Want to be sedated (for surgery)? Anesthesia assistants could help shorten wait times

One solution to the severe shortage of Canadian anesthesiologists may be to increase the ranking of anesthesia assistants, advocates say.

“In situations where we have serious surgical care problems, we must consider creative solutions to move forward and provide people with the care they need,” Dr. Sally Bird, a pediatric anesthesiologist and director of pediatric anesthesia at IWK Health Center in Halifax, told Barry Brian Goldman, a host of CBC Radio Radio. White coat, black art.

Although many Canadians may not be familiar with their jobs yet, Anesthesia Assistant Career Established More than 50 years ago, in Quebec, about 15 years ago in most other provinces. However, they are not available everywhere.

As the name suggests, the anesthesia assistant (AAS) works under the direct supervision of an anesthesiologist.

“The role of anesthesia assistant is to expand the care and services of doctors and specialists in anesthesia departments,” said Rob Bryan, a senior AA at Mackenzie Health, Ontario, north of Toronto.

“Doctors are always responsible for the care of patients,” Brian said. White coat, black art Go to the hospital.

By comparison, A nurse who has been specially trained is called a nurse anesthesiologist Anesthesia can be performed independently of American doctors, but they have been unable to perform anesthesia in Canada since the end of World War II.

A nurse anesthesiologist (also known as a certified registered nurse anesthesiologist) can have its own practice, similar to how nurse practitioners provide primary care without a family doctor. This means they can fill gaps in rural and remote areas of the United States, for example, providing sedation in places where otherwise it is impossible to obtain epidural labor and childbirth.

The responsibilities of AA vary in each province

Canadian anesthesiologists say it doesn’t make sense to initiate new procedures to prove nurse anesthesiologists, because Canada already has an established system whose AAS can be expanded, not only in quantity, but also within the scope of practice.

“We have worked well as a team and have already had a high level of trust,” said Bird of IWK.

This is also the official position of Canadian anesthesiologists. Propose a position statement The last time a nurse anesthesiologist was introduced in British Columbia, saying the organization “resolutely rejected” Canadian nurse anesthesiologists. Instead, it is Plan to resolve surgery waiting time Includes increased number and availability of well-trained AAs.

Most anesthesia assistants have a background as a respiratory therapist (RT), although some assistants look at the grade of registered nurses and have additional training in anesthesia.

Mackenzie Health’s Bryan has a name called Certified clinical anesthesia assistantor CCAA, given RTS like him by the Canadian Association of Respiratory Therapists, received additional training. Not all anesthesia assistants in Canada have CCAAs like him.

While the anesthesia assistants that allow assistants vary from province to province, they become part of anesthesia teams in an increasing number of regions in Canada.

Watch | Canada is still working to clear the surgical backlog:

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New data from the Canadian Institute of Health Information shows that patients in all provinces have longer waiting times than some prioritized orthopedic and cancer surgeries before the pandemic, but that’s not all bad news – overall, there are more surgeries than ever before.

“It’s very incredible for people with a lot of expertise”

Dr. Jerod Gollant, secretary of anesthesiology at Mackenzie Health, said it usually had to postpone the procedures before AAS joined hospital staff because there were not enough anesthesiologists.

He said that is not happening now, as the anesthesia assistant allows the department to increase efficiency and see more patients.

For example, working multiple AAs in the endoscopy department under the supervision of an anesthesiologist, allowing another anesthesiologist to be released to work elsewhere in the hospital.

“So we were able to provide therapeutic diagnostic and screening endoscopy procedures to all our communities, without canceling any surgery downstairs in the main operating room.”

Bird, the hospital’s director of pediatric anesthesia, said the scope of practice for AAS has gradually expanded at IWK in Halifax.

“Initially, when they started, they would do things like helping us get patients to sleep, helping in the recovery room,” she said. “But we slowly realized that these people are very incredible people, and they provide a lot of expertise, so the anesthesia assistants we work with are doing independent procedural sedation.”

Sami Jreige is one of the certified clinical anesthesia assistants in partnership with Bird.

“We are somewhat unique in what AAS can do. … We can provide patients with deep sedation to perform surgery that otherwise requires an anesthesiologist,” he said.

“This is probably my favorite part of my job to be able to go out and clean up the waitlist or elective cases specifically targeting AAS, where we can get the job done more timely and efficiently.”

Limited training ability

An editorial Canadian Journal of Anesthesiology In September 2024, not only did they lack awareness of career, but they also had too low training ability.

The editorial pointed out that there is Only four in Canada have received four accredited AA training programs – Two ontario, two in British Columbia, and one in Alberta.

“I honestly don’t think we’re a very famous profession,” Jerrig said.

Carolyn McCoy, director of professional practice at Canadian respiratory therapists who represent a certified clinical anesthesia assistant, said it would take one to two years to complete the additional training required to become a CCAA.

“Usually, because education to be anesthesia assistants has no funds to pay the bill…the vast majority continue to work full-time while receiving this extra education.”

The Canadian Journal of Nasthesiology editorial said that training subsidies could be part of the increase in the number of AAS, which could make payments better. It says the supply of well-trained AAS is even stronger, which is also key to avoid burnout from existing anesthesiologists.

Bird said she firmly believes that AAS can provide a stronger anesthesia workforce in Canada, especially given that many hospitals already have anesthesia assistants.

“With… some additional guidance and training, they can do more, which will benefit everyone in the system: patients, health care providers and anesthesiologists.”