaty 5 territories, the homelands of the Mètis Nation and the original lands of the Inuit people. The WRHA respects and acknowledges harms and mistakes, and we dedicate ourselves to collaborate in partnership with First Nation Mètis and Inuit people in the spirit of reconciliation. [Facebook-logo]@winnipegregionalhealthauthority [twitter.png] @WinnipegRHA [website-logo-png] www.wrha.mb.ca<http://www.wrha.mb.ca/> REMOTE WORK DAY: PLANNED ABSENCES: July 4 - 12 September 19 - October 4 Disclaimer : This email (including any attachments or enclosed documents) is intended for the addressee(s) only and may contain privileged, proprietary or confidential information. Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited. If you receive this email in error, please notify the sender immediately, return the original (if applicable) and delete the email. Avis : Le présent courriel (y compris toute pièce jointe) est destiné à la personne ou aux personnes à qui il est adressé, et peut contenir des renseignements confidentiels, privés ou protégés par un privilège juridique. Toute utilisation, divulgation, distribution, copie ou diffusion non autorisée est strictement défendue. Si vous avez reçu le présent courriel par erreur, veuillez en informer immédiatement l'expéditeur, retourner l'original (le cas échéant) et supprimer ce courriel.

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HSC & Women's OR Schedule
by Jashandeep Gill 13 Aug '26

13 Aug '26

Caution! This message was sent from outside the University of Manitoba. Hi, Please find attached the HSC & Women's OR schedule. Thanks, Jashan Jashandeep Gill Secretary III | HSC Winnipeg Shared Health Department of Anesthesiology, Perioperative & Pain Medicine| Harry Medovy House, 2nd Floor AE235 - 671 William Ave, Winnipeg MB R3E 0Z2 Phone: 204-787-7497 Fax: 204- 787-3656 Jgill17(a)sharedhealthmb.ca<mailto:Jgill17@sharedhealthmb.ca> | www.hsc.mb.ca<http://www.hsc.mb.ca/> | www.sharedhealthmb.ca<http://www.sharedhealthmb.ca/> Disclaimer : This email (including any attachments or enclosed documents) is intended for the addressee(s) only and may contain privileged, proprietary or confidential information. Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited. If you receive this email in error, please notify the sender immediately, return the original (if applicable) and delete the email. Avis : Le pr?sent courriel (y compris toute pi?ce jointe) est destin? ? la personne ou aux personnes ? qui il est adress?, et peut contenir des renseignements confidentiels, priv?s ou prot?g?s par un privil?ge juridique. Toute utilisation, divulgation, distribution, copie ou diffusion non autoris?e est strictement d?fendue. Si vous avez re?u le pr?sent courriel par erreur, veuillez en informer imm?diatement l'exp?diteur, retourner l'original (le cas ?ch?ant) et supprimer ce courriel.

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New Surgeon
by Marshall Tenenbein, Dr. 11 Aug '26

11 Aug '26

See attached announcement. ________________________________ Disclaimer : This email (including any attachments or enclosed documents) is intended for the addressee(s) only and may contain privileged, proprietary or confidential information. Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited. If you receive this email in error, please notify the sender immediately, return the original (if applicable) and delete the email. Avis : Le pr?sent courriel (y compris toute pi?ce jointe) est destin? ? la personne ou aux personnes ? qui il est adress?, et peut contenir des renseignements confidentiels, priv?s ou prot?g?s par un privil?ge juridique. Toute utilisation, divulgation, distribution, copie ou diffusion non autoris?e est strictement d?fendue. Si vous avez re?u le pr?sent courriel par erreur, veuillez en informer imm?diatement l'exp?diteur, retourner l'original (le cas ?ch?ant) et supprimer ce courriel.

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HSC & Womens's OR Schedule
by Jashandeep Gill 06 Aug '26

06 Aug '26

Caution! This message was sent from outside the University of Manitoba. Hi, Please find attached the HSC & Women's OR schedule. Thanks, Jashan Jashandeep Gill Secretary III | HSC Winnipeg Shared Health Department of Anesthesiology, Perioperative & Pain Medicine| Harry Medovy House, 2nd Floor AE235 - 671 William Ave, Winnipeg MB R3E 0Z2 Phone: 204-787-7497 Fax: 204- 787-3656 Jgill17(a)sharedhealthmb.ca<mailto:Jgill17@sharedhealthmb.ca> | www.hsc.mb.ca<http://www.hsc.mb.ca/> | www.sharedhealthmb.ca<http://www.sharedhealthmb.ca/> Disclaimer : This email (including any attachments or enclosed documents) is intended for the addressee(s) only and may contain privileged, proprietary or confidential information. Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited. If you receive this email in error, please notify the sender immediately, return the original (if applicable) and delete the email. Avis : Le pr?sent courriel (y compris toute pi?ce jointe) est destin? ? la personne ou aux personnes ? qui il est adress?, et peut contenir des renseignements confidentiels, priv?s ou prot?g?s par un privil?ge juridique. Toute utilisation, divulgation, distribution, copie ou diffusion non autoris?e est strictement d?fendue. Si vous avez re?u le pr?sent courriel par erreur, veuillez en informer imm?diatement l'exp?diteur, retourner l'original (le cas ?ch?ant) et supprimer ce courriel.

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OR Dress Code
by Marshall Tenenbein 05 Aug '26

05 Aug '26

HSC Anesthesiologists, Please review the following OR dress code guidance. * Personal arm coverings should be covered by a hospital-laundered, long-sleeved jacket. * The jacket should be close fitting, fully cover the arms, be changed daily, and be laundered by the hospital after each use. * When performing preoperative or preprocedural skin preparation, the sleeves should be tight fitting. A sterile sleeve may also be worn to reduce the risk of contaminating the prepared area. * Religious head coverings may be worn in the perioperative environment but should be completely covered by an appropriate disposable surgical hat. * All hair and loose portions of the head covering should be fully contained. For procedures requiring a sterile scrub, including central line insertion, surgical epidural placement, labour epidurals, and scrubbing for surgical procedures: * The hands and arms must be exposed to approximately two inches above the elbows for the duration of the scrub. * Arm coverings will therefore need to be removed or rolled securely above the elbows before scrubbing. * The usual infection prevention and control scrub procedure should then be completed. * Once the scrub is complete, a sterile gown can be donned to cover the arms. A presentation from OR educator, Candace Ashton about Routine OR Practices along with the WRHA OR Dress Code Policy is attached for reference.

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