CRNA scope of practice

allnurses Guide · Apr 10, 2012

I was wondering what some of the non-anesthesia related duties a CRNA may be asked to perform with or without MDA supervision/approval. Among others, I am specifically wondering if a CRNA would ever be asked to perform a lumbar puncture.

Yes, I have been asked/done a lumbar puncture when the ER physician wasn't able to get it after several attempts. There isn't anything special to doing a lumbar puncture and anesthesia providers that do spinals on a regular basis are probably the best at doing lumbar punctures r/t our experience with spinals.

Why the concern/question?

Nolander · Apr 10, 2012

Yes, I have been asked/done a lumbar puncture when the ER physician wasn't able to get it after several attempts. There isn't anything special to doing a lumbar puncture and anesthesia providers that do spinals on a regular basis are probably the best at doing lumbar punctures r/t our experience with spinals.
Why the concern/question?

I've mainly just been wondering what CRNA's do outside traditional anesthesia and the OR...

subee, MSN, CRNA · Apr 11, 2012

I was wondering what some of the non-anesthesia related duties a CRNA may be asked to perform with or without MDA supervision/approval. Among others, I am specifically wondering if a CRNA would ever be asked to perform a lumbar puncture.

Why would you classify a LP as a non-anesthesia related duty? What's the situation that causes you ask the question? CRNAs are credentialed differently at institutions just as the docs are.

Nolander · Apr 12, 2012

Why would you classify a LP as a non-anesthesia related duty? What's the situation that causes you ask the question? CRNAs are credentialed differently at institutions just as the docs are.

I'm not trying to get into semantics. I mainly just wanted to know if they would regularly be asked to do spinal taps, and it wouldn't be something that would be unusual for them to do on a regular basis.

aRNnAR · Apr 14, 2012

There are 6 anesthesia providers where I work (5 CRNAs & 1 MD). We perform 90% of the LPs at our facility. There are a cpl of Drs who do them, but most will not even attempt. I work without MDA supervision. The MDA is my boss, but he does his own cases and is in the call rotation just like the CRNAs so pretty much everything we do, we do without MDA supervision. The others things that I occasionally do along these lines is IJ CVLs in the ICU (usually the surgeons do these since they prefer SC CVLs), Art lines in the ICU, & "difficult" intubations in the ER or in OB.

Nolander · Apr 14, 2012

There are 6 anesthesia providers where I work (5 CRNAs & 1 MD). We perform 90% of the LPs at our facility. There are a cpl of Drs who do them, but most will not even attempt. I work without MDA supervision. The MDA is my boss, but he does his own cases and is in the call rotation just like the CRNAs so pretty much everything we do, we do without MDA supervision. The others things that I occasionally do along these lines is IJ CVLs in the ICU (usually the surgeons do these since they prefer SC CVLs), Art lines in the ICU, & "difficult" intubations in the ER or in OB.

so then who do you hand the sample over to?

aRNnAR · Apr 20, 2012

so then who do you hand the sample over to?

the nurse, who sends them to the lab for analysis

Nolander · Apr 21, 2012

Well I was just reading in laboratory test reference manual that LP's are performed by a physician

allnurses Guide · Apr 21, 2012

Yes, and if you goto the ASA or AMA websites you will find that they state APNs aren't supposed to do half the things they do on a regular basis. There is ignorance and politics in books just as there is in real life.

BCRNA · Apr 22, 2012

You will find many references will state a physician has to do something, it is because the general public has no concept of advanced practice nurses. It is just easier to say physician than physician, nurse practitioner, nurse anesthetist, physician assistant, or etc.