Physician Assistants (PAs) are frequently delegated the task of performing invasive procedures. While there is a nearly 40 year record of PAs performing procedures of various types, limited published information is available that verifies the safety of delegating these medical responsibilities. As the scope of practice expands for the PA profession, research data will be necessary to document the safety and effectiveness of PAs performing invasive procedures. This prospectivestudy followed 9 PAs inserting central venous catheter (CVC) lines in pulmonary critical care and cardiothoracic surgery settings in a large urban hospital from June 1, 2002 through December 1, 2002. Each PA required general supervision for the procedures. The most common complication of CVC placement is pneumothorax. None of these occurred during the study period in 233 CVC lines inserted by PAs. Additionally, during the study period, this group of PAs inserted 75 Swan-Ganz catheters, performed 25 thoracenteses, 30 endotracheal intubations, and 10 chest tube placements. Complications were noted and recorded via the on site researcher. The only complication noted during the study period was a single pneumothorax while performing a thoracentesis. This research study demonstrates that with the proper training and supervision from a physician, PAs can perform invasive medical procedures with a complication rate comparable to that of physicians in a similar setting.




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