Is it just me...

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DocVapor

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Or does anyone else get a little bit of (sick) pleasure when dads vagal down while placing a labor epidural in wife/baby mama?

This only goes for when the dad doesn't actually hit the floor. I have had enough happen in my short time that I universally talk to dads about it as I am consenting the mom. Thankfully nurses here are pros with handling it, and more than enough show up when the call goes out.

Just had one. Really makes my night.

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everywhere i have worked we always ask dad/family to leave when placing epidural. much easier on everyone
 
It's just you. I frequently tell people that I allow one adult patient per room. So at our place, dad can stay, but he plants himself in a seat where he can't see the Tuohy, and offers his moral support to mom. Can't do that? I'm sorry but I will need you to step out of the room.
 
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If dads are passing out on you then you may be taking too long to place it. Just saying!
 
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Or does anyone else get a little bit of (sick) pleasure when dads vagal down while placing a labor epidural in wife/baby mama?

No, this happened to me a couple times during residency (thankfully only light-headedness) and I made a rule that Dad had to sit down if he wanted to stay. I want to be focused on placing the epidural, not on making sure dad doesn't hit the deck. The L&D nurses told me many stories of family members fainting and hitting the floor causing an injury requiring a visit to the emergency room. While it's (I guess?) funny to joke about in theory, in practice it's a totally avoidable injury and somewhat predictable. Remember do no harm?

The place where my wife is about to deliver doesn't allow any family members in the room, which is fine by me.
 
Our rule was one adult, had to be sitting, in front of the patient. The ones that wanted to come around and watch were the ones I always worried about, because they were the most likely to vagal.
 
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I'm not sure I get actually pleasure but I do know the best part is the look of "WTF, man up! I'm the one with a needle in the back. " on the wife's face.
 
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The only dad-fainting I took some enjoyment from (in retrospect) was a poor guy who was standing in the designated support spot (in front of the patient, charged with the task of giving her something to lean forward upon). She had her arms over his shoulders, head to one side of his, shoulder in front of his neck. She was so anxious and was holding on so tight her shoulder started choking him out. I look up from the epidural and his face is kind of red and bug-eyed, and he's trying desperately to stay still. Then he went a little more still.
 
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All these folks saying that your epidural is taking too long need to STFU. This is why you have the dads sit down for the epidural placement regardless of duration. This case settled for millions...

Man faints, dies after seeing epidural
Wife sues California hospital for wrongful death

Updated: 11:18 a.m. ET July 8, 2005
LOS ANGELES - A California woman is suing a hospital for wrongful death because her husband fainted and suffered a fatal injury after helping delivery room staff give her a pain-killing injection.

Jeanette Passalaqua, 32, filed the suit against Kaiser Foundation Hospitals and Southern California Permanente Medical Group Inc. in San Bernardino County state court last week.

In June 2004, Passalaqua’s husband, Steven Passalaqua, was asked by Kaiser staff to hold and steady his wife while an employee inserted an epidural needle into her back, court papers said.

The sight of the needle caused Steven Passalaqua, 33, to faint and he fell backward, striking his head on an aluminum cap molding at the base of the wall.

Jeanette Passalaqua delivered the couple’s second child, a boy, later that day. Steven Passalaqua, however, suffered a brain hemorrhage as a result of his fall and died two days later, the lawsuit said.

The suit seeks unspecified damages related to Steven Passalaqua’s death and to Jeanette Passalaqua’s emotional distress at being widowed with two young children.

Because Passalaqua was solicited by Kaiser to assist in the epidural, the lawsuit said, the hospital “owed him a duty to exercise reasonable care to prevent foreseeable injuries resulting from his participation.”

A spokesman for Oakland, California-based Kaiser Permanente called the death “a tragic accident.”

“Some of the allegations in the lawsuit are simply that --allegations. The legal process is under way and we should respect that,” said Kaiser spokesman Jim Anderson.
 
All these folks saying that your epidural is taking too long need to STFU. This is why you have the dads sit down for the epidural placement regardless of duration. This case settled for millions...

Man faints, dies after seeing epidural
Wife sues California hospital for wrongful death

Updated: 11:18 a.m. ET July 8, 2005
LOS ANGELES - A California woman is suing a hospital for wrongful death because her husband fainted and suffered a fatal injury after helping delivery room staff give her a pain-killing injection.

Jeanette Passalaqua, 32, filed the suit against Kaiser Foundation Hospitals and Southern California Permanente Medical Group Inc. in San Bernardino County state court last week.

In June 2004, Passalaqua’s husband, Steven Passalaqua, was asked by Kaiser staff to hold and steady his wife while an employee inserted an epidural needle into her back, court papers said.

The sight of the needle caused Steven Passalaqua, 33, to faint and he fell backward, striking his head on an aluminum cap molding at the base of the wall.

Jeanette Passalaqua delivered the couple’s second child, a boy, later that day. Steven Passalaqua, however, suffered a brain hemorrhage as a result of his fall and died two days later, the lawsuit said.

The suit seeks unspecified damages related to Steven Passalaqua’s death and to Jeanette Passalaqua’s emotional distress at being widowed with two young children.

Because Passalaqua was solicited by Kaiser to assist in the epidural, the lawsuit said, the hospital “owed him a duty to exercise reasonable care to prevent foreseeable injuries resulting from his participation.”

A spokesman for Oakland, California-based Kaiser Permanente called the death “a tragic accident.”

“Some of the allegations in the lawsuit are simply that --allegations. The legal process is under way and we should respect that,” said Kaiser spokesman Jim Anderson.

That’s America for you.....
 
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I once had a nursing student pass out and shart herself while I was opening the tray

Play it safe and have them sit down
 
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Sure some dads and students pass out from seeing epidurals but I’ve also seen it plenty of times during other parts of delivery or after seeing the open belly during a c section. Not quite sure I understand why anyone should be liable.
 
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Interesting thoughts. I'm a CA-1 and this has happened a grand total of 4 times to me - only ever light-headedness, never any actual fainting. It is our policy one adult in room, standing in front of mom to help support her. I always have a chair directly behind them for these instances. I'm tall enough that beds go up as high as they possibly go. Nurses are always directly at dad's side. I don't let them come around and tell them not to look over shoulder at what I'm doing.

Could I be faster? Sure. I'm still at a point in my career I'd rather be more careful.

Thanks for the legal case, @Tuohy

Thanks for advice everyone else. I'll bring this info up at our next department meeting.
 
All these folks saying that your epidural is taking too long need to STFU. This is why you have the dads sit down for the epidural placement regardless of duration. This case settled for millions...

Man faints, dies after seeing epidural
Wife sues California hospital for wrongful death

Updated: 11:18 a.m. ET July 8, 2005
LOS ANGELES - A California woman is suing a hospital for wrongful death because her husband fainted and suffered a fatal injury after helping delivery room staff give her a pain-killing injection.

Jeanette Passalaqua, 32, filed the suit against Kaiser Foundation Hospitals and Southern California Permanente Medical Group Inc. in San Bernardino County state court last week.

In June 2004, Passalaqua’s husband, Steven Passalaqua, was asked by Kaiser staff to hold and steady his wife while an employee inserted an epidural needle into her back, court papers said.

The sight of the needle caused Steven Passalaqua, 33, to faint and he fell backward, striking his head on an aluminum cap molding at the base of the wall.

Jeanette Passalaqua delivered the couple’s second child, a boy, later that day. Steven Passalaqua, however, suffered a brain hemorrhage as a result of his fall and died two days later, the lawsuit said.

The suit seeks unspecified damages related to Steven Passalaqua’s death and to Jeanette Passalaqua’s emotional distress at being widowed with two young children.

Because Passalaqua was solicited by Kaiser to assist in the epidural, the lawsuit said, the hospital “owed him a duty to exercise reasonable care to prevent foreseeable injuries resulting from his participation.”

A spokesman for Oakland, California-based Kaiser Permanente called the death “a tragic accident.”

“Some of the allegations in the lawsuit are simply that --allegations. The legal process is under way and we should respect that,” said Kaiser spokesman Jim Anderson.


So we are liable if dad faints while sitting down in front of mom? Should we not be allowing dad in the room at all? Ain't nobody got time for a lawsuit!
 
So we are liable if dad faints while sitting down in front of mom? Should we not be allowing dad in the room at all? Ain't nobody got time for a lawsuit!

what got them in trouble was asking Dad to support mom? if the nurse is supporting and he just faints in the chair it’s a different story
 
Not quite sure I understand why anyone should be liable.
What you think is irrelevant compared to what a lawyer and jury think.

Because of the Kaiser story above, I have everyone in room leave for epidural. No risk is better than any risk, especially for something so mundane as a labor epidural.
 
What you think is irrelevant compared to what a lawyer and jury think.

Because of the Kaiser story above, I have everyone in room leave for epidural. No risk is better than any risk, especially for something so mundane as a labor epidural.

And that's to honest truth right there. The fact that we let anyone stay in the room for a "semi-sterile" procedure is more of a privilege than anything. I'm very similar to most on here, you either sit down or get out.
 
what got them in trouble was asking Dad to support mom?

Yup. That's the reason they had to pony up. They asked dad to stand and help hold/position mom.

I've had one person pass out on me. It was actually the patient's sister, and it happened after the cath was in while the tegaderm was going on. Fortunately, she was seated. Unfortunately, she was seated on a rolling stool. Turns out those don't help much.
 
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Ok so what if the nurse holding the patient passes out, hits her head, dies from brain hemorrhage, what is stopping the family of the nurse from suing the hospital for millions?
 
Ok so what if the nurse holding the patient passes out, hits her head, dies from brain hemorrhage, what is stopping the family of the nurse from suing the hospital for millions?

It's a bit harder to make a case when the RN is voluntarily doing a job she was trained and licensed to do. The hospital is not asking her to do anything "outside her scope of practice."
 
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It's a bit harder to make a case when the RN is voluntarily doing a job she was trained and licensed to do. The hospital is not asking her to do anything "outside her scope of practice."

I can see them arguing against that in court. I highly doubt she was officially trained to hold the patient for an epidural.
 
I can see them arguing against that in court. I highly doubt she was officially trained to hold the patient for an epidural.

How would one go about "officially" training someone to hold the patient, then? If an L&D nurse isn't trained then... who is?
 
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Ok so what if the nurse holding the patient passes out, hits her head, dies from brain hemorrhage, what is stopping the family of the nurse from suing the hospital for millions?

why would the nurse pass out?? esp l&d rns - they have pretty good fortitude
 
How would one go about "officially" training someone to hold the patient, then? If an L&D nurse isn't trained then... who is?

exactly! no one is. therefore i think lawyers will target it if the situation arises. the nurse is voluntarily helping. just like a family member who wants to hold his wife is. only difference is we know the LD nurses so less likely to pass out than a family member who we just met.
 
I would argue it's a know occupational hazard that the nurse is aware of when she signs the employment contract. She can get workers comp no prob, but sueing for millions is gonna be a hard sell.

I can't believe you don't see how this is different from asking Joe Blow off the street to assist during a medical procedure for which he have had no prior training or exposure.
 
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Step 1 Throw everyone out. One can stay IF the mother wants.
Step 2 Sit on the couch or you have to leave.
But, but, but... No. It’s dangerous for you and a distraction for me. You don’t want me distracted when I have a needle next to your wife/girlfriend/whatever’s spinal cord do you?
L&D is the one area where I’m very rigid and it’s my way or call me for the C section.


--
Il Destriero
 
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exactly! no one is. therefore i think lawyers will target it if the situation arises. the nurse is voluntarily helping. just like a family member who wants to hold his wife is. only difference is we know the LD nurses so less likely to pass out than a family member who we just met.

I would argue it's a know occupational hazard that the nurse is aware of when she signs the employment contract. She can get workers comp no prob, but sueing for millions is gonna be a hard sell.

I can't believe you don't see how this is different from asking Joe Blow off the street to assist during a medical procedure for which he have had no prior training or exposure.

Exactly this. The nurses aren't voluntarily helping, it's part of their job.
 
I can see them arguing against that in court. I highly doubt she was officially trained to hold the patient for an epidural.
but that’s no different from her (or you and i) passing out, hitting our head, and dying on the job

thats why credentialing has that questionnaire that asks “ are you physically capable to do this job...bla bla bla or something”

similar to NFL players families suing for CTE its tough when the person signed up for the job, knowing the risks
 
I have had a family member hit the deck from a seated position while placing an arterial line in his wife who was the patient. Had to dive and grab him with my gloves, breaking all the sterility. It was not a difficult placement I had barely even started when he crapped out.
 
I have had a family member hit the deck from a seated position while placing an arterial line in his wife who was the patient. Had to dive and grab him with my gloves, breaking all the sterility. It was not a difficult placement I had barely even started when he crapped out.

aline sterility?
 
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Maybe i should start kicking family members out when i place IVs
I've had both mother and son pass out on me at the same time when I placed an IV in the daughter. I now have all non-medical personnel sit down while I place any needle when family are around or they get out of the room.
 
Ok so what if the nurse holding the patient passes out, hits her head, dies from brain hemorrhage, what is stopping the family of the nurse from suing the hospital for millions?

If a nurse dies on the job from falling and hitting her head, you can be darn sure there will be a lawsuit. There is no question in my mind that there would be a lawsuit and that the hospital would settle. There are not many jobs where you walk into work thinking "I know the risks of my job and one of them dying."
 
If a nurse dies on the job from falling and hitting her head, you can be darn sure there will be a lawsuit. There is no question in my mind that there would be a lawsuit and that the hospital would settle. There are not many jobs where you walk into work thinking "I know the risks of my job and one of them dying."

And that's why you, me, and most other doctors don't find themselves on juries. We're way to rational as opposed to the general public. We all know that "nurse sees needle, collapsed, hit her head, and died" isn't the fault of the hospital. But general public person, who mostly hates hospitals and think they billing them out of house and home (which can be true) will take pleasure in having a hospital for over millions to a grieving family. So you're right, they'll settle because the hospital knows they'll do a whole helluvah lot better in settlement vs a jury of "Americans"

But as I think about this, you're essentially saying that anywhere someone passes out, falls, hits their head, and dies, is game for a lawsuit, which I may not buy so much. A slip and fall is a different situation or asking dad to do something that he's not in the hospital to do is a different situation. The hypothetical nurse would basically be doing her a keel over.
 
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And that's why you, me, and most other doctors don't find themselves on juries. We're way to rational as opposed to the general public. We all know that "nurse sees needle, collapsed, hit her head, and died" isn't the fault of the hospital. But general public person, who mostly hates hospitals and think they billing them out of house and home (which can be true) will take pleasure in having a hospital for over millions to a grieving family. So you're right, they'll settle because the hospital knows they'll do a whole helluvah lot better in settlement vs a jury of "Americans"

But as I think about this, you're essentially saying that anywhere someone passes out, falls, hits their head, and dies, is game for a lawsuit, which I may not buy so much. A slip and fall is a different situation or asking dad to do something that he's not in the hospital to do is a different situation. The hypothetical nurse would basically be doing her a keel over.

That's why there is insurance. If you own a home and someone walks to your door and has syncope on your doorstep and falls and dies, you can be sure there will be a claim against your homeowner's insurance. It's the same in the passing out and dying at the hospital situation. The hospital is insured against these kinds of things.

Obviously if an autopsy revealed the person had a massive MI, that is no fault of the hospital. However, a syncope episode is a lot harder to diagnose (especially at autopsy) and how do we know the fall wasn't a result of an overzealous floor waxer (who always seems to wax the floor right outside the call room on the night that I am on call at 2am).

But yeah, these lawsuits would never make it to trial. Imagine the slam dunk for the lawyer to say "Nurse XYZ, leaves behind 3 beautiful children and a loving husband..." Game over.
 
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