ralatek

I also took the boards recently and had the 100 questions. I found out in 5 days that I passed. I'm sure you passed too. Just to clarify, I actually found out I passed by looking on the AANA website before I even knew my in-laws received my Fedex package. I did an online verification of certification and it popped up my info with CRNA after my name. A few hours later, my mother-in-law called to let me know the package came and read me the letter over the phone.

More likely the surgeon told the anesthetist that the patient was swallowing and hence more propofol to deepen the anesthetic. If there was active swelling of the airway that the surgeon could see, that constitutes a bigger problem and propofol will not do anything for airway swelling.

You are right about everthing but metabolism. Both roc and vec are primarily metabolized by the liver with some renal excretion.

The medicare opt-out has nothing to do with independent practice of a CRNA. It is a billing issue. In those states that have NOT opted out, a CRNA must be supervised in order to receive full reimbursement for MEDICARE cases they do. The supervising physician need not be an anesthesiologist. CRNAs are licensed to practice independent in all 50 states. The individual institutions then set their own policy and procedures that govern nurse anesthesia practice.

Just goes to show you how awesome CRNAs are in that they provide the same quality of care and can learn anesthesia in 1/2 the time according to the above posted time table. Granted, the 12 year time frame (MDA) is accurate but I think you underestimated the CRNA time table a bit. I would add another year or two to that 6 for the critical care experience that is necessary. Yes, some could get in with the minimum 1 year and obtain their BSN at the same time but that definetly does not make up the majority.

The CRNA titrates all vasoactive gtts. As mentioned previously, some procedures require lowing the blood pressure for periods of time for specific reasons, (decrease bleeding, during vascular clamping) and can be accomplished by a variety of ways all in which the anesthetist is directly involved with.

Well, not a CRNA yet but due to finish school in the next couple of months. My current day is as follows: up by 5:15, in the OR by 6:15 setting up for the days cases. See the first patient around 7am and hopefully if all the stars are aligned, in the room at 730. In my program, the last 6 months you run your own room and will function much the same as a CRNA practicing in the ACT model. Usually due between 4-6 cases/day. Sometimes less, sometimes more. Usually out by 430p. Look up your next days cases that evening. Usually study after dinner and by 10p off to bed. At this point, I've finished class work and use my nights to study for boards. It's a long and sometimes lonely road but everyone I talk to says its well worth it. I've enjoyed it as much as one can enjoy being a "student" in the clinical setting and am looking forward to being done. Hope this gives you little insight as to what it might be like.

I have over 600 with 3 more months to go.

Bottom line...it doesn't really matter what unit it is. As long as you get plenty of vents, hemodynamic monitoring, vasopressors, etc. Go to the unit you think you'll be most happy with. Your attitude will be better and you'll want to learn all you can. As for the above poster's ranking...I went to #4 (CCU), worked for 2 years, accepted to nurse anesthesia school on first attempt, and now finishing up my senior residency. Good luck

you'll get plenty of chances to start IVs and you'll catch some heat for not being good at it. That is a skill that most of your CRNA instructors feel you should have mastered as a ICU nurse. Practice, practice, practice...

I just keep reminding myself I've only been doing this for 18 months now and there is no possible way I can be an expert...despite the expectations. I just try to improve each day no matter how big or small the improvement. If you're learning and improving each day, you're doing what you're supposed to be doing. I've beat myself up too much over the last semester to worry about it anymore. I'm in my senior residency and have 4 months to go. If I can keep improving each day that's fine by me. I don't have to be greatest CRNA that ever lived once a graduate. That will come with some time and experience:rotfl:

The way it was explained to me was that during PPV, intrathoracic pressure increases and venous return to the R heart decreases thereby decreasing LV preload and hence, decreasing arterial blood pressure. During periods of hypovolemia this up and down tracing of the a-line waveform becomes more apparent and can be used as a rough estimate of volume status. I've tried to reference this explanation in a textbook with no luck. Any other opinions??

Nope we don't manage vents and such in the ICU...we do it in the OR. And I'm not talking about punching in a Tv and RR. We get some very sick patients with major pulm issuse that require a good understanding of vent management. Alot of the newer anesthesia machines are capable of most vent settings you would find in the ICU. And its not just pulm management either, its everything else. So if you want to get technical, a CRNA in the OR may not be the "ultimate in critical care," but it comes dang close.

I seem to be seeing it used more at our main clinical site. We do the standard 25mg in 250ml (0.1mg/ml). Some will then draw up 10ml into a syringe and bolus 0.5-1ml increments

Please take time and research the facts before you post false statements. It is obvious you don't fully understand the history and current practice of nurse anesthetists.

yep...but according to paindoc in another post, AAs where paid less than CRNAs and therefore a better option to employ AAs rather than CRNAs. Just curious is all.

And you don't think the ASA is guilty of "dirty" politics. Give me a break...I just find it funny that my post at the top of the page didn't get any response from paindoc or jwk. Oh well.

Welcome to allnurses!!

Happened to see a decent formula on T.V. the other day. Take your total salary (i.e. 120,000) and divide that number by 12. That gives you your monthly salary. Take that number (10,000 in this case) and divide that by 2 =5,000. The show said you shouldn't spend more than this dollar amount (in this case 5,000) in mortgage, taxes, insurances, monthly bills, etc. Just what I saw. Not in the positon just yet to see how this would work.

Could be caused by hypovolemia. This wandering waveform is best seen when the patient is on mech ventilation. Br J Anaesth. 1999 Feb;82(2):178-81.

Paindoc, According to the AA website, CRNA and AA salaries are virtually the same. I've also read statements on this board that jwk's CRNA colleagues earn the same amount as his AA colleagues. Interesting. Makes me wonder what the real salary comparisons are?

As stated previously, ETT placement is not routinely checked via x-ray. At most institutions that I rotate thru, if central lines are placed prior to induction, an x-ray is obtained after the case before we leave the room. Mainly to r/o pneumothorax. The central lines are used in the OR for fluids, blood, vasopressors w/o checking placement with CXR. Good blood aspirate after placement is adequate for verifying placement for the OR.

succinylcholine 0.5-1.0mg/kg IV. Other pharmacologic options include rocuronium 0.4mg/kg IV or lidocaine 1-1.5mg/kg. This info was found in Morgan & Mikhail in the Pediatric anesthesia chapter.