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Sources of Medical Information
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
Patricia J. Bartzak, Deborah Enicke, Patricia Ann “Stormy” Green
Either an anesthesiologist or a certified registered nurse anesthetist (CRNA) provide anesthesia and patient monitoring during surgical procedures. Some states allow a certified anesthesiologist assistant (CAA) to provide anesthesia care for patients undergoing operative procedures. CAAs must meet certain educational criteria and pass a national exam (American Academy of Anesthesiologist Assistants, 2017). Sometimes the induction is performed by a CRNA or CAA with an anesthesiologist present, who subsequently leaves the OR suite to oversee another anesthesia provider.
Healthcare Politics
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
Advanced practice nurses are carving out a new role in healthcare delivery. The advanced practice nurse is an umbrella term given to a registered nurse who has at least a master’s degree in educational and clinical practice requirements beyond the years of basic nursing education required of all RNs. Advanced practice nurses can be classified into four types: nurse practitioner (NP), certified nurse midwife (CNM), clinical nurse specialist (CNS), and certified registered nurse anesthetist (CRNA). NPs are qualified to handle a wide range of basic health problems, and most of them have specialties, such as adult, family, or pediatric care. CNMs provide well-woman gynecological and low-risk obstetrical care. CNSs are qualified to handle a wide range of physical and mental health problems, and they provide primary care and psychotherapy. CRNAs administer anesthetics given to patients each year (Santiago 2017a, 2017b).
Moderate Sedation in Dermatologic Surgery
Published in Marwali Harahap, Adel R. Abadir, Anesthesia and Analgesia in Dermatologic Surgery, 2019
Torres Omar, Scarborough Dwight, Bisaccia Emil
The CRNA, or trained anesthetist, is a key individual when it comes to monitoring the administration of anesthesia; otherwise, the surgeon could risk compromising the safety of the patient by concentrating too much of his or her efforts in keeping control over the administration of anesthetics. In any case, the surgeon must be knowledgeable of the agents used in anesthesia as well as understand physiologic monitoring and airway management, so as to take appropriate actions in case of complications.
Procedural Sedation by Non-Anesthesiologists: A Review of Malpractice Litigation
Published in Journal of Legal Medicine, 2022
Of the remaining four cases of medical malpractice related to conscious sedation, one involved a lack of qualified personnel, when a patient aspirated during sedation by a certified registered nurse anesthetist and no physician anesthesiologist was in the hospital, thus deeming the surgeon her supervisor. This supervisory role was permitted by the policies of the hospital, but the surgeon testified that he was unaware he was supervising the certified registered nurse anesthetist. It was alleged that oversedation of the patient led to the aspiration and subsequent acute respiratory distress syndrome from which the patient died. The second case alleged, in contrast to the many cases of drug overdose, that an inadequate sedation level resulted in abortion of an MRI scan that was vital for treatment. One case involved a fall from the procedure table, and the final case in the data set alleged failure to monitor/drug overdose.
Medical thoracoscopy in the diagnosis of pleural disease: a guide for the clinician
Published in Expert Review of Respiratory Medicine, 2020
Faisal Shaikh, Robert J. Lentz, David Feller-Kopman, Fabien Maldonado
Procedural sedation and analgesia can be administered by an anesthesiologist, certified registered nurse anesthetist, a registered nurse, or the proceduralists themselves. Standard monitoring for all procedures should include heart rate, respiratory rate, oxygen saturatiosaturation, and end-tidal CO2. Typically, a benzodiazepine is used in combination with an opioid. Although propofol has recently been proposed as a possible alternative, studies show that it is associated with an increased incidence of hypotension and hypoxemia in patients undergoing MT. Its use is therefore discouraged unless the procedure is being performed under general anesthesia (GA) with an airway in place [30]. Benefits of performing the procedure under GA include the ability to de-gas the ipsilateral lung, providing an increased vision of the thorax. This, however, is typically not required for most diagnostic cases (i.e. identification of malignancy), talc poudrage, or placement of an indwelling pleural catheter (IPC).
Redpilling: A professional reflects on white racial privilege and drug policy in American health care
Published in Journal of Ethnicity in Substance Abuse, 2018
At two hospitals in North Carolina where I worked, pharmacists tended to be wary of anesthesiologists and certified registered nurse anesthetists (CRNA). At both hospitals, most of the people in charge of sedation during surgery were CRNAs, which are essentially registered nurses additionally trained to help guide patients through the process of sedation. They work under the supervision of anesthesiologists in most states in the United States. From the point of view of the clinicians, pharmacy placed too much control on the clinicians’ handling of drugs. “You are treating us like druggies,” a White female CRNA joked to me one evening. “Some of you are, and we don’t know which ones,” I replied. One pharmacist, a Black woman, was adamant that the pharmacy would (and could) keep a surgery from taking place if the “anesthesiology people,” as she called them, continued to question procedures for distributing drugs.