Difference in responsibilitites/practice between CRNA and Anesthesiologist?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

BuckRx

Full Member
10+ Year Member
Joined
Feb 14, 2010
Messages
35
Reaction score
3
I've become aware that this is quite an inflammatory topic, but I was just curious as to what are the responsibility/practice/procedure restrictions on CRNAs that MDs don't have. Like... do CRNAs do complicated hearts and heads cases etc.?

I was hoping for some concrete examples e.g. specific medical/surgical situations where the roles/capabilities differ?

Anecdotes welcome if need be.

Search function just got me generalizations and education differences. Thanks.

Members don't see this ad.
 
To be kind,

You are correct. This is the most inflammatory question you could ask.

Take some gentle advice from an old guy who has been both a CRNA and an Anesthesiologist in his lifetime, find someone at your institution to ask about this.

Nothing good will come of asking here, believe me.
 
To be kind,

You are correct. This is the most inflammatory question you could ask.

Take some gentle advice from an old guy who has been both a CRNA and an Anesthesiologist in his lifetime, find someone at your institution to ask about this.

Nothing good will come of asking here, believe me.

That's fair, you're right. Just figured I might fish for a couple posts of objectivity before the inevitable flame war. My curiosity is genuine.
 
Members don't see this ad :)
Any shot someone could give me a brief PM on this sort of thing? After this post I'll just drop it.
 
in general:

the anesthesiologist gives/chooses induction drugs and overall aneshetic plan, the crna is usually given the chance to intubate or manage the airway on the first attempt provided all is well, then the crna usually tapes the tube, does all the little stuff (turn on bair hugger, gas, ng to suction) until the case is completely in the maintenance phase, the attending might chime in and say, hey lets give this much fluid, this much narcotic, call me or not for wake up and leaves the room to do other things, run other rooms, be available for codes, etc.. the crna stays in the room and charts, gives narcs, monitors to ensure all looks well, call the anesthesiologist prn problems (ie sudden desats or changes during the case)

when there are advanced procedures to be done (ie not the usual IVs, alines, lma/ett placement, Og placement, etc) such as central lines, swanns, ultrasound guided blocks, difficult iv or aline, or difficult airway require an advanced device like a scope, thoracic neuraxial anesthesia, or when serious medical management needs to happen like giving blood products appropriately, electrolyte and volume replacement, pressor/narcotic/hypnotic drips.. the attending MD USUALLY does the procedure/management himself - now this varies institution to institution and a cardiac CRNA at some big center im sure places central lines routinely, and some probably like to do us guided blocks and manage electrolytes but it is all between what the anesthesiologist feels comfortable giving up control over - which is why it is such a heated topic

procedures like epidurals/spinals, ultrasound guided nerve blocks, central line/swann, really difficult airway, unit intubations/problems, vent setting/medical and fluid and product management - are what is being discussed as to in what setting its appropriate to have non MDs doing these procedures
 
Top