CRNAs specializing in trauma

[mark2climb]

Are there any CRNAs here who specialize in trauma or take trauma call at a Level I facility? If so, what is your scope of practice? Are you only responsible for airway management or do you make recommendations for the resuscitation as well?

Following the resuscitation, do you then follow the pt to the OR or hand them off?

Thanks!

[EmeraldNYL, BSN, RN]

Lots of CRNAs take call in trauma centers. I work in a very busy Level II trauma center and a CRNA always has the trauma beeper. We respond to all trauma activations and manage the airway in the trauma bay. If the patient needs to come up to the OR, we will travel with the pt. and then continue to resucitate the patient in the OR. Once in the OR, we will place additional lines if necessary, hang blood, send labs, whatever is necessary.

[CCRN-CMC-CSC]

We do not have a CRNA dedicated to trauma only but they do assign one CRNA to the Trauma Team. So whichever CRNA has the trauma beeper goes to the ER whenever a trauma comes in. They do follow them to the OR if needed.

[foraneman]

It all depends on the institution. For example at the University of Maryland Shock Trauma Center, CRNAs treat only trauma patients and attend to them from the time they arrive in the facility, including the resucitation phase. They are responsible for insertion of central lines and fluid/blood resucitation as well as airway management.

At Graday memorial in Atlanta (level 1) anesthesia does not see the patient until they are transfered to the OR and are not part of the trauma team admitting the patient. Thus the CRNA has no control over the volume resucitation or preparation of the patient that roles thru the OR door...which sucks.

Greg

[traumaguy8]

Is it safe to assume that crna's that work in level 1 trauma centers place more cvls, arterial lines, and emergent intubations than other hospitals? I have yet to shadow through a level 1 trauma OR but that really seems like it would be exciting.

[EmeraldNYL, BSN, RN]

Is it safe to assume that crna's that work in level 1 trauma centers place more cvls, arterial lines, and emergent intubations than other hospitals? I have yet to shadow through a level 1 trauma OR but that really seems like it would be exciting.

Yes, that is a correct assumption. Very exciting, but very high stress as well. Don't plan on seeing the call room at all during the night if you work at a very busy trauma center.

[mark2climb]

Are practicing CRNAs finding that training for trauma care happening OJT or are there programs out there that train CRNAs for trauma specific anesthesia? I suspect that the Cowley Shock Trauma Center at Univ of Maryland provides some specific training but how about other facilities?

[sewnew]

Here is the link to Univ. of MD's Shock Trauma anesthesiology page.

http://www.umm.edu/shocktrauma/trauma_anesth.htm

It gives a really good description about their anesthesia services.

[stephenfnielsen]

Perhaps an overly lay question, but where do respiratory therapists fit into the team if the CRNA is managing the airway in the ED? It seems like in the EDs where I'm from there are more Rts than you could fit in two bariatric o2 tents in every direction you look (and no CRNAs).