AANA journal
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The purpose of this research was to examine the collaborative perceptions that Certified Registered Nurse Anesthetists (CRNAs) and anesthesiologists have of each other in nurse anesthesia educational programs. Methods included a cross sectional survey of all nurse anesthesia programs in the United States. Data was collected from the program director and one anesthesiologist of each program. ⋯ A major area of concern raised in the present study was that inadequate collaborative practices persist which could be indicative of critical deficiencies in the educational system and clinical practice settings of both providers. Efforts by all involved must be made at the national, state, and local levels to establish better relationships between CRNAs and anesthesiologists. Mending counterproductive differences is imperative for cost-effective and high quality anesthesia services.
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Advances in technology have provided the means to reduce the length of stay for some surgical patients while offering increased quality of care. Videoscopic surgery is a rapidly expanding technology with increasing applications. When used in place of open thoracotomy, thoracoscopy offers the patient a less traumatic treatment modality. This procedure presents challenges to the anesthetist in choosing anesthetic technique, patient monitoring, and maintenance of cardiorespiratory function in the presence of pneumothorax and a variety of coexisting disease states.
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Airway management of the parturient has serious implications for the anesthetist. Meticulous patient evaluation and preparation is essential. A management plan that can be implemented in the event of failed intubation should be familiar to all anesthetists who are involved in obstetrical anesthesia.