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Anesthesia Services

The Tomah Memorial Hospital Department of Anesthesia is staffed by Certified Registered Nurse Anesthetists (CRNA) who provide all anesthesia services.

Services

Anesthesia For Surgery Patients requiring surgery have the opportunity to meet with a CRNA prior to their surgery (usually the morning prior to surgery) to discuss the anesthetic options available. Together, the CRNA and the patient choose an anesthetic that is mutually agreed upon by the patient, surgeon, and CRNA. Often, patients are able to choose from a regional anesthetic such as a spinal anesthetic, an epidural, a regional block, local anesthesia with sedation or a general anesthetic.

Labor Analgesia   Patients delivering their children may at times require pain relief that cannot be provided by I.V. pain medications. After consultation with your physician or nurse midwife, a CRNA can place a labor epidural or perform an intrathecal narcotic injection that usually provides excellent pain relief.

Lumbar Epidural Steroid Injection Patients experiencing back pain and who are determined by their physician to be candidates for epidural steroid injections may have the injections performed at Tomah Memorial.

Advanced Airway Management and Trauma Care A Certified Registered Nurse Anesthetist (CRNA) is available to provide anesthesia care to patients at Tomah Memorial Hospital.

Please contact the Department of Anesthesia at (608) 374-0297 at Tomah Memorial Hospital for any questions or concerns related to anesthesia services.


Frequently Asked Questions

Who will administer my anesthetic?
Anesthesia services at Tomah Memorial Hospital are performed by CRNAs (Certified Registered Nurse Anesthetists). Certified Registered Nurse Anesthetists are advanced-practice nurses certified to administer anesthesia in a number of settings. Certified Registered Nurse Anesthetists are registered nurses with critical care nursing experience who have completed a 24 to 36 month anesthesia education program. Nurse Anesthetists receive certification by passing a national examination provided by the American Association of Nurse Anesthetists. Continued education is required to maintain certification. CRNAs at Tomah Memorial Hospital perform all aspects of anesthesia care under physician supervision. These aspects of care include preoperative evaluation, development of an anesthesia plan, administering the anesthetic, and post-op evaluation.

What information will the Certified Registered Nurse Anesthetist need to know about me prior to my surgery?
You should be prepared to provide a list of all medications, vitamins, herbal supplements, and over the counter medication you presently regularly or occasionally take. If you have ever experienced side effects or allergic reactions to any past medications this information should be provided. Be prepared to list any previous anesthetics you may have received and discuss any problems or complications you experienced. You should know if any member of your biological family ever experienced a problem or unusual event with a previous anesthetic they may have had. The CRNA (Certified Registered Nurse Anesthetist) will need to know if you presently have or have recently recovered from a cold or upper respiratory infection. If you have asthma or are a present or past smoker this will be important information to provide. If you have acid reflux symptoms or take medications for stomach upset or acid reflux you should be able to discuss the frequency of medication use and symptom occurrence. Be sure to follow any orders regarding when you should stop eating or drinking. Providing this information to the CRNA will help to assure a successful anesthesia experience.

Can I continue taking my herbal supplements before surgery?
Herbal supplements have become popular over the past few years as the general population has become aware of the health benefits. For many people herbal supplements have become a daily part of their health maintenance program. Unfortunately, taking herbal supplements right up to the day of surgery may have a negative effective on the outcome of surgery.

Some of the herbal supplements may either interact with the anesthetic a person receives or may cause an increased risk for bleeding. Garlic, ginko, feverfew, ginseng, and vitamin E are just a few of the many herbal supplements that may increase the risk of bleeding. Kava and St. John's Wart may cause additional sedation. Ephedra can negatively affect blood pressure, heart rate, and cause disturbances of heart rhythm.

Until further research results are available, the best advice for a person with an upcoming surgery is to stop taking the medication at least two weeks prior to the scheduled surgery date. Herbal supplements need to be considered medication, so when your health care professional asks you what medications you take be sure to include any vitamins, herbal supplements and other over the counter medications you regularly or occasionally use.

Hopefully, following this advice will help you avoid some of the complications these supplements might otherwise cause during your surgery.

I don't want to be awake during my surgery. What are my options?
When trying to decide on what anesthetic is the best, most people agree on one thing: they do not want to feel, hear or see anything. Consequently, most people just want to be "knocked out or put to sleep". What many people do not know is that being knocked out means exposing a person to a number of risks that may not be necessary. Being knocked out (general anesthesia) usually involves the placement of a breathing tube in the windpipe, being placed on a ventilator, receiving additional drugs, and the possibility of more pain and nausea in the recovery period. Depending on a person's medical condition general anesthesia may not be the best choice for a patient.

Admittedly, there are times when a general anesthetic is the best or only choice available. But, when a spinal, epidural or regional block would provide good operating conditions these choices are offered. The goal of not seeing, hearing or feeling surgery can still be met even if only the portion of the body where surgery is occurring is "numbed". A good regional anesthetic combined with enough IV sedation to cause a person to lightly sleep during the surgery is often times a safe alternative in meeting the goal of not seeing, feeling or hearing surgery. Very commonly patients having an arthroscopy or hernia repair can undergo a spinal anesthetic, receive IV sedation and leave the operating room without having heard, felt or seen their surgery. These people are more awake and alert, and experience less pain and nausea after surgery.

When discussing your anesthesia plan with the CRNA (Certified Registered Nurse Anesthetist) at Tomah Memorial Hospital please know you do not have to be knocked out or put to sleep in order to have a positive surgery experience.

How does a nurse become a Certified Registered Nurse Anesthetist?
A nurse attends an accredited nurse anesthesia education program to receive an extensive education in anesthesia. The programs are 24 to 36 months in length and contain classroom and clinical experience. The classroom curriculum emphasizes anatomy, physiology, pathophysiology, biochemistry, chemistry, physics, and pharmacology related to anesthesia. The clinical component provides experience with a wide variety of anesthesia techniques. All nurse anesthesia education programs offer a master's degree. The education programs prepare the student to take the national certification exam.

Requirements:
Admission requirements include a bachelor's of science in nursing or another appropriate baccalaureate degree from an approved nursing program, a license to practice nursing, and a minimum of one year of acute care nursing experience.
For additional information contact the anesthesia department at Tomah Memorial Hospital or the American Association of Nurse Anesthetists at www.aana.com or by phone at (847) 692 7050.

Is there a chance I could "wake up" in the middle of my surgery?
Unfortunately, remembering conversations or "feeling the surgery" are risks associated with general anesthesia. Experiencing awareness during anesthesia can have a long lasting psychological effect. For that reason the CRNAs (Certified Registered Nurse Anesthetists) at Tomah Memorial Hospital make every effort to prevent the occurrence of awareness during surgery. The CRNA providing your care constantly monitors and evaluates your response to surgery. A monitor that measures EEG waveforms (brain wave activity) is used for the majority of patients receiving a general anesthetic. This monitor translates these waveforms into a numerical value that indicates the depth of your hypnotic state during anesthesia. Information derived from this monitor helps the CRNA administer an anesthetic that decreases the chance of awareness during surgery and decreases the chance of a slow emergence from anesthesia. If you have surgery at Tomah Memorial Hospital you can be relieved to know that your anesthesia care is designed to prevent you from experiencing awareness during surgery.