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Government Health Policy and Nurse Anesthetists

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Recent federal legislation and changes to the U.S. Medicare program have expanded opportunities for certified registered nurse anesthetists (CRNAs) to provide care to more patients and receive reimbursement for their services, yet many states still restrict their scope of practice and limit their pay.
A special section in the current issue of Clinical Scholars Review, the journal of advanced practice nursing published by Columbia Nursing, explores how the Affordable Care Act (ACA) empowers CRNAs to help make anesthesia services more accessible to patients; it also highlights laws in New York and other states that may impede the expanded access to care envisioned by ACA.

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Management of difficult airway patients and the use of a difficult airway registry at a tertiary care pediatric hospital. Sheeran PW ,  Walsh BK ,  Finley AM ,  Martin AK ,  Brenski AC . Author information Abstract BACKGROUND: Appropriate recognition and management of the pediatric difficult airway is essential. Two patient deaths in a 2-year period involving children with a known difficult airway led to the formation of the institution's multidisciplinary Difficult Airway Committee. METHODS: Patients with a suspected difficult airway or a known difficult airway are entered into a registry of difficult airway patients. A note describing the airway and any experiences at airway manipulation is entered as part of a difficult airway note in the patient's electronic medical record as soon as the patient is recognized as having a difficult airway. A call system has been developed to mobilize expert emergency airway assistance for these patients. Multi...
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