How to enter an anesthesia case in the ACGME Case Log

Where do you enter a case?

Sign in to the ACGME's ADS site, open Case Logs in the left-hand menu, and choose Add. The ACGME Case Logs phone app and a phone browser work too. Edit, Download, Update Case Year and Reports sit in the same menu.

What does the menu at the top of the form do?

The menu at the top switches the checkboxes below between Procedures and Pain. The header fields stay the same in both. Because the menu swaps the whole body, a case with an anesthetic and a pain evaluation takes two entries.

What goes in the header?

Case ID is a label of your choosing. Use one that identifies no patient: never a name, a record number or a birthday. Your program may set a naming pattern. Case Date is the day of the case.

Case Year is your year in the program, not your CA number. In a four-year program, year 2 is CA-1. In a three-year program, year 1 is CA-1. The year starts on the one ADS lists for you, and you change the year for a case from an earlier year.

Patient Age is one of five bands: under 3 months, 3 months to under 3 years, 3 to under 12 years, 12 to under 65 years, and 65 and older.

Site and Attending come from lists your program keeps. If an attending is missing, ask your program coordinator to add that person. A resident cannot add one.

What are the two flags under the header?

Life-Threatening Pathology takes Trauma or Non-Trauma. Difficult Airway Management takes Anticipated or Unanticipated. Pick one only when the case had one. The ACGME minimum of 20 life-threatening cases is counted from the first flag.

Which boxes are in the body?

Under Procedures: ASA Physical Status, from 1 to 6, each with an E for emergency. Then the anesthesia type, airway technique, procedure category, specialized vascular access and specialized monitoring. The neuraxial and nerve block site sections are marked optional.

The anesthesia types are general, MAC or sedation, spinal, epidural, combined spinal-epidural, and a peripheral nerve block, single shot or continuous.

The twelve procedure categories are cardiac with and without bypass, cesarean and high-risk cesarean, and vaginal delivery and high-risk vaginal delivery. Intracerebral cases split into endovascular, open vascular and open nonvascular. The rest are intrathoracic non-cardiac, and major vessel surgery, open or endovascular.

The form abbreviates its labels. “W/out CPB” is cardiac surgery without bypass, and “Vag del” is a vaginal delivery.

Under Pain: a new patient evaluation, a post-operative evaluation, and pain procedures.

Can one case count twice?

Yes. The ACGME says that when two major anesthetic techniques are used in one procedure, both count. A general anesthetic with an epidural counts as a general anesthetic and as an epidural.

An epidural used during surgery counts as an epidural anesthetic. An epidural placed only for post-operative pain counts as an epidural for pain management. A regional anesthetic with sedation or MAC counts as both.

Can two residents log the same case?

Both can log a major case if both were involved in the majority of the case, including its most significant parts. When one resident finishes a case for another, only the resident who did the most significant parts logs the case.

Which fields feed the minimums?

The minimums are patient counts in categories such as children, obstetrics, cardiac, intracerebral and blocks. There is no minimum for total cases, ASA status, airway technique or lines. The table below lists every category with a minimum.

Where does Capnolog fit?

This part is about Capnolog, the app behind this page. Log each case on your phone in seconds, and the Capnolog browser extension fills these fields on the ACGME form. You check every field and press Submit yourself. Your first 50 filed cases are free.

Three things set Capnolog apart from the other anesthesia case-log apps. Spoken case detail is parsed on the phone, not sent to a server. Each category shows the national average beside the minimum. A nested case counts in every line it belongs to.

The anesthesia comparison page names the other apps, including Anesto and Follie. Every row there comes from each app's own listing, including the rows Capnolog loses.