 So there are lots of us who really want to know like what exactly can a PA do I mean I know you're called a physician assistant so what exactly is it that you do? And so that is the question that we're going to be answering in this video. What's up you guys? This is Don. Welcome back to my channel. So if you're new to my channel take a look around if you like what you see go ahead and subscribe. Please hit that like button and that notification bell because it really helps my YouTube algorithm out a lot. But I had a question posed by Kavon Cannon and he asked can you talk about trauma PA's scope of practice in depth? Do you intubate? Are you supervised when doing so? Are you trained in bedside ultrasound? Do you play subclavian and arterial lines? How often is the attending physician or surgeon in the trauma bay with you? Do you manage unstable hip fractures etc? Do you transfer or give report to the admitting provider at another higher acuity facility? Thanks Adana. We appreciate your content. Okay so that is a lot of questions to unpack in this one video so I'm going to do my best to do like answer all your questions I'll read through it again. But what do we do as trauma PA's because if you don't know I am a trauma PA and so more so an acute care surgery PA so I deal with trauma general surgery, vascular anthoracic surgery so we cover a lot. As far as intubations no we don't do the intubations the anesthesiologists or the like nurse anesthetists they're the ones that are actually doing the intubations where although we're trained to do that in PA school like we learn intubations and lumbar punctures and all of those various different things like central lines we don't do those at least at my facility maybe at another facility they allow their PA's to you know go ahead and do the intubations but for me we don't do that because we have the anesthesiologists that come and perform that task for us so that is to answer that question no so first question checked right you asked am I supervised when I do so well since I don't do them no I'm not supervised because we don't do those and says are we trained in bedside ultrasound so yes we are we're trained in bedside ultrasound at in school and more so in the field and it all depends on what specialty you're in but as a trauma PA we need to learn how to do a fast exam because when our patients are coming in we're trying to do like a really quick assessment of what is going on with them so we have to do this like focus ultrasound assessment of the patient and so we do lots and lots of fast exams when dealing with our trauma patients that are initially coming in and so that is something that we're trained in and then we also use ultrasounds to put in line so that is your next question you asked do we place subclavian and arterial lines so we do lines all the time now obviously our ICU colleagues our ICU PAs they do lines like all day every day like that is like their bread and butter in the ICU but in a very like acute high acuity like trauma very emergent situation not only do we put in chest tubes but we place various different arterial lines so we may need to put literally an A line in so that we can see what the patient is doing we may have to put central lines in so central venous catheters and we'll do those typically in the like the femoral artery but when it comes to if our patient is a little bit more stable we might put one in the subclavian and it's we don't care too much about like the dropping a lung because we can easily put a chest tube in but you know if you don't need to um we don't necessarily go in the subclavian because although the femoral artery in the femoral area is a little bit more dirty because it's right by the groin there is less vascularature there and less like various different organs and things that we are really concerned about when you're going in the subclavian or the jugular your subclavian you're really worried about the lung and collapsing that lung so we do place those lines and we do those pretty often on our job it says how often is the attending physician or surgeon in the trauma bay with you so my attending is it depends on which attending is there I guess you could say so for the most part they'll come down here and there right you know sometimes they're there you know right when the trauma is called we all get there at the same time we're the ones kind of running the primary assessment while they're in the back kind of you know conducting the show um making sure that everybody is doing their particular role but not always it's not always the case sometimes they're in the OR and a trauma comes in and they're not there at all but they'll come back once they're done with the OR to just be like you know hey what happened is everything okay is the patient fine you know that kind of stuff just because at the end of the day you know they're going to be under their service and so they want to know like who the patient is and get an assessment of that patient sometimes it's a matter of like a call and they will see the patient on their own you know when they have time so I may go in for a consult see the patient do my assessment tell my attending what's going on they will give me some insight on things that I can do you know maybe some various different labs that I should order or put this patient on like antibiotics if I haven't already done so just a little bit of cleanup work if there was something that I may have missed which again you know I'm new like it's almost been a year but I'm I still consider myself new so I don't know everything but I will call them let them know and at the end of the day they have enough faith in you as the PA to be like okay I trust your judgment and so that's cool we'll roll with that but then they'll see the patient like on their own when they're they're ready to do their own rounds so it all depends on on who the attending is and who the PA is and the type of relationship that you guys have in the trust that you have but they're not always in the trauma bay with us running the trauma sometimes they're off in the operating room doing things and we have to do that on our own and so I like I don't know if this is necessarily the case for all trauma PAs I don't know how other hospitals work but for my hospital you know I think that we have a really good race working relationship with our attendings and they really do trust us a lot and give us a lot of leeway when it comes to like actually being practitioners you know licensed practitioners that can kind of do this job and so I really appreciate that and I can't take that for granted because again I don't know what it is like at other places all right so your next question said do you manage unstable hip fractures so I mean technically but not really so like yes like if somebody comes in and they fracture their hip you know we do this bull body scan we call it a shan scan and so it's you know depending on where the injury is we might do like a maxillofacial CT we definitely do chest abdomen and pelvis and then again if you have like any extremities that the orthopedic team may need um just to check out like the vasculature to see if it's been compromised or not we will include those as well so if there is a hip fracture that come you know somebody comes in they have like a pelvis fracture and they're bleeding out or something we put a pelvic binder in um we're making sure that we're pushing blood all of that kind of stuff and then our attendings will you know we're like okay we got to go to the OR and so you'll go to the OR to kind of try and stop the bleeding but you also call the ortho team on board to help with that in terms of stabilizing the bone that's broken the hip that's broken or maybe it's a femur and so do we manage that to a certain degree but for the most part since it's the bone you know we usually call the orthopedic surgeon but more so the orthopedic PA that's on and they will come they will assess the patient and they'll talk to their attending and then we'll coordinate that way so that's typically how it works at my hospital and I think that's how it works at most places you will initially assess the patient you will manage what you can for the patient and then you kind of outsource to the various different specialty teams because this is their specialty and they know exactly what they're doing okay all right um you asked do you transfer or give report to the admitting provider at another higher acuity facility so like I can tell Kmon that you are like for sure in the medical field or you're like in PA school or something like that because you know like the realm of how things work you know the operations of exactly how things work so do we transfer yeah there are times when we do transfer and it's not always because of you know there it's like more high acuity per se they're made they're just sometimes things that we don't have at our hospital so you know there are like optimal like ophthalmology right if there's something going on with the patient's eye we do have ophthalmologists that are on our team um at the hospital but some of them don't do particular surgeries or um you know we may not have the necessary equipment at our hospital and so we do transfer to our sister hospital um that's further north and that tends to happen from time to time but typically for the most part we try not to transfer really lots of people in other hospitals are kind of transferring to us so that's what we get a lot of we'll get calls saying hey you know we have a pending transfer for an SBO or we have a pending transfer for an API or a pending transfer for an MVC or they will drive people from like 45 minutes away if they can't fly them to our hospital because our hospital is the high acuity hospital and but then we do have a sister hospital that deals with things that where we may fall a little short in terms of oh we don't have that equipment or um our particular surgeon doesn't perform that particular surgery so that's really how it goes but I mean we're pretty we're a pretty decent hospital and uh and I like that aspect of it because I get to see a lot and get to learn a lot and as a new grad that is like the number one thing that you can ask for more learning because when you're in school you're learning like the book work you're learning how it says to do it in the book but practical stuff hands on seeing like some of these surgeons that have been practicing for decades and then you see how they're doing it as opposed to how the book said and you're like wow I didn't realize that that was even an option and you see them how they are just masters of their their craft and their trade that is amazing and so um still learning a lot really really excited um I'm I'm happy that I'm in the field that I'm in right now um obviously trying to learn as much as I can still studying right now I'm studying for my atls so studying for that so we'll see how that goes I'll let you guys know but you're constantly learning like this is lifelong learning um so if you don't want to be a lifelong learner then being a pa is not necessarily for you but if you do then go ahead and subscribe to this channel again because it helps my youtube algorithm a lot and go ahead and continue to get you know the knowledge like through google and youtube and books and school um because it's only going to be a benefit to you in the future all right so hopefully you guys like this video thanks k mom for asking me that question please you guys continue to leave me your comments and your questions in the comment section below go ahead and like this video subscribe to my channel follow me on instagram at adana pa and on instagram I get that's the university where we help you get into and through pa and thank you guys so much for watching I will talk to you guys next time