I think you misunderstand me. I’m not saying I’m not willing to help out if someone needs help. I absolutely am willing to help and do help. I just don’t want to be asked to stand outside the room just in case someone needs help.
Eh, not every pneumothorax needs a chest tube but that’s neither here nor there.
lol I have never called an ER doc in my life for anything. I wish ai could say the reverse was true.
I have no idea what that means.
You're not the intended audience so I wouldn't lose sleep over it.
Yet, you'll be ending up on our tracking board one of these days won't you big guy? If there's one thing this specialty has taught me is that all you Monday quarterbacking specialists end up in our department eventually. Either calling us frantically headed to our ED with your loved one or showing up as a patient. It won't be your best day....but we'll help you get through it all the same.
Don't take it personal. He's not talking about that. How many anesthesiologists need to call an ER doc to bail them out? I am clueless what gas does what and how to operate most of their equipment.
That’s a weird experience. Was it an anesthesiologist that came? I would never use Precedex as an induction agent. I’m sorry you had such a horrible experience.
Ours asked too and we decided against it. Plastics wanted to get called for simple lac repairs. Ortho for reductions. We decided against all of it.
Hahaha, your such a piece of work. You’re not even a real doc. You push drugs, watch over some nurses that does a similar job, and do some blood patch. I doubt you know much about actually taking care of a patient. 🙂
He is one of the mods that attacks posters he disagrees with. best to ignore
Yeah man. It was wild times. So many hungry unicorns in the ER.
The point is man.....it's just absolutely absurd to me that these guys are even taking the time to finger wag in here about calling them down to the ED. As if it EVER happens.
Let's try to keep it nice and civil.
Many Level I trauma centers have anesthesia routinely respond to all Level I activations. We do, and I feel sorry for them because they waste their time 90% of the time. The other 10% they are just going back to the OR quickly. I can count on one hand the number of times that anesthesiology has intubated a trauma patient in the ER.
At the Level 1 trauma center I work at, anesthesia has to show up for every serious* trauma. I tell our anesthesia residents their sole job in being there is to listen to EMS report, patients LOC on arrival, understand what injuries are identified, what lines the patient has, what has already happened in the trauma bay, etc. If the trauma surgeons say OR stat, the resident then communicates what they know to the OR anesthesia team and assigns who is going to do what as soon as the patient enters the OR.
Those are billed procedures. Our contract gives us first right of refusal.
I wonder if the barrier was expected standard of care and materials availability. Most inpatient units don’t have the capabilities for required monitoring for MAC; ICUs being the exception.
Just because a patient is in the OR doesn’t mean they have to have general sedation. They could find an open room wherever there’s capabilities and do moderate sedation.
Yeah that's been a thing for many years at this point. Wouldn't surprise me if it was a very old April fool's joke that just stuck around.
Interestingly. we have assisted on traumas and c sections in the OR.
I actually had the exact same experience, including the radial arterial line.
WTF? In what world are we getting called to the OR to run a code?
Honestly, I kinda love having an a-line in for arrests. Takes all the guess work out of pulse checks, helps titrate epi dosing, differentiates psuedo-pea from pea, etc. But I tend to think that in many of these cases, people can easily lose situational awareness and become task-focused. Also, occasionally there's an element of subconscious desire to abdicate responsibility due to discomfort.
Check femoral with ultrasound.
I leave my ED to get coffee or a snack but I guess the difference is I can always run back.
Disagree. Inpatients are constantly boarded in the ED. The ED is defined in our hospital policy as a disaster/critical care overflow area. There is no regulatory concern with bringing a patient to the ED. We are the highest level of care.
When I practiced EM, I had to run codes allll over the hospital. Even when solo coverage in the ED.
I can understand that an administration might argue that. It doesn't make it correct. Not even taking into account that they're simply shifting the liability onto the ED doc, it is easy enough to define a hospital protocol which allows for this situation. The fact that they choose not to doesn't mean it's not an option.
There are regulatory issues at play as well as insurance/reimbursement issues. Moving the patient from inpatient to ED is often viewed by most insurers as discharging the patient, and bringing them back into the inpatient side would be viewed as a readmission.
A hospital protocol is not the end all be all in the medical world. Just ask your big brother (government). Like everything else, it’s never an issue until it becomes an issue.
It's not an EMTALA violation to transfer from inpatient of one hospital to ED of another, but the receiving ED has no EMTALA obligations to accept an inpatient from another hospital. However, if the patient is in observation status, then EMTALA applies.
Exactly. I’ve had this argument so many times.
