Epidural responsibility

allnurses Guide · Dec 10, 2015

This is just for my own information...this is hard for me to put into words because it sounds like a silly question. But I wanna ask anyways. Is it the responsibility of the MD or the anesthetist to place an epidural for any reason (not just for child birth)? Would there be any reason for placement by MD only? What is the anesthetist/MD responsible for once placed? Who prescribes and makes changes to the Rx if needed? If ya'll have any additional info, please share! I do not want to be an anesthetist. I'm just super curious about it all.
Again, I'm sorry if these questions sound silly. Just wanted to hear the answer from people with experience.

Epidurals are usually placed and managed by anesthesia providers only. The anesthesia provider could be a CRNA or an anesthesiologist.

MrPopeye · Dec 10, 2015

Are there specialties in the field? Or if a CRNA is working at a hospital, would the same person provide anesthesia in the OR and go straight to an epidural for a woman in labor?

allnurses Guide · Dec 10, 2015

Are there specialties in the field? Or if a CRNA is working at a hospital, would the same person provide anesthesia in the OR and go straight to an epidural for a woman in labor?

Yes, some anesthesia providers do specialize.

I would venture to guess that most hospitals CRNAs work in both the OR and OB.

SoldierNurse22, BSN, RN · Dec 11, 2015

Are there specialties in the field? Or if a CRNA is working at a hospital, would the same person provide anesthesia in the OR and go straight to an epidural for a woman in labor?

I don't know of any CRNAs in our hospital that are only OB. They are on duty hospital-wide and bounce between the OR and L&D.

NPOaftermidnight, MSN, RN, NP · Dec 17, 2015

I'm assuming it is like this everywhere, but I can only speak for what we do at my hospital. Anesthesiologists/anesthesia residents are the ones who place epidurals. We have an "Acute Pain Service" that oversees the management of epidurals and changes orders as needed. Usually it is an NP covering this service, sometimes it is an anesthesia resident. They are also the ones that give boluses if necessary. Bedside nurses are responsible for monitoring the site/effectiveness/complications/VS/etc.

I work in a SICU and we see epidurals fairly frequently. OB might be totally different.