Nice_Category t1_iur6a43 wrote on November 2, 2022 at 12:57 PM

Reply to comment by 613codyrex in Jury awards $21m to family of patient after simple leg surgery left him in a vegetative state by TheFullerTron

Not MDs, but CRNA school is a PhD equivalent now. They are typically very well trained and know what they're doing. I'd be fine having a CRNA watching over me during surgery.

I also work in surgery and very closely with anesthesia and the surgeon. Just like anything, there are certain surgeons, anesthesiologists, and CRNAs I wouldn't want on my surgical team. But I wouldn't disqualify a CRNA because of their title. They are highly trained.

Lacy-Elk-Undies t1_iutgohs wrote on November 2, 2022 at 10:04 PM

FNP here, so take this with a grain of salt. When I looked at CRNA programs myself, they had very strict prerequisites. Most required at least 2 years of ICU experience, 3.9 or higher undergrad GPA, multiple recommendations, and rounds of interviews. The programs itself had about a quarter of the number of students than an FNP program, and had higher GPA standards to pass. So saying it’s a nursing degree with one extra year is discounting a lot of the background (which is less than an MD, but that is kind of the point of that degree).

One thing I thought was interesting was how one of the articles said that two CRNAs had administered blood pressure meds. When did the second one come in the OR? Was that before or after the 12 min break? Was there an attempt to reach the anesthesiologist and that’s why the second CRNA was there? Also, does supervising mean actively monitoring? I know I’m other specialties, supervising means that they physician may review the notes and treatment plan later, but there isn’t usually active participation on the spot.

Nice_Category t1_iutkiqc wrote on November 2, 2022 at 10:31 PM

So I do surgical neurophysiology/neuromonitoring for brain and spine procedures and nearly all of my cases are with CRNAs. Typically, the anesthesiologist will come in with the patient (along with the CRNA) and assist with getting the patient to sleep and intubated, then positioned onto the operating table. After that they leave and go assist with other cases or do whatever it is they do, leaving the CRNA in the OR to administer the case. 99% of cases have no issues, and the anesthesiologist may pop his head in a few times throughout the case to see if the CRNA needs anything. Another CRNA may stop by to give a break. Then, at wake up after the case is finished, you might see the anesthesiologist, but maybe not. That's a typical case.

If ANYTHING goes wrong, they call the anesthesiologist immediately while trying to correct the issue. This could be something like an irregular BP, suspected issues with a leak in the airway, IV or art line issues, or something as serious as pulmonary edima during extubation.