I work at Detroit Receiving Hospital in the SICU. The CRNA is paged during codes and intubation requests. They work independant of the MDA during these situations. The only time I have seen an MDA on our unit was during a fiberoptic intubation that was extremely difficult, in which time the CRNA paged the MDA for assistance. The MDA watched as the CRNA performed the intubation. The CRNA's also respond to all trauma codes that enter the ER (very busy) and intubate if the resident physicians have problems. The CRNA will continue care for the patient if they are a surgical candidate, and transport the patient to the ICU. From the conversations with the CRNA's, they love the autonomy that DRH offers. The case load is high along with the aquity level.