Anesthetist and Surgeon in O.R.

[MacBook]

Little me asking a question. Why is it that during the induction of anesthetics while you have the anesthetist working and getting the pt ready the surgeon is also present? Why do they not start scrubbing as opposed to waiting for the pt be under?

Pardon my pre-hospital background. Have very little understanding of standard in hospital/surgical procedures. Just this has been something that's boggled my mind for a while.
I appreciate the time taken to answer this

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[Noyac]

Little me asking a question. Why is it that during the induction of anesthetics while you have the anesthetist working and getting the pt ready the surgeon is also present? Why do they not start scrubbing as opposed to waiting for the pt be under?

Pardon my pre-hospital background. Have very little understanding of standard in hospital/surgical procedures. Just this has been something that's boggled my mind for a while.
I appreciate the time taken to answer this

Thats a good question. Mostly its common courtesy but as far as I know it probably started many years ago when induction of anesthesia was a particularly dangerous part of the case. Everyone that can be of help was in the room ready to assist if needed.

 

[Tenesma]

typically most susrgeons want to make sure the patient is properly positioned and well padded, etc... after a few neuropraxia/neuropathy cases, you would become pretty vigilant as well....

 

[militarymd]

our surgeons don't come into the room until after the patient is prepped and drapped, and their assistants close for them.

 

[jetproppilot]

our surgeons don't come into the room until after the patient is prepped and drapped, and their assistants close for them.

I agree with Mil that the situation you posted about doesnt happen everywhere.

Most of our surgeons arent in the room either until the patient is asleep.

 

[dfk]

in our facility, we cannot bring the patient into the room until AT LEAST the surgeon is in the building or medicate the patient until the surgeon has seen the patient. my thinking, aside from above, is that sometimes you can induce he patient with the thinking that the surgeon is "on the way", and come to find out, they don't make it for quite some time there after...
having a patient under any longer than needed is desirably unnecessary..

 

[Bertelman]

in our facility, we cannot bring the patient into the room until AT LEAST the surgeon is in the building or medicate the patient until the surgeon has seen the patient. my thinking, aside from above, is that sometimes you can induce he patient with the thinking that the surgeon is "on the way", and come to find out, they don't make it for quite some time there after...
having a patient under any longer than needed is desirably unnecessary..

I think that's true for just about any facility. What Mil and JPP are describing is a surgeon who waits until the room is ready to appear in the OR. Not that he's necessarily waiting. Maybe dictating the last case, grabbing a snack, rounding upstairs.

I imagine the surgeon is more likely to be in the room for induction at an academic center, as there is more turnaround time.

 

[IctalSmile]

our surgeons don't come into the room until after the patient is prepped and drapped, and their assistants close for them.

Same here.....they dont pop in the room til atleast a few minutes after the patients has been in dream land, and let asst.'s sew em back up.

 

[MacBook]

I really appreciate the replies everyone.

The facility in question is right on the edge of the University Campus. It is a teaching hospital. It also serves as our Trauma Centre. That might be why they run the way they do?

Thanks again

 

[militarymd]

it took me a little bit to get used to NOT having the surgeon around.


But now it feels weird when they're in the room, like I'm being slow or something.


My thoracic surgeon used to watch me before he got to know me...going to sleep and waking up, but then after knowing that I'm competent, he would disappear just like everyone else.

 

[Idiopathic]

in our facility, we cannot bring the patient into the room until AT LEAST the surgeon is in the building or medicate the patient until the surgeon has seen the patient. my thinking, aside from above, is that sometimes you can induce he patient with the thinking that the surgeon is "on the way", and come to find out, they don't make it for quite some time there after...
having a patient under any longer than needed is desirably unnecessary..

yeah, but our hospital allows for an intern or some other "operative entity" to satisfy this requirement.

I only see surgeons in the room for induction with things like traumas, big pericardial effusions or leaky aneurysms. Never for lower acuity cases.