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- Page navigation anchor for Anesthesia Assistants: An Integral Part of Canadian Anesthesia Care TeamsAnesthesia Assistants: An Integral Part of Canadian Anesthesia Care Teams
In his marvelously understated way, Mark Twain once commented that, “Reports of my death have been greatly exaggerated.” Likewise, contrary to Josh Booth’s recent assertion1, anesthesia assistants (AAs) are not a failed solution but represent a major advance in the provision of physician-led anesthesia care in the context of the Anesthesia Care Team (ACT).
Rather than using his own unreferenced knowledge to draw sweeping conclusions, Booth would have been better informed by consulting the 2016 National Competency Framework (NCF) for AAs.2 There he would have found a comprehensive and nationally validated list of the competencies that enable AAs to be such an essential part of the ACT. AAs enact these competencies in the Operating Room as well as in an increasing number of satellite areas. AAs also respond to arrests, traumas, obstetrical emergencies, massive transfusion scenarios and are important members of COVID intubation teams. To describe these critical contributions as simply being “a second set of hands” shows a deep lack of insight into ACT dynamics where every member is a highly skilled and experienced clinician.
It is also important to be aware that the NCF has subsequently facilitated the development of a national accreditation process for AA education programs, a national exam for graduates of these programs, and the nationally recognized Certified Clinical Anesthesia Assistant (CCAA) designation, offered through the Canadian Society of Respirat...
Show MoreCompeting Interests: None declared.References
- 1. Josh Booth. Anesthesia assistants — a failed solution since 2005. CMAJ 2020;192:E1216-E1216.
- 2. Canadian Society of Respiratory Therapists (2016). National Competency Framework in Anesthesia Assistance. https://www.csrt.com/wp-content/uploads/Validated2016AANationalCompetencyFramework.pdf
- 3. Beed, J., Brown, S., & Rose, K. A Plan to Evolve the Anesthesia Care Team Model in Ontario: Report of the ACT 2. Implementation Advisory Committee. Ontario Medical Association & the Ontario Ministry of Health and Long Term Care.
- 4. Middleton, C., Dunington, S., & Cox, J. (May 25, 2018). Evolving Practice of the Anesthesia Assistant [Conference presentation]. CSRT Annual Educational Conference, Vancouver, BC, Canada.
- 5. Orser, B. A., & Wilson, C. R. (2020). Canada needs a national strategy for anesthesia services in rural and remote regions. CMAJ, 192(30), E861-E863.
- Page navigation anchor for RE: Anesthesia assistants — a failed solution since 2005RE: Anesthesia assistants — a failed solution since 2005
A Response to J. Booth
It is clear to me reading your response that you have no idea of the scope of practice or history of anesthesia assistants in Canada. Practice varies from province to province with some provinces, Manitoba for example, having their anesthesia assistants running lists on their own with an anesthesiologist overseeing 2-4 rooms depending on the procedures. Your title 'a failed solution since 2005' is amusing since that is about when anesthesia assistants were introduced to the operating rooms in Canada. It has taken the better part of the last 10 years for the profession to gain traction, funding and undergo a educational revamp. It is only the last 5 years where conversations and programs have started regarding independent practice. It has been through the relationship and trust our groups have garnered, via years of co-operation and training, with the anesthesiologists that has allowed for us to get to this point. The suggestion that this is a failed solution when it hasn't been tried is misleading. The numbers you present of 49 million anesthetics given by CRNAs is also misleading. In anesthesia there is often a debate between sedation and general anesthesia. These mean vastly different things and the terms cannot be interchanged. Furthermore our two health systems are completely different. Quoting articles about what works for the US healthcare and trying to apply them to the Canadian system is like saying what's best for...
Show MoreCompeting Interests: None declared.References
- Josh Booth. Anesthesia assistants — a failed solution since 2005. CMAJ 2020;192:E1216-E1216.