COA case minimums

Graduates of a COA-accredited nurse anesthesia program must report specific clinical-experience minimums to the NBCRNA for NCE eligibility. Numbers below are the authoritative figures from the NBCRNA NCE Handbook (v05.03, Appendix A, revised January 14, 2026). Always confirm against the current source — these are summary targets.

Total Cases: 600 · Clinical Hours: ≥ 2000 — Total Cases is a standalone requirement, not the sum of the categories below. A single case can count toward multiple categories (e.g., a thoracotomy under GA with epidural counts toward general, regional, intrathoracic, and pain-management), so the category minimums do not add up to the total.

Patient Assessment

Initial preanesthetic assessment

≥ 50

Postanesthetic assessment

≥ 50

Special Cases (age & type)

Geriatric (65+ yr)

≥ 100

Pediatric (2–12 yr)

≥ 30

Pediatric (< 2 yr)

≥ 10

Neonate (< 4 wk)

—

Trauma / emergency

≥ 30

Obstetrical management

≥ 10 cesarean delivery, ≥ 10 labor analgesia

≥ 30

Pain management encounters

≥ 15

Anatomic Categories

Categories below do not sum to Total Cases (a single case may map to none, one, or several).

Intra-abdominal

≥ 75

Intracranial (includes open)

≥ 3 open

≥ 5

Intrathoracic

Total of heart, lung & other; ≥ 5 open-heart, ≥ 5 lung

≥ 15

Oropharyngeal

≥ 20

Neuroskeletal

≥ 20

Neck

≥ 5

Vascular

≥ 10

Methods of Anesthesia & Airway

General anesthesia

≥ 400

General anesthetic induction (minimal/no assistance)

≥ 50

Inhalation induction

≥ 25

Mask management

≥ 25

Supraglottic airway devices (LMA, etc.)

≥ 35

Tracheal intubation

≥ 250

Alternative tracheal intubation techniques

≥ 5 endoscopic

≥ 25

Emergence from anesthesia

≥ 300

Moderate / deep sedation

≥ 25

Regional Techniques

Regional techniques — actual administration

≥ 10 spinal, ≥ 10 epidural, ≥ 10 peripheral & other

≥ 35

Regional techniques — management

≥ 35

Invasive Lines & Monitoring

Items marked * are required for NAEP enrollees after 1/1/2022.

Arterial puncture / catheter insertion

≥ 25

Intra-arterial BP monitoring

≥ 30

Central venous catheter (CVC) placement — non-PICC

≥ 1 actual

≥ 10

CVC monitoring

≥ 15

Ultrasound-guided techniques *

≥ 10 regional, ≥ 10 vascular

≥ 20

Intravenous catheter placement

≥ 100

Assessment of chest X-ray *

≥ 5

COA Standards (official) →

COA case minimums

Methods of Anesthesia & Airway

General anesthesia

≥ 400

General anesthetic induction (minimal/no assistance)

≥ 50

Inhalation induction

≥ 25

Mask management

≥ 25

Supraglottic airway devices (LMA, etc.)

≥ 35

Tracheal intubation

≥ 250

Alternative tracheal intubation techniques

≥ 5 endoscopic

≥ 25

Emergence from anesthesia

≥ 300

Moderate / deep sedation

≥ 25

Invasive Lines & Monitoring

Items marked * are required for NAEP enrollees after 1/1/2022.

Arterial puncture / catheter insertion

≥ 25

Intra-arterial BP monitoring

≥ 30

Central venous catheter (CVC) placement — non-PICC

≥ 1 actual

≥ 10

CVC monitoring

≥ 15

Ultrasound-guided techniques *

≥ 10 regional, ≥ 10 vascular

≥ 20

Intravenous catheter placement

≥ 100

Assessment of chest X-ray *

≥ 5