Every year in January, we celebrate CRNA week. Most people don’t even know we exist, what we do, or what we are capable of. Let me illustrate a story of how we make a difference everyday and the importance of the previous anesthetic record.
Last week, I encounter a patient that I’ve taken care of twice before (how likely is it amongst 30 CRNAs at the hospital that I get to take care of him 3 times in a row?). I was able to connect with this person and spouse quickly and go over the previous anesthetic record. Since I remembered how it took much longer from him to recover from anesthesia, I adjusted my anesthetic and he recovered much more quickly.
Another patient had a history of postoperative nausea and vomiting so I performed a Total IV Anesthesia (TIVA) and the patient wasn’t nauseous postoperatively.
Another patient had a true history of a difficult airway so we were able to perform a spinal for this particular case.
Another patient had a history of requiring a lot of vasopressors so a drip was used throughout the case and led to a smooth and stable anesthetic (otherwise known as railroad tracks, one of our favorites).
Another patient required extra TLC, explanations and a calming presence prior to the induction of anesthesia. Frequently how you feel going to sleep is how you wake up.
Another patient had a history of emergence delirium and that allowed me to provide additional medication to reduce its occurrence.
Many patients state that their previous anesthetic went well so you can repeat a similar anesthetic and expect it to go well, especially if it is a similar type of surgery or procedure.
As they say, you’re only as good as your last anesthetic. Every case, you find ways to improve your anesthetic technique and tailor the anesthetic based on the individual.