We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric anesthesiologists and highlight the importance of further research in improving the treatment of this common and challenging peri-anesthetic occurrence.

Purpose Fulfilling the current societal expectations for professionalism in medicine requires a clear understanding of the specific skills, attitudes, and behaviours expected of practitioners. This Continuing Professional Development (CPD) module discusses professionalism as it relates to the practice of anesthesiology. Principal findings While many of the attributes of the professional are generic, performance expectations must be interpreted in a specialty-specific context. Anesthesiologists face challenges to their professionalism in the timeconstrained, highly technical and stressful operating room environment. Ongoing shifts in the models of health care delivery require the adaptation of anesthesiology practice to meet changing demands. Consequently, anesthesiologists' practice environment has extended into preoperative assessment units, acute pain services, and perioperative medicine. Application of principles of biomedical ethics, understanding of medico-legal and regulatory aspects of practice, and attention to personal health and career sustainability are intrinsic aspects of professional practice. More recently, focus on adverse event management and continuous quality improvement has created the need for specific skill sets, which must be included in training and continuing professional development programs. The medical education literature suggests teaching and evaluation methods suited to the development of competence in all aspects of professionalism. Finally, professionalism requires the availability of remediation programs for learners and practitioners in difficulty. Conclusion The attitudes, skills, and behaviours that define professionalism in anesthesiology must be taught and evaluated to establish a basic level of competence by the completion of specialty training. Throughout their careers, anesthesiologists must continue their professional development to meet current and future societal expectations and shifting norms of health care delivery.

At our institution, most operating theatres do not have distinct oxygen flowmeters for delivering supplemental oxygen to patients. An informal survey of our colleagues revealed many different methods for attaching nasal prongs to the anaesthetic machine to provide supplemental oxygen during conscious sedation.Previous studies of nasal prongs have discussed the fraction of inspired oxygen (FI02) delivered by nasal prongs, ~ the range of i::102 produced, z and the effect on FIO2 of mouth breathing) "4 oxygen flow setting, and peak inspiratory flow; 5 but in all the studies, the nasal prongs were attached directly to a wall flowmeter. There CAN J ANAESTH 1996 ! 43:6 / pp 636-9