An anesthesia assistant (AA) is an advanced practice health care professional, regulated as a member of the College of Respiratory Therapists of Ontario or the College of Nurses of Ontario.

Key Responsibilities of Anesthesia Assistants

The AA plays an important role in the Anesthesia Care Team with unique responsibilities to both surgical and non-surgical patients, as well as to the Anesthesia Department. An AA may work in many different areas and have varied duties.

Main OR Service

  • POCU IV and arterial line insertions
  • Assistance with induction of anesthesia
  • Emergency/difficult airway assistance
  • Crisis management assistance (e.g. arrest, massive blood loss/transfusion)
  • PACU post-op ventilation, treatments, interventions
  • Technical support of anesthesia equipment
  • Training/orientation of staff, students, residents and fellows in several disciplines

Out-of-OR Anesthesia

  • Assistance in Interventional Radiology
  • Assistance in Angiography
  • Assistance in the Catheterization Lab and provision of conscious sedation
  • Assist with maintenance of anesthesia in gamma knife cases
  • Assist with research, conscious sedation and GA cases in the MRI unit

Monitoring of Patients under General Anesthesia

Performance of Conscious Sedation in the following areas:

  • Echo Lab – for transesophageal echocardiograms
  • Catheterization Lab – for biventricular pacemaker Insertions
  • Ophthalmology Surgeries – cataracts and retinal
  • Kensington Eye Institute – ophthalmology
  • Plastics – hand/arm surgeries
  • Orthopedic Surgery – knees, hips, ankle, foot
  • Neurosurgery – stereotactic

Block Room

  • Sedation of patients undergoing regional blocks
  • Assistance to anesthetist during the performance of blocks

Simulation Lab

  • Run lab for recertification and training of critical care nurses, respiratory therapists and AAs
  • Run simulations for clinical clerks and residents

Preoperative Assessment and Patient Preparation

  • Perform preoperative patient assessment of health status as it relates to the relative risks
  • Perform diagnostic laboratory and related studies as appropriate
  • Setup, calibrate, maintain and troubleshoot machines, devices and physiologic monitors used in pre-anesthetic evaluation, pain management and anesthetic/resuscitative care
  • Prepare anesthetic medications based on the type of surgery, method of anesthesia, patient condition and as directed by the responsible anesthesiologist
  • Formulation of anesthesia care plan

Intraoperative Anesthesia Management

  • Establish peripheral venous access
  • Institute non-invasive physiologic monitoring
  • Assist with/perform arterial puncture/catheter insertion
  • Assist the attending anesthesiologist with the establishment of central venous access, institution of invasive physiologic monitoring, elective/emergent complex airway management, acute/chronic pain management
  • Provision of conscious sedation
  • Provision of general anesthesia

Postoperative Patient Care

  • Transportation of patients to PACU and/or ICU
  • Postoperative patient assessment
  • Recognize and initiate appropriate corrective action to counteract problems that may develop postoperatively, in consultation with the responsible anesthesiologist

Assistance with Peripheral and Neuraxial Blockade

  • Assistance with the provision of local/regional anesthetics, including epidural/spinal procedures, local nerve blocks, intravenous regional anesthesia and continuous spinal/epidural (CSE) procedures
  • Provide conscious sedation and monitoring during and following regional anesthetic techniques
  • Monitor hemodynamic function and actively treat with fluid and/or vasopressor medications as required
  • Patient positioning
  • Manipulation of peripheral nerve stimulator
  • Preparation and injection of multiple local anesthetics +/- addition of concentrated epinephrine, along with emergency drug preparation as ordered by the anesthetist
  • Assistance with assessment of nerve block before surgery

Anesthesia Crisis Management

  • Identification of anesthetic crisis and assist in management
  • Initiating Basic and Advanced Cardiac Life Support protocols, MH protocols as indicated, within the scope of the AA's scope of practice, medical directives and delegated controlled acts, while awaiting the arrival of the responsible anesthesiologist
  • Administration of emergency drugs as indicated and directed by the responsible anesthesiologist


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