Csection finish

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Carm

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Just a quick poll. When are you guys stopping the anesthetic on your Csections? Are you rolling them to recovery and charting one more set of vitals or documenting last set in OR and letting nurses take patients to recovery? Obviously I am talking about SAB for surgery.

As general rule I have been standing at head of bed for another 10 minutes watching nurse and scrub do whatever it is they do changing bedding etc to transport a perfectly stable patient who is now off monitors to recovery suite down the hall.

Last weekend it was driving me crazy because I am impatient and had cases to do in main OR. Documented last set of vitals and called end of anesthesia time while still in OR. We do the same thing for MAC's, but obviously the nurse was very concerned because this was a change in her routine. Just curious how others are handling situation.
 
Just a quick poll. When are you guys stopping the anesthetic on your Csections? Are you rolling them to recovery and charting one more set of vitals or documenting last set in OR and letting nurses take patients to recovery? Obviously I am talking about SAB for surgery.

As general rule I have been standing at head of bed for another 10 minutes watching nurse and scrub do whatever it is they do changing bedding etc to transport a perfectly stable patient who is now off monitors to recovery suite down the hall.

Last weekend it was driving me crazy because I am impatient and had cases to do in main OR. Documented last set of vitals and called end of anesthesia time while still in OR. We do the same thing for MAC's, but obviously the nurse was very concerned because this was a change in her routine. Just curious how others are handling situation.

It depends on a couple things. First, is there an institutional policy dealing with this? If it's tightly written that you must transport the patient to the PACU, then that may be your only real choice.

Our routine is that we take the patient to PACU. The case is done, dressing goes on, a little belly rub, move to stretcher, and off to PACU. This should not be a long process. They should not be cleaning and making up the room for the next case with the patient still in the room.

However - at our place, ALL the L&D nurses cross-train across all areas - L&D, L&D OR, and L&D PACU, and they all get ACLS. On occasion, we are so stacked up in post partum that we hold patients in the PACU, which if it fills up, we can't get patients out of the OR. In that case, assuming the patient is stable, we WILL sign off to the OR nurse and leave, because we know that nurse can also function as a PACU nurse. We just give a report, leave them on the monitors, write a set of vitals for "PACU" and we're done. They don't like it, but I get really irritated waiting for a PACU slot (same goes for the regular OR's as well), since that's generally a nursing management problem with transporting patients or inadequate staffing, neither of which set well with me.

Anesthesia time is not cheap, and combined with OR time, it gets even more expensive. The combination at our place is probably upwards of $30 per minute. I push hard to get the patient out of the OR ASAP.
 
At one of our locations we have to get a set of vitals after the patient leaves the room whether it is the PACU or her previous L&D room, either is acceptable. The RN follows the pt from the OR to the PACU and is her RN in both locations, if it was an emergent C/S or failure to progress, then she has generally started with her, and the RN stays with the patient -- which is nice in that the RN already knows the patient pretty well.

At this hospital, though, the nurses print off a tele strip after the case (PACU or L&D room), and we sign it. It's the one place that we have to do that. So then I count my end of anesthesia time as signing that tele strip as that's usually the last thing that happens.
 
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