Another day, another kidney

Started by deleted87051
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Well, it's a systems issue of not having a pathologist available for frozens. No formal communication between the radiologist and the surgeon.

The renal vein could have done better to declare itself. The renal artery wasn't pulsatile enough. The ureters just sat there like its job is to do nothing but to get pissed on.

Don't even get me started on anesthesia. Do they need a goddam aline every time for these cases? what was that, his 4th break during the case?
 
dchz said:
Don't even get me started on anesthesia. Do they need a goddam aline every time for these cases? what was that, his 4th break during the case?
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I do anesthesia for a lot of ALIFs and I almost never insert an aline unless there is a patient indication. That is extremely rare because the surgeons aren’t dumb enough to do ALIFs on medical trainwrecks. Thankfully I don’t work with Dr. Death types.
 
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My hospital won’t credential you without a 1/3 mil policy.
 
nimbus said:
I do anesthesia for a lot of ALIFs and I almost never insert an aline unless there is a patient indication. That is extremely rare because the surgeons aren’t dumb enough to do ALIFs on medical trainwrecks. Thankfully I don’t work with Dr. Death types.
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It's great that you guys have that standard. But what's so tough about putting in an Art line? I have never regretted putting one in and if you've done enough, you can usually get one in less than 5 minutes.
 
jope said:
It's great that you guys have that standard. But what's so tough about putting in an Art line? I have never regretted putting one in and if you've done enough, you can usually get one in less than 5 minutes.
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It’s not tough. I put in many many Aline’s....I’m an outlier according to CMS/propublica treatment tracker😉. But I haven’t found them necessary for ALIFs with our surgeons.
 
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jope said:
It's great that you guys have that standard. But what's so tough about putting in an Art line? I have never regretted putting one in and if you've done enough, you can usually get one in less than 5 minutes.
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What's the indication for an a-line? We do a ton of ALIFs, many of them on ASA 1-2 patients. The procedure itself certainly isn't an indication for one.
 
jwk said:
What's the indication for an a-line? We do a ton of ALIFs, many of them on ASA 1-2 patients. The procedure itself certainly isn't an indication for one.
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Because you need an A-line to tell you if they rupture one of the iliacs, duh!
 
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nimbus said:
because the surgeons aren’t dumb enough to do ALIFs on medical trainwrecks. .
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oh yes they are!!. There are bottom feeders who will operate on anything. THey dont care as long as it keeps them in business is all that matters.
 
A line and large bore IV. I’ve seen an assistant yank and tear the iliac vein. Bled like a stuck pig and then had to go to Cath lab for stenting the vein because the tear was impossible to fix.


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