RE.2 Protocol administration of anesthesia by nurse anesthetist

Policy:
A Nurse Anesthetist (NA) or a Certified Registered Nurse Anesthetist (CRNA) may be utilized for the administration of anesthetic agents consistent with the procedure outlined below. Only anesthesia providers credentialed consistent with the process detailed in the Medical Staff Bylaws will be allowed to work at this organization.
 
Procedure:
In consultation with the attending physician, the CRNA may  perform any or all of the following:
1.  Perform and document a preanesthetic assessment and evaluation of the patient, including;
    A.  Obtaining the appropriate consent for anesthesia (or assuring that documentation is on file);
    B.  Obtaining an appropriate health history;
    C.  Conducting an appropriate physical screening assessment;
    D. Requesting consultations and diagnostic studies; 
    E. Selecting, obtaining, ordering, or administering preanesthetic medications and fluids; and, 
2.  Develop and implement an anesthetic plan.
3.Select and initiate the planned anesthetic technique which may include: general anesthesia, regional aesthesia, local              anesthesia, and intravenous sedation.
4. Select, obtain, or administer the anesthetics, adjuvant drugs, accessory drugs, and fluids necessary to manage the                   anesthetic, maintain the patient's physiologic homeostasis, and correct abnormal responses to the anesthetic or surgery.
5. Select and use appropriate non-invasive or invasive monitoring modalities for collecting and interpreting patient                   physiological data.
6. Manage the patient's airway and pulmonary status using any of the following appropriate modalities:                                   endotracheal intubation, mechanical ventilation, pharmacologic support, respiratory therapy, or extubation.
7. Manage emergence and recovery from anesthesia by selecting, obtaining, ordering, and/or administering medications,          fluids, or ventilatory support in order to:
    A.  Maintain homeostasis, 
    B.  Provide relief from pain and anesthesia side effects
    C.  Prevent and/or manage complications.
8.  Release or discharge a patient from post-anesthesia care area and provide post-anesthesia evaluation and care. 
9.  Order, initiate, or modify pain relief therapy through the utilization of drugs, regional anesthetic techniques, or other accepted pain relief modalities.
10. Respond to emergency situations. 

11. Perform additional responsibilities that are within the expertise of the individual CRNA.

Approved By Governing Board
RE.2
Control #42.0
GUPTA GASTRO