Another Typical Night On Call

[slunk]

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Yes I am offended.

What kind of idiotic logic are you using???
Does adding a disclaimer permit you to make racist remarks as the forum moderator?

Would you make derogatory racial comments towards another group?
It would not be tolerated and you would be banned from the forums.

You are just showing your true colors by making racist remarks against an ethnic group with no political clout and hence there is no fear of repercussion for you.

I forgot to mention that in addition to being Asian I believe that MMD has nappy hair.

On a more serious note though I have to refer you to my post:



If you are still offended then I don't know what else I can say to you.

 

[Planktonmd]

".

So ...for you...a DEFINITE kill is OK, but risking a patient's life for YOUR personal comfort is OK....

See, I was not a candidate to become an astronaut like you, so I don't feel comfortable urinating in dappers.
And I actually like your compassion when you describe how you would stand there and watch a patient fall from the bed and not try to help because you might hurt your back.
Man you are such a great patient advocate 😀

 

[Planktonmd]

Yes I am offended.

What kind of idiotic logic are you using???
Does adding a disclaimer permit you to make racist remarks as the forum moderator?

Would you make derogatory racial comments towards another group?
It would not be tolerated and you would be banned from the forums.

You are just showing your true colors by making racist remarks against an ethnic group with no political clout and hence there is no fear of repercussion for you.

That's your opinion and you are entitled to it.
I actually won't be surprised if I found out that you are MMD under a different name, there is a striking resemblance in the style (or the lack of it for that matter).

 

[jwk]

You should not leave the patient you are taking care of to go start a stat c section. You call your backup anesthesiologist if you have one (we always have a second call MD), or you call a CRNA. The anesthetic for the stat section will start when that person arrives, if it's a CRNA then I would leave the CRNA to finish the ongoing case and go to do the section myself.
If they can't wait 30 minutes for this to happen then they can start under local.
If the hospital wants to guarantee immediate availability of an anesthesia provider for a stat c section they need to pay for a dedicated 24 hours OB anesthesia provider.
When you are doing 1/1 anesthesia your only obligation is toward the patient you are taking care of.

If you are billing medical direction, you can legally, morally, and ethically leave the patient with an anesthetist and go start the emergency C/S before another anesthesia body shows up. Clearly if you're personally administering an anesthetic with no one else around, you can't leave that patient unattended to start the C/S or any other case.

 

[Planktonmd]

If you are billing medical direction, you can legally, morally, and ethically leave the patient with an anesthetist and go start the emergency C/S before another anesthesia body shows up. Clearly if you're personally administering an anesthetic with no one else around, you can't leave that patient unattended to start the C/S or any other case.

Absolutely,
The question was (If I understood correctly) If you were by yourself doing a case and no one else was around would you leave your patient unattended, to go do a stat c section.
My answer to this is no.

 

[Monty Python]

Absolutely,
The question was (If I understood correctly) If you were by yourself doing a case and no one else was around would you leave your patient unattended, to go do a stat c section.
My answer to this is no.

While this may sound harsh and cold, a legal answer is that you've not previously established a relationship with the stat C/section patient and thus have no duty to provide care.

Ah, here's the rub: what if you've previously inserted a labor epidural, but now when the stat C/section is called you're tied up in the OR with an appy. You're the only anesthesiologist/anesthetist in house. Have you breached your duty to the OB pt since you're now temporarily unavailable? I don't know.

 

[pd4emergence]

That's pretty much how ya gotta bill it, and yes, it does suck. I'm not sure on this, but for some reason I'm thinking the medically directed and medically supervised times can be broken down separately, e.g. you could have had your CABG with 2 hours of medically directed time and 30 minutes of supervised time. You would have to go back and document at what point the changeover(s) occurred.

If this is a common occurrence, having that spare person around to cover OB might be worth it. We always have someone in reserve, but we're a big group with a high volume practice, and I realize that the economics of a smaller group might prevent this. If your volume doesn't support the cost, that of course brings in the hospital subsidy question.

Not really a common for us but it does happen from time to time. Usually, we have time to have somebody else get there. We have both a CRNA and an MD in reserve on home call. For this c section I just did not feel like there was time. I would have had to wait at least 10-15 minutes for someone to get there. I know what ACOG says about the whole 30 minute thing but I felt like that extra 10 or 15 minutes would make a difference in this situation.

pd4

 

[poresofkohn]

It's no wonder lurkers find this a hostile, unwelcoming environment..........

>
Speak for yourself pallie, this is WAY better than any of the estrogen laced sub-******ed banter that goes on over at Allasses! I've been saving my SDN cherry for a thread just like this. And FTR - the only thing better than watching 2 extremely well educated, extremely well paid people argue like a bunch of catty school girls on the internet, is parking in their space and secretly watching them throw a clot over it. In conclusion I'll say that I have absolutely nothing constructive to add to this discussion.

 

[coprolalia]

Yeah, now this is an example of a thread that definitely needs to be closed.

-copro

 

[radslooking]

Yeah, now this is an example of a thread that definitely needs to be closed.

-copro

um. yeah. i think somebody typed before thinking.

 

[ZonaRidicularis]

z

 

[Planktonmd]

Leave the astronauts out of this!

🙂
Understood.