Pediatric Anesthesia Overview
Pediatric anesthesia represents a subspecialty area where CRNAs with additional training can find rewarding opportunities.
Where CRNAs Practice Pediatric Anesthesia
Settings
| Setting | CRNA Role | Volume |
|---|---|---|
| **Children's hospitals** | Team with MDA | High |
| **Community hospitals** | May be primary | Variable |
| **Dental surgery centers** | Often primary | High |
| **Outpatient surgery centers** | Primary or team | Moderate |
Case Types
| Age Group | Common Procedures |
|---|---|
| **Neonates** | Rare for CRNAs outside specialized centers |
| **Infants** | Hernia repair, pyloromyotomy |
| **Toddlers** | Myringotomy, dental, minor surgery |
| **School-age** | T&A, ortho, dental |
| **Adolescents** | Similar to adults, still requires special approach |
Skills Required
Core Competencies
| Skill | Why Essential |
|---|---|
| **Age-appropriate airway management** | Different anatomy |
| **Weight-based dosing** | Pediatric pharmacology |
| **IV access in small patients** | Technical challenge |
| **Mask induction** | Often preferred |
| **Recognition of congenital issues** | Screen for undiagnosed conditions |
| **Parent communication** | Family-centered care |
Equipment Familiarity
- Pediatric airways (sizes, uncuffed vs cuffed)
- LMAs (pediatric sizes)
- Small IV catheters
- Pediatric circuits
- Age-appropriate monitoring
Training Pathways
How to Gain Pediatric Experience
| Method | Duration | Notes |
|---|---|---|
| **CRNA program exposure** | Variable | Often limited |
| **On-job training** | 6-12 months | Mentored cases |
| **Pediatric-focused facilities** | Ongoing | Build volume |
| **CME courses** | Days | Supplement |
What Employers Look For
| Requirement | Standard |
|---|---|
| **Minimum pediatric cases** | Often 100+ in training |
| **Recent pediatric experience** | Within 2-3 years |
| **Certifications** | PALS required |
| **Comfort level** | Confident with age groups served |
Job Availability
Where to Find Pediatric Positions
| Source | Notes |
|---|---|
| **Children's hospitals** | Dedicated pediatric teams |
| **Dental anesthesia groups** | High pediatric volume |
| **Multi-specialty ASCs** | Mixed caseload |
| **Community hospitals with peds program** | Variable volume |
Geographic Distribution
- Major metros with children's hospitals
- Academic medical centers
- Dental surgery networks
Compensation
Pediatric vs General
| Setting | General | Pediatric-Focused |
|---|---|---|
| Community hospital | $215,000 | $215,000-225,000 |
| Children's hospital | — | $205,000-230,000 |
| Dental anesthesia | $190,000 | $190,000-210,000 |
Pediatric positions often pay comparably to general, sometimes with lifestyle benefits (major children's hospitals often have better call coverage).
Challenges of Pediatric Practice
What's Different
| Challenge | Reality |
|---|---|
| **Higher stakes** | Less margin for error |
| **Emotional toll** | Sick children are hard |
| **Parent interactions** | Additional stress |
| **Rare emergencies** | Must stay sharp |
| **Limited supervision** | In some settings |
Rewards
| Benefit | Impact |
|---|---|
| **Diverse cases** | Good variety |
| **Skill development** | Transfer to all practice |
| **Rewarding outcomes** | Generally healthy patients |
| **Family impact** | Meaningful work |
Is Pediatric Right for You?
Good Fit
- CRNAs who enjoy children
- Those comfortable with family dynamics
- Experienced practitioners
- Those wanting subspecialty focus
Less Ideal
- High anxiety around small patients
- Those preferring adult-only practice
- New graduates (need foundation first)
Maintaining Pediatric Skills
If Not Full-Time Pediatric
| Strategy | Approach |
|---|---|
| **Request pediatric cases** | At current facility |
| **PRN at children's hospital** | Supplement |
| **Annual CME** | Pediatric-focused courses |
| **Simulation** | Pediatric emergency scenarios |
Conclusion
Pediatric anesthesia offers CRNAs rewarding subspecialty practice with excellent outcomes and family interaction. Success requires appropriate training, comfort with pediatric pharmacology and airway management, and the right temperament for working with children and anxious parents. Positions exist across settings from children's hospitals to dental surgery centers.
Practice information from Anesearch, January 2025.