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The American Association of Nurse Anesthetists notes that more than 32 million anesthetic procedures are carried out annually in U.S. medical facilities, and the majority of these are administered by nurse anesthetists. In some states, nurse anesthetists are the only anesthesia providers in nearly 100 percent of the rural hospitals.
Nurse anesthetists are clearly important members of health care teams across the country. Prior to surgery, a nurse anesthetist takes the patient's history, evaluates his or her anesthesia needs, and forms a plan for the best possible management of the case (often in consultation with an anesthesiologist). The nurse anesthetist also explains the planned procedures to the patient and answers questions the patient might have. Prior to the operation, the nurse anesthetist administers an intravenous (IV) sedative to relax the patient. Then the nurse anesthetist administers a combination of drugs to establish and maintain the patient in a controlled state of unconsciousness, insensibility to pain, and muscular relaxation. Some general anesthetics are administered by inhalation through a mask and tube, and others are administered intravenously. Because the muscular relaxants prevent patients from breathing on their own, the nurse anesthetist has to provide artificial respiration through a tube inserted into the windpipe. Throughout the surgery, the nurse anesthetist monitors the patient's vital signs by watching the video and digital displays. The nurse anesthetist is also responsible for maintaining the patient's blood, water, and salt levels as well as continually readjusting the flow of anesthetics and other medications to ensure optimal results. After surgery, nurse anesthetists monitor the patient's return to consciousness and watch for complications. The nurse anesthetists must be skilled in the use of airways, ventilators, IVs, blood- and fluid-replacement techniques, and postoperative pain management.