Mar 4, '03
first to answer MDA supervision question:
It is a legal requirement for an AA to be certified at a hospital to assist in Anesthesia Care that the following must occur: 1) the MDA has to be either in the room with the AA, in the hallway right outside the door of that room, or in the room adjacent to the AA (for example, if the MDA needs a bathroom break he needs another MDA to step in to continue supervision)... so the AA is technically always in the vicinity of the MDA. 2) the patients whole anesthetic management is based on the MDA's plan without any deviation alowed unless the MDA changes the plan 3) the MDA has to be present in the room for intubation/emergence and any other critical period.... (the above is based on a summary of the legislative rights attributed to AAs)
So you can see that the AA fills the role of the anesthesia extender and allows the MDA to run 2 rooms for the price of one MDA - and also allows for higher turnover.... I agree that this will not help rural america as rural america is underserved by MDAs right now, but what this will do is free-up more CRNAs to go to those rural areas where they can provide independent care.
Basically AAs are the equivalent to Anesthesia as PAs are to Medicine/Surgery/Pediatrics/Psychiatry
Family Medicine/OB-Gyn... same amount of training, etc... same backgrounds (most AAs that I have met were respiratory therapists - who are relatively comfortable with the basics of airway management.) In fact, in Canada where they have a similar system set-up mainly to CUT costs - requirements for acceptance are a medical background with a bachelors (ie: respiratory/Paramedic/Nursing).
AAs will never take jobs away from CRNAs - seeing as they need to be very closely supervised as opposed to CRNAs who can practice independently. Not to mention the ridiculous shortage of anesthesia providers out there... or the fact that there are only 900AAs and 30,000 CRNAs
and I agree with the previous statement: "you can teach a monkey to do anything" ... AAs will never make anesthetic decisions on their own that may affect patient care... but over time/experience they will become very adept at maintaining airways and at recognizing the early signals of danger.
my 2 cents,
Last edit by Tenesma on Mar 4, '03
Mar 4, '03
I second what you said, and would like to add that CRNA's have been the subject of research study after research study trying to determine wheather CRNA's are capable of providing safe, competent anesthesia. CRNA's have passed this "litmus test" with flying colors on every occasion. I would be comfortable with CRNA's providing my anesthesia because, as a group, they have a "PROVEN TRACK RECORD". It may be that AA's are competant and safe, then again maybe not.
The thing I find interesting is that the ASA is so quick to embrace AA's. As London88 said, if the ASA believes that CRNA's are unsafe, despite over 100 years of practice and research proving otherwise, then that can only lead to one conclusion about AA's...
Last edit by K38s on Mar 4, '03