anesthesiologists for GI moderate sedation?

Specialties Gastroenterology

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I work part time at an out patient surgery/GI clinic. I was told that anesthesiologists will now give all moderate sedation to GI patients. Formerly RN's did this. Is this becoming the norm? So many ways this seems crazy but what do I know?

Depends on the drugs being used. Yes, it is more and more common. Our CRNAs do all of the cases in the GI Lab now and they also do our AICD/PPM cases in the cath lab.

Hi, thanks for your input. I'm kind of okay with CRNA's. I don't know enough about the changes since I work part time. Maybe they will go with propofol? It just seems like such a bigger expense to add to the bill. I know insurance will pay for it, but insurance companies don't get money from trees in their back yard!!!!! Every bodies rates go up. Seems like we should be finding ways to cut costs not make procedures more expensive?

Hi, thanks for your input. I'm kind of okay with CRNA's. I don't know enough about the changes since I work part time. Maybe they will go with propofol? It just seems like such a bigger expense to add to the bill. I know insurance will pay for it, but insurance companies don't get money from trees in their back yard!!!!! Every bodies rates go up. Seems like we should be finding ways to cut costs not make procedures more expensive?

GI Sedation has pretty much gone to propofol with a few exceptions. Easy on easy off. You can easily do 15-20 cases per provider per day with propofol and reduce PACU length of stay over having used versed, fent, demerol, etc.

Why are you "kind of okay with CRNAs?" Are you referring to the practice of a CRNA over an anesthesiologist or are you talking about costs and insurance billing?

Hi, I think CRNA's are great, I don't know why they aren't used more!!! My comment was purely in reference to the cost.

I reciever a letter from the endo center that was to do my colonoscopy stating that an anesthesiologist would perfom the sedation. Fine, since propofol will be used, I'm comfortable with an MD, not a RN (CRNA) doing this. My wife (she's an MD) arrive and I get gowned and IV started).....before I sign the consent, my wife and I have questions for the anesthesiologist..........guess what? no MD in the building. A chatty CRNA tried to convince me that: "she was just as qualified and any anesthesiologist to administer propofol"..at that point my wife corrected her: "sorry. but you are a nurse. not a physician"....My wifeasked a great question; since we live in PA and the local hospital uses the ACT model for anesthesia cases, why praytell do they let nurses (CRNA) practice solo across the street at the endo facility? answer: it's profitable and dangerous for the patient...in the endo lab, CRNA need to be supervised just as they would be in a hospital. My wife was a nurse before going to med school...so she's sympathetic to nursing..BUT: I never want an unsupervised nurse (CRNA) doing my anesthesia.

We have gone with anesthesiologists doing propofol sedation for GI cases. Our facility doesn't use CRNA's, (again I think CRNA's are great.)

Some said since propofol acts quicker the GI can schedule more cases, they go quicker. Yeah, true, but just a few weeks ago the GI cases were delayed almost an hour because the anesthesiologist assigned to that room was delayed with his surgical case lasting longer than expected.

Specializes in Anesthesia.
it's profitable and dangerous for the patient...in the endo lab, CRNA need to be supervised just as they would be in a hospital.

Where is your research to backup your statement? CRNAs are just as safe as MDAs. You can do a search on here for some of the recent research studies.

You seem to have some beef with CRNAs and GI procedures....

wtbcrna, for what my 2 cents is worth, I completely agree with you. I am a big fan of CRNA's and thought the previous poster's reaction was a little over the top!!!!!

I reciever a letter from the endo center that was to do my colonoscopy stating that an anesthesiologist would perfom the sedation. Fine, since propofol will be used, I'm comfortable with an MD, not a RN (CRNA) doing this. My wife (she's an MD) arrive and I get gowned and IV started).....before I sign the consent, my wife and I have questions for the anesthesiologist..........guess what? no MD in the building. A chatty CRNA tried to convince me that: "she was just as qualified and any anesthesiologist to administer propofol"..at that point my wife corrected her: "sorry. but you are a nurse. not a physician"....My wifeasked a great question; since we live in PA and the local hospital uses the ACT model for anesthesia cases, why praytell do they let nurses (CRNA) practice solo across the street at the endo facility? answer: it's profitable and dangerous for the patient...in the endo lab, CRNA need to be supervised just as they would be in a hospital. My wife was a nurse before going to med school...so she's sympathetic to nursing..BUT: I never want an unsupervised nurse (CRNA) doing my anesthesia.

Sorry I have to disagree with you 11 years I had a surgery done with a anesthesiologist that nightmare he forgot to turn on the o2 there nothing like filling yourself being pairlized and haveinng a mask with no air put on your face :eek: I work up from that with a poped jaw from the tube :crying2:

sence then I have had 5 surgeries done by (CRNA) and have not had any problems at all :) I am going to alway request a (CRNA) if I can .

I reciever a letter from the endo center that was to do my colonoscopy stating that an anesthesiologist would perfom the sedation. Fine, since propofol will be used, I'm comfortable with an MD, not a RN (CRNA) doing this. My wife (she's an MD) arrive and I get gowned and IV started).....before I sign the consent, my wife and I have questions for the anesthesiologist..........guess what? no MD in the building. A chatty CRNA tried to convince me that: "she was just as qualified and any anesthesiologist to administer propofol"..at that point my wife corrected her: "sorry. but you are a nurse. not a physician"....My wifeasked a great question; since we live in PA and the local hospital uses the ACT model for anesthesia cases, why praytell do they let nurses (CRNA) practice solo across the street at the endo facility? answer: it's profitable and dangerous for the patient...in the endo lab, CRNA need to be supervised just as they would be in a hospital. My wife was a nurse before going to med school...so she's sympathetic to nursing..BUT: I never want an unsupervised nurse (CRNA) doing my anesthesia.

Sorry I have to disagree with you 11 years I had a surgery done with a anesthesiologist that nightmare he forgot to turn on the o2 there nothing like filling yourself being pairlized and haveinng a mask with no air put on your face :eek: I work up from that with a poped jaw from the tube :crying2:

sence then I have had 5 surgeries done by (CRNA) and have not had any problems at all :) I am going to alway request a (CRNA) if I can .

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