paindoc

paindoc

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All Content by paindoc

  1. an interesting and somewhat ignorant article title

    paindoc replied to zrmorgan's topic in Certified Registered Nurse Anesthetist, CRNA

    Soooo....what are "anesthetic drugs"? Versed is a general anesthetic and so is fentanyl given in high enough quantities...so are those anesthetic drugs? Propofol can be a simple sedative given in...

  2. Why CRNAs are here to stay

    paindoc replied to aquaphoneRN's topic in Certified Registered Nurse Anesthetist, CRNA

    In my experience with CRNAs, they select lifestyle over compensation, less risky cases than cutting edge, and work less hours than the MD equivalents. The majority are female and many take time off...

  3. Not trying to stir up bad ideas, but......

    paindoc replied to Brian_SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    I don't think most CRNAs have the type of dual diploma/degree training as you, so kudos to you for going on and furthering your education. I don't know the percentages of CRNAs that train along side...

  4. Not trying to stir up bad ideas, but......

    paindoc replied to Brian_SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    I think it is important to remember that CRNAs are very very good within a focused, very limited scope of practice. It is true they can anesthetize infants and geriatrics. But they have nowhere near...

  5. Not trying to stir up bad ideas, but......

    paindoc replied to Brian_SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    CRNAs have training in a highly technical specialized field while NPs have a very broad swath of training across many fields. It is not reasonable to assume generalists such as family practitioners...

  6. Not trying to stir up bad ideas, but......

    paindoc replied to Brian_SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    CRNAs now have excellent training for providing most anesthetics, but placing a CRNA in a clinic situation treating patients typically seen by trained NPs would not make any sense and may be unsafe...

  7. Not trying to stir up bad ideas, but......

    paindoc replied to Brian_SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    The definition of an APN does vary from state to state. In Indiana, it is a law that CRNAs are not APNs, it is not opinion. As for the legislative comments, you must be kidding if you think...

  8. Not trying to stir up bad ideas, but......

    paindoc replied to Brian_SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    Indiana. And I did not say there was legislation...but that the legislature made that determination in their deliberations regarding CRNAs vs APNs. We have specific requirements in IN for APN that...

  9. Not trying to stir up bad ideas, but......

    paindoc replied to Brian_SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    CRNAs in our state are by law NOT advanced practice nurses. They cannot write narcotic or other prescriptions and can only administer drugs. The state legislature has determined they do not have...

  10. an interesting and somewhat ignorant article title

    paindoc replied to zrmorgan's topic in Certified Registered Nurse Anesthetist, CRNA

    One of the most important aspects of outpatient office anesthesia or hospital anesthesia (eg GI lab) is that the anesthetics are NOT being administered by qualified physicians or CRNAs. It is highly...

  11. Loss of resistance

    paindoc replied to SigmaSRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    647. Valentine SJ, Jarvis AP, Shutt LE. Comparative study of the effects of air or saline to identify the extradural space.Br J Anaesth. 1991 Feb;66(2):224-7. 839. Aida S, Taga K, Yamakura T, Endoh H,...

  12. Loss of resistance

    paindoc replied to SigmaSRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    Sorry, but pneumocephalus does not mean filling the entire cranial vault with air. 1cc of air can easily travel subarachnoid during a noted or unrecognized dural puncture, and cause a whopping...

  13. Loss of resistance

    paindoc replied to SigmaSRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    Use of air is far more hazardous than saline for loss of resistance techniques. There have been reported cases and series of pneumocephalus, canal compression, nerve root compression,...

  14. magazine article about addiction

    paindoc replied to NiteyNight's topic in Certified Registered Nurse Anesthetist, CRNA

    Since I do not administer anesthesia any longer (except for in office MAC), I have no axe to grind with CRNAs and have worked with them for years. Sometimes it helps to have a MD's perspective on...

  15. magazine article about addiction

    paindoc replied to NiteyNight's topic in Certified Registered Nurse Anesthetist, CRNA

    It is quite likely the people writing the article are way off base. Fentanyl is not a volatile gas, and can only be exhaled in water vapor, and this in extremely minute quantities. Most of those...

  16. Pregnant in the OR???

    paindoc replied to ColoradoCRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    TIVA= total intravenous anesthesia No volatile inhalational agents, and no nitrous oxide gasses=no harm to the pregnant female in the OR. Constant infusions of remifentanyl plus propofol or...

  17. Pregnant in the OR???

    paindoc replied to ColoradoCRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    One word:

  18. CRNA vs. MDA SALARY

    paindoc replied to matt12345654321's topic in Certified Registered Nurse Anesthetist, CRNA

    When this happened at the Univ of Kentucky several years ago during a shortage of residents, and when UK hired locum CRNAs making more than the attending physicians, half the physicians were gone...

  19. My CRNA friends do illegal drugs

    paindoc replied to DrugReptoNurse's topic in Certified Registered Nurse Anesthetist, CRNA

    Having to deal with patients that feel it is just fine to use recreational drugs whenever they damned will please and in whatever intervals they wish (appropriate use of recreational drugs is...

  20. Pregnant in the OR???

    paindoc replied to ColoradoCRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    I knew a nurse that actually did become pregnant in the OR....but we don't need to discuss any more

  21. Need help with a research project!!

    paindoc replied to mummer43's topic in Certified Registered Nurse Anesthetist, CRNA

    Anesthesiology. 2001 Nov;95(5):1120-4. Comment in: Anesthesiology. 2002 Sep;97(3):757; author reply 758. Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous...

  22. Non anesthesia provider providing anesthesia

    paindoc replied to EMS/ICU/SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    Obviously, you do not practice pain management, so I can forgive your ignorance. As for sedation, we do charge for it CPT 99144. We are not reimbursed by medicare for this code, and we are reimbursed...

  23. Non anesthesia provider providing anesthesia

    paindoc replied to EMS/ICU/SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    The technique is not meant as an endorsement- it is one of many ways in which to practice safe anesthesia. At some point what would be considered "luck" by those that are detractors of a particular...

  24. Non anesthesia provider providing anesthesia

    paindoc replied to EMS/ICU/SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    Usually 1-2 boluses for short cases, and for longer cases continuous infusion based on their

  25. Non anesthesia provider providing anesthesia

    paindoc replied to EMS/ICU/SRNA's topic in Certified Registered Nurse Anesthetist, CRNA

    If I might interject, I am a MD pain physician now in AA (anesthesiologists anonymous) that has had RNs inject propofol for over 12,000 cases in the prone position with an unprotected airway. Used in...