Ward Claire A, Berry Melissa, Bou-Habib Maria, Law Julia, Milne Andrew D
Perioperative Services Nova Scotia Health Authority.
Anesthesia Nova Scotia Health Authority.
Can J Respir Ther. 2025 Apr 25;61:78-86. doi: 10.29390/001c.136463. eCollection 2025.
Anesthesia assistants (AAs) are respiratory therapists or nurses who have additional sub-specialty training in the provision and maintenance of anesthesia. Their skill set includes advanced airway management, vascular access, and knowledge of vasoactive medications and resuscitative protocols. AAs function as non-physician members of the anesthesia team and can act as physician extenders to help offset the current shortage of anesthesiologists.
This study was a retrospective analysis of AA roles at code blue events at an adult academic teaching centre. Data was extracted from administrative data collection forms completed by AAs at adult code blue events between 2017 and 2022. The data elements that each form captured included time and location of event, presumed cause of the code, airway management details, vascular access provision, medication preparation or administration, human factors and cognitive supports provided to the team by the AAs.
Administrative data collection forms from 320 code blue events were analyzed in this study. The most common primary causes of the code blue events were "arrest" (39%) and "respiratory failure" (26%). Regular floor beds (47%) and the intermediate care units (18%) were the most common locations of code blue events. Airway support was required in 77% of the codes, and in 50% of the cases requiring intubation, it was performed by the AAs. The first pass success rate for AA intubations was 83%, and overall success rate was 96%. In addition to airway management at codes, the AAs also reported providing numerous other valuable contributions to the team. The most reported supports provided to the team included cognitive support regarding resuscitation (49% of cases), intravenous access (19% of cases), and medication preparation or administration (9% of cases). Other roles included placement of arterial lines and drawing blood gases, obtaining interosseous vascular access, and assisting with patient transport to critical care units after resuscitation.
Our study characterizes the supporting roles that AAs can provide as members of the code blue team and demonstrates their contributions to management of critically ill patients. The AAs' airway management, vascular access skillsets, and knowledge of vasoactive and resuscitative medications and protocols make them well-suited to the code blue team. In addition to assisting within the operating room team, AAs can also provide valuable support in non-operating room environments such as cardiopulmonary arrests.
麻醉助理（AAs）是指经过额外的麻醉提供与维持亚专业培训的呼吸治疗师或护士。他们的技能包括高级气道管理、血管通路建立，以及血管活性药物和复苏方案的知识。麻醉助理作为麻醉团队中的非医师成员，可以充当医师助手，以帮助缓解目前麻醉医师短缺的问题。
本研究是对一家成人学术教学中心心脏骤停事件中麻醉助理角色的回顾性分析。数据从麻醉助理在2017年至2022年期间成人心脏骤停事件中填写的行政数据收集表中提取。每份表格记录的数据元素包括事件发生的时间和地点、心脏骤停的推测原因、气道管理细节、血管通路建立情况、药物准备或给药情况，以及麻醉助理为团队提供的人为因素和认知支持。
本研究分析了320例心脏骤停事件的行政数据收集表。心脏骤停事件最常见的主要原因是“心脏骤停”（39%）和“呼吸衰竭”（26%）。普通病房（47%）和中级护理单元（18%）是心脏骤停事件最常见的发生地点。77%的心脏骤停事件需要气道支持，在50%需要插管的病例中，由麻醉助理进行插管操作。麻醉助理插管的首次成功率为83%，总体成功率为96%。除了在心脏骤停事件中进行气道管理外，麻醉助理还报告为团队做出了许多其他有价值的贡献。报告最多的为团队提供的支持包括复苏方面的认知支持（49%的病例）、静脉通路建立（19%的病例）以及药物准备或给药（9%的病例）。其他职责包括放置动脉导管和采集血气、获得骨髓血管通路，以及在复苏后协助将患者转运至重症监护病房。
我们的研究描述了麻醉助理作为心脏骤停团队成员可以提供的支持性角色，并展示了他们对危重症患者管理的贡献。麻醉助理的气道管理、血管通路技能，以及血管活性和复苏药物及方案的知识使他们非常适合心脏骤停团队。除了在手术室团队中提供协助外，麻醉助理还可以在非手术室环境如心肺骤停中提供有价值的支持。
