California Certified Registered Nurse Anesthetist Workforce Study.

BACKGROUND: Nurse anesthesia in California has been instrumental in shaping Certified Registered Nurse Anesthetist (CRNA) practice nationally, but to date, no workforce data has been published on this group of Advanced Practice Registered Nurses. PURPOSE: The purpose of this workforce study was to explore the demographic information, education, and practice patterns of CRNAs working in California. METHODS: Survey methodology was conducted to gather workforce data from a sample of licensed CRNAs working in California. DISCUSSION: California CRNAs provide anesthesia services in very diverse settings among different anesthesia delivery models, including independent practice. CRNAs practice in a majority of California counties and are the sole anesthesia providers for four underserved counties. CONCLUSION: The CRNA workforce in California is comparatively young, highly educated, and desires more education. CRNAs improve access to care for California patients; however, more ethnically diverse CRNAs and CRNAs with Non-Surgical Pain Management Certification are needed.

Anesthesia case management for bariatric surgery.

An increasing number of bariatric surgeries are performed every year. A thorough understanding of the pathophysiologic changes, surgical procedure, and anesthesia case management for morbidly obese patients and of the pharmacology of weight-reduction and anesthetic drugs is essential to provide high-quality anesthetic care. The various comorbidities associated with obesity may complicate anesthetic management. Anesthetists must perform a thorough preoperative assessment to identify potential risk factors related to anesthesia and adequately prepare for intraoperative management. Intubation, maintenance of oxygenation, and pain management may be particularly challenging, and various strategies are presented. In addition, an obese patient is at higher risk for postoperative complications. Signs and symptoms of surgical complications may mimic medical complications, making diagnosis difficult.