The Anesthesia Consultant

APRIL 25, 2021

On March 28, 2021 the anesthesia world in the United States was rocked by the headline: “ Wisconsin Hospital Replaces All Anesthesiologists With CRNAs. “ The hospital was Watertown Regional Medical Center, located in Watertown, Wisconsin , population 23,861, midway between Milwaukee and Madison. Why did this change happen?

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PANA

FEBRUARY 28, 2023

Dawn Bent, DNP, MSN, CRNA , didn’t choose to be a nurse anesthetist as much as the profession chose her. She was working as an ICU nurse for eight years when one of the anesthesiologists that she worked with told her: “I think you would be a great nurse anesthetist.” Christopher’s Hospital for Children.

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The Anesthesia Consultant

JULY 12, 2021

Anesthesiologists could chat with the surgeons and/or nurses, make an occasional phone call, and at times read materials they brought with them into the operating room. Every hospital operating room is equipped with a computer connected to the internet. Love it or hate it, the EMR is here to stay.

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The Anesthesia Consultant

FEBRUARY 16, 2021

To aid you in visualizing yourself in the hospital, I’m substituting the pronoun “you” instead of “I” in the narrative below. You complete your morning bathroom and breakfast routines, and leave your residence at 0630 hours for the hospital. You take the elevator to the third floor and proceed to the locker room.

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Anesthesiologist Vital Signs Operating Room Post-Anesthesia 52

The Anesthesia Consultant

AUGUST 26, 2015

No, it’s not the nurse anesthetists, nor the stress of covering surgeries in the middle of the night, nor the stress of saving patients who are trying to die in front of our eyes during acute care emergencies. This network of patients will serve to keep their clinics and hospitals full and profitable. What is this threat?

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Nurse Anesthetist Anesthesiologist Post-Anesthesia Anesthesia 52

The Anesthesia Consultant

APRIL 12, 2020

Surgeons, anesthesiologists, certified nurse anesthetists, and operating room nurses are barely working at all now, for the fourth consecutive week. Elective surgery has been cancelled at the hospital I work at, Stanford University Hospital, per the CMS edict.

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The Anesthesia Consultant

JANUARY 29, 2018

Anesthesiologists still work in hospital operating rooms, but their expertise is also needed in other places, including invasive radiology, gastrointestinal endoscopy, electrophysiology and more. The job of a certified nurse anesthetist was listed as #11 on the Best Paying Jobs list.

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The Anesthesia Consultant

SEPTEMBER 15, 2020

Surgeons work with physician anesthesiologists, with certified nurse anesthetists (CRNAs), or with an anesthesia care team that includes both physician anesthesiologists and CRNAs. Anesthesiologists typically spend 90+% of their working hours in the operating room. They are: The patient must not move.

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The Anesthesia Consultant

NOVEMBER 15, 2017

Let’s look at a case study which highlights a specific risk of general anesthesia at a freestanding surgery center or a surgeon’s office operating room, when the anesthesiologist departs soon after the case is finished. The patient enters the operating room at 0730 hours. The patient consents. Can this scenario occur?

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The Anesthesia Consultant

FEBRUARY 6, 2019

A typical hospital will have dozens of other anesthesia providers working in the same building. In an anesthesia care team, a physician anesthesiologist supervises up to four operating rooms and each operating room is staffed with a certified registered nurse anesthetist (CRNA). Sound scary?

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The Anesthesia Consultant

APRIL 26, 2018

Norman Shumway MD PhD, a Stanford surgical professor and legend, invented the heart transplantation procedure and performed the first heart transplant in the USA on January 6, 1968 in operating room 13 of Stanford University Hospital. Upon arrival at the airport in the donor city, an ambulance transported us to the hospital.

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The Anesthesia Consultant

JUNE 12, 2023

Here are some general steps that might be considered: Alert the medical team: The anesthesiologist or healthcare providers in the operating room need to be notified immediately about the patient’s deteriorating condition. The surgeon and additional medical personnel may also be called upon for assistance. No, not really.

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The Anesthesia Consultant

JANUARY 19, 2017

We’re entering an era of metrics for physicians, in which the government and hospital systems will collect data to monitor quality and performance. Many hospitals and surgical centers prefer to have an RN place the preoperative IVs. Stick up for the circulating nurse and the scrub tech as well, if necessary.

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The Anesthesia Consultant

FEBRUARY 22, 2018

You won’t see us crying, as Dr. Baker is doing in panel 4, but the anesthesiologist’s rapid heart rate and the adrenaline rush in high pressure operating room situations accompany the growth of every anesthesiologist from inexperience trainee to seasoned professional.

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The Anesthesia Consultant

OCTOBER 28, 2018

Dental cases are common, and are frequently referred to a hospital because the typical care systems at an outpatient surgery center or a dental office are inadequate to complete a successful anesthetic. He is verbal with his mother, but refuses to interact with the anesthesia or nursing personnel. mg/kg midazolam, and.02

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The Anesthesia Consultant

JULY 25, 2022

This was a landmark paper on the topic of anesthesiologist:CRNA staffing ratios, which documented that having physician anesthesiologists direct three or four operating rooms simultaneously for major noncardiac inpatient surgical procedures increased the 30-day risks of patient morbidity and mortality.

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The Anesthesia Consultant

SEPTEMBER 25, 2015

THE JULY EFFECT AND THE NOVEMBER EFFECT: In American teaching hospitals, newly minted doctors begin internships each July. The term “July Effect” was coined to describe this shift change in academic hospitals each July, when the arrival of inexperienced doctors may increase the risks of medical care.

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The Anesthesia Consultant

JANUARY 2, 2016

I’m writing this from the perspective of a busy clinician who has worked as an anesthesiologist in California in both private practice and at a major university hospital for over 30 years. More care team anesthesia and more Certified Nurse Anesthetists (CRNAs).

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The Anesthesia Consultant

DECEMBER 29, 2015

More likely to work part-time, and with a nurse anesthetist care-team delivery system. The authors of this paper proposed regulations to include: no further on-call duties for those aged 60 and older, no further high-acuity cases for those aged 65 and older, and retirement from operating room clinical practice at age 70.

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The Anesthesia Consultant

FEBRUARY 8, 2016

You’re on your at the hospital, sometimes on weekend nights, and sometimes at 3 a.m. If there’s a hospital location or an anesthesia group you’re particularly interested in, but they are not advertising a job opening. Find out who the leader of the group is, and call the operating room or the anesthesia company’s phone number.

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The Anesthesia Consultant

OCTOBER 8, 2019

In contrast, other operating room professionals are usually relaxed and winding down at this time, because the surgical procedure is finished. She walked out of the hospital two days later. If an anesthesia care team is attending to you, how many rooms is each physician anesthesiologist supervising?

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The Anesthesia Consultant

DECEMBER 19, 2016

No data exists to support that initial video laryngoscopy is safer or more effective than direct laryngoscopy when used by anesthesiologists in operating rooms. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door.

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The Anesthesia Consultant

OCTOBER 21, 2015

3) Physicians from a Thai teaching hospital reviewed 44,339 emergency surgery patients from 2003 to 2011, and found the incidence of perioperative cardiac arrest in emergency surgery was 163 per 10,000 cases. A 9-year survey in a Brazilian tertiary teaching hospital. Anesthesiologists will continue to be challenged. References: 1.

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The Anesthesia Consultant

AUGUST 7, 2017

Anesthesiologists work in operating rooms and intensive care units—acute care settings which demand vigilance, steady hands, and quick thinking. These arenas will be: 1) diagnosis of images, 2) clinics, and 3) operating rooms/intensive care units. What will an AIM robot doctor look like?

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The Anesthesia Consultant

JUNE 27, 2017

Maggie is paralyzed from the neck down— a ventilator-dependent quadriplegic—and is hospitalized in a private room. In 8 scenes of in-hospital cardiac arrest, 7 of the 8, or 88% of the patients survived, compared to survival rates of 23.9% But how about singing the sexual song in the operating room? Remarkable!

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The Anesthesia Consultant

OCTOBER 8, 2015

Anesthetist options were limited. Before her surgery, Alexandra reclined awake on the operating room table. Her eyes were closed, and she was unaware I’d entered the room. Life is a series of choices. I chose to be my wife’s doctor. It was an opportunity to silence her, and I took it.

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The Anesthesia Consultant

APRIL 2, 2016

Our facility, the Plastic Surgery Center in Palo Alto, has two operating rooms. At times the second room is not occupied, and a solo anesthesiologist is the only anesthesia professional present on site and must be prepared to handle any and all emergencies. Hibbing also happens to be the hometown of music icon Bob Dylan.

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The Anesthesia Consultant

AUGUST 16, 2018

He walked out the hospital alive and well. When a bad outcome like this occurs in a hospital or surgery center, a facility’s Quality Assurance Committee examines the details of the case—not to assign blame—but to identify flaws in patient care systems which must be improved in the future.

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The Anesthesia Consultant

JUNE 23, 2016

Such cases sometimes present to a pediatric hospital for anesthetic care, but at times the child will be treated in a dental office. At this point, the anesthesiologist can take the patient away from the parent and proceed into the operating room, where either an intravenous anesthetic or an inhaled sevoflurane anesthetic can be initiated.

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The Anesthesia Consultant

MAY 6, 2017

The Merriam-Webster online dictionary defines private practice as: “a professional business (such as that of a lawyer or doctor) that is not controlled or paid for by the government or a larger company (such as a hospital).” In my community the dentists are all in private practice, as are most of the accountants, psychologists, and attorneys.

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Anesthesia Anesthesiologist Post-Anesthesia Nurse Anesthetist 52

The Anesthesia Consultant

DECEMBER 19, 2016

The boy suffers a penetrating open eye injury, and is taken to the nearest hospital. A children’s hospital or a university hospital will have a team of pediatric anesthesiologists with specialized training on call for emergencies. A 3-year-old boy is eating a McDonalds Happy Meal on the lawn of the restaurant. What do you do?

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The Anesthesia Consultant

NOVEMBER 16, 2015

I agree with him that the current cumbersome EHRs come between doctors and patients during hospital care. My criticisms include: Different EHRs at different hospitals are unable to communicate with each other. If you work at different hospitals with different EHRs, you have to be trained and retrained in multiple EHR platforms.

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General Anesthesia Post-Anesthesia Anesthesia Anesthesiologist 52

The Anesthesia Consultant

JUNE 26, 2018

Each operating room anesthesia location is the epicenter of computerized medical record-keeping machines, computerized Pyxis-style drug storage systems, computerized labeling machines, and bar-code reading billing machines. Anesthesia in 2018 is markedly different from anesthesia in the 1990s.

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The Anesthesia Consultant

SEPTEMBER 1, 2017

A total of 266 cases of brain damage or death during anesthesia care in the operating room under the care of a solo anesthesiologist occurred. All the anesthesiologists were single practitioners, that is, they were not part of an anesthesia care team with a nurse anesthetist. Resist these pressures.

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The Anesthesia Consultant

AUGUST 28, 2016

An operating room anesthesia practice is somewhat akin to being a taxi cab driver. The Veterans Affairs hospitals are currently pondering a move to allow CRNAs to practice independently without any physician anesthesiologist present. What specific factors determine how high the anesthesiologist’s salary will be?

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The Anesthesia Consultant

MAY 4, 2016

CASE TWO: A 55-year old female is scheduled for a facelift at a freestanding plastic surgery center operating room. She is transferred to a local hospital and admitted to the intensive care unit. Abdominal surgery and general anesthesia in this patient population are not without risk, even with optimal anesthetic care.

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The Anesthesia Consultant

NOVEMBER 12, 2015

It was Johnny’s first day of school and my first day to report to the local hospital. I needed to be at Hibbing General Hospital before 7:30. The hospital was a three-block hike from Dom’s house, so it made sense to leave the battered BMW on the curb and walk to Hibbing General. The kitchen was quiet as a library.

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