How does hospital call work?

[rotarman]

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Suppose I were to fall and cram a pencil in my eye at noon on a weekday; who would perform emergency surgery? My hospital doesn't have an ophthalmologist on staff. Would someone leave their scheduled clinic or surgeries and come to the hospital?

 

[DrZeke]

If there is no ophthalmologist on call, then most likely that patient would be assessed by the ER who would determine that patient needs evaluation by ophthalmology. At that time they start calling nearby hospitals that have ophthalmology on call and they usually do an ER to ER transfer. Technically they should not discharge a trauma from their ER to the office of an ophthalmologist. However, some ER's do this...though I believe it's not supposed to go down like that..

 

[eye love lamp]

Suppose I were to fall and cram a pencil in my eye at noon on a weekday; who would perform emergency surgery? My hospital doesn't have an ophthalmologist on staff. Would someone leave their scheduled clinic or surgeries and come to the hospital?

Also not many surgeries (including your pencil crammed into the eye) actually require STAT surgery. You could be placed on IV antibiotics and your globe can be closed within 24 hours.

 

[MstaKing10]

If you have an open globe in the ER and there is no ophthalmologist on call, and equally importantly, no OR equipment to fix said globe (i.e. Scope, ophthalmology instruments etc) then the patient is transferred directly to an accepting hospital with the appropriate staff and equipment to manage the patient. This applies to other complex emergency cases where a hospital (usually small community hospital) is not prepared to deal with.

This can of course lead to turfing issues where the ER calls something an open globe when in fact it's just a subconj hemorrhage.

 

[DrZeke]

This can of course lead to turfing issues where the ER calls something an open globe when in fact it's just a subconj hemorrhage.

classic 🙂

 

[hurdlepup]

This can of course lead to turfing issues where the ER calls something an open globe when in fact it's just a subconj hemorrhage.

Life Flight!![emoji79]


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[Pinkertinkle]

You'll be transferred to a ER with an ophthalmologist on call who will do your case in the evening after his clinic or surgery is over. Or if there's a university near by you'll get sent there and the residents and fellows will deal with you.

 

[orbitsurgMD]

Suppose I were to fall and cram a pencil in my eye at noon on a weekday; who would perform emergency surgery? My hospital doesn't have an ophthalmologist on staff. Would someone leave their scheduled clinic or surgeries and come to the hospital?

If there are no ophthalmologists on staff and the ED attending thinks a patient needs to see one emergently, they would be transferred to a hospital ED where that specialist was available. Usually the ED chooses, not the patient, and it is based on availability. If a patient insists on going to a particular center, the ED may go along but document that the patient refused transfer to a center they felt was more appropriate.

If you are sent to an academic center, your first ophthalmology contact will likely be a resident.

 

[rotarman]

Thanks all for the explanations. I thought it would be weird to be on call while you were simultaneously in your office doing clinic/surgery. There are a few ophthalmologists in my town, but none on staff so perhaps they sometimes send patients to them in the evening as someone mentioned. There's also an academic center about an hour away, so I guess they could ship me there too.