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[Volatile]

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[Siggy]

The only procedure I don't do is LPs, but our neuro team does those. Most of my colleagues will call IR for thoras and paras. I can't imagine handing off airways unless it's anticipated to be seriously difficult (like impinging mass or known difficult airway, not just obese). Same with lines.

 

[tartesos]

How many of you guys are doing your own procedures in the ICU (airways, lines, LP’s etc)? work as an anesthesiologist in a community hospital and somehow our group has become first call for these procedures, our intensivists won’t touch a patient anymore. This is day and night. We all take home call, so most of the time we’re not in house when they’re calling us at night and on weekends. Our group is ready to say no more but curious how it works at other hospitals. Financially, these pay so poorly its not even worth our time so there’s no incentive. Are we crazy for thinking an intensivist should be capable of doing these?

This is common for small hospitals where icu is run by pulm/ccm that also do consults and clinic and are not in house.

If they are intensivist’s in house that’s very unusual.

 

[tartesos]

Tha

They are here during the day. They are not in clinic. It’s home call at night for all of us and it’s obvious they just don’t feel like coming in at night to do their procedures but are very willing to call us at home to go in and do them. We are extremely busy during the day doing our job, it’s very frustrating to constantly get called to do someone else’s. They will literally be in house for rounds, and say “bed 4 needs intubation, bed 6 needs a CVL, bed 8 needs a dialysis line etc.” our position is just do the darn procedures while you are here. They are YOUR patients on YOUR service and YOU are credentialed and capable.

that’s a ****ty set up for sure.

Sorry dude.

 

[psychbender]

At my mid to large community level 2 trauma center, the intensivists will ask do at least lines and airways ourselves. Some will LP, others send those to IR. They'll generally only call the anesthesiologists for airways they think will be difficult (occasionally, later than they should). When I'm wearing my ICU hat, though, they tend to curbside me a lot, as then it's just phoning a friend, rather than calling for help.

I used to moonlight (anesthesiology) at a very small hospital in rural Georgia, with Pulm-CC in house during the day only. I sometimes got called at night by a surgeon or whoever was at home covering the patient to come in and tube, then help with any resuscitation, as the ER doc was the only physician in-house.

 

[Radetzky]

Ridiculous and embarrassing for the “intensivists” involved

 

[tartesos]

Ridiculous and embarrassing for the “intensivists” involved

Most likely old Pulm/ccm docs that have been spoiled for so long that they lost their skills doing procedures or prioritize churning patients over procedures because of $.

But embarrassing nonetheless.