Kick the father out?

[Gas]

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I love these forums. As a new attending, I find these forums invaluable for information about how others practice and for advice.

So what do you guys do with the father when doing a labor epidural? Kick them out, keep them in the room, give them the option, or just ignore them? Where I trained, it was hospital policy for all fathers/family members to leave. At my present gig, the anesthesiologist gets the final word. So far, I've only let a couple stay, and I demand that they stay in the front with the woman so they don't see what I am doing.

I heard of a case in California where a father passed out, had a cerebral hemorrhage and had to get a decompressive craniotomy which he ultimately did not survive. Might be urban legend, but sounds possible. Can the anesthesiologist be held liable for that?

 

[militarymd]

it was real case....

I let them watch....it's the only time when doing anesthesia is a "show"...where it is important for you to look "good" doing it.......

Lawsuits come when they "think" you've done a bad job....usually not when you actually do a bad job.

I make them sit though.

 

[zippy2u]

For the "new age" crowd, One family member stays with mother but sits next to her in a rocking chair holding her hand and gently "cooing" words of encouragement. For gangsta crowd, G6P5 mommy gets booted out of car with "positive taillight sign" at ER door so ya don't have to worry about family members. Regards, ---Zippy

 

[coprolalia]

For the "new age" crowd, One family member stays with mother but sits next to her in a rocking chair holding her hand and gently "cooing" words of encouragement. For gangsta crowd, G6P5 mommy gets booted out of car with "positive taillight sign" at ER door so ya don't have to worry about family members. Regards, ---Zippy

You forgot to mention that she is 23-years-old.

-copro

 

[coprolalia]

You forgot to mention that she is 23-years-old.

... and weighs 300-lbs.

-copro

 

[cchoukal]

sounds like my hospital... a 250 lb minimum seems to be in the admission criteria. We usually let one family member stay and help position mom.

 

[Arch Guillotti]

I let one person stay and I make them come around to the front of the patient so that they can't see what I'm doing.

 

[VentdependenT]

Baby daddy or grandma (usually one or the other is present. Most often the latter) sit down with hands on patients knees.

I don't want em to even see the epidural needle because their eyes bug out and it scares the hell out of the patient.

I just don't have it in me to code the dad for a head bleed while mom is in labor on the edge of the bed.

 

[Salt Creep]

This isn't the same thing but similar - my wife had to have a stat section a couple years ago. I was a med student and had worked as an EMT - I can stay out of the way. When they took her back, I went and put on scrubs, but then couldn't go in. That really pi$$ed me off, and still kinda does.

I think mil's point is an excellent one.

And to better answer your question, at the hospital associated with my med school, the dads sit in front of the mom.

 

[CanGas]

One family member in room, all the rest to leave. Generally Dad or Grandma. They SIT in front of the patient to help keep them in nice position.

We've had a c-spine injury from a standing dad go down backwards into the wall.

 

[usnavdoc]

This isn't the same thing but similar - my wife had to have a stat section a couple years ago. I was a med student and had worked as an EMT - I can stay out of the way. When they took her back, I went and put on scrubs, but then couldn't go in. That really pi$$ed me off, and still kinda does.

I think mil's point is an excellent one.

And to better answer your question, at the hospital associated with my med school, the dads sit in front of the mom.

We dont let anyone in during stat C/S. Thats generally a life and death situation for the baby or both mom and the baby. Having a father in there that turns hysterical is not helpful. Thats just a general policy that protects all involved.

I generally tell the family, friends, baby daddy, etc...to leave and the RN will call them when they can come back.

 

[rsgillmd]

I love these forums. As a new attending, I find these forums invaluable for information about how others practice and for advice.

So what do you guys do with the father when doing a labor epidural? Kick them out, keep them in the room, give them the option, or just ignore them? Where I trained, it was hospital policy for all fathers/family members to leave. At my present gig, the anesthesiologist gets the final word. So far, I've only let a couple stay, and I demand that they stay in the front with the woman so they don't see what I am doing.

I heard of a case in California where a father passed out, had a cerebral hemorrhage and had to get a decompressive craniotomy which he ultimately did not survive. Might be urban legend, but sounds possible. Can the anesthesiologist be held liable for that?

Our "hospital policy" (admittedly I haven't seen it) is that family members leave the room. Although, when I was at Coney Island in August of my CA-2 year, I let the husband stay b/c he was a MS3, but I made him hold his wife.

 

[rsgillmd]

This isn't the same thing but similar - my wife had to have a stat section a couple years ago. I was a med student and had worked as an EMT - I can stay out of the way. When they took her back, I went and put on scrubs, but then couldn't go in. That really pi$$ed me off, and still kinda does.....

At Maimonides we let a family member sit with the patient on C/S under neuraxial anesthesia (after block has been tested), but if it's GA, no family members allowed.

 

[coprolalia]

I let one person stay and I make them come around to the front of the patient so that they can't see what I'm doing.

Yeah, and they probably aren't going to be wearing a mask either. A nice "cough" on your sterile field and you better prophylactically orally swab them to speciate their natural oral flora lest someone try to blame you for that epidural abscess...

-copro

 

[aged]

One gets to stay and be supportive the rest out.

 

[mmag]

One person gets to stay and stand on mom's front side to coach.

I witnessed a case where a babydaddy opened the room door during the middle of the epidural, saw the reflection of what the resident was doing on big pane window (it was at night, and the woman faced the door), and passed out right in the doorway. He had to go to the ER and missed the birth while waiting to be seen.

 

[New2Midwest]

True story about the father having an ICH after watching an epidural and ultimately dying-was at a Kaiser hospital in Cali...

 

[oudoc08]

I had been a full-time paramedic for 5 years in 2002 when my youngest was born. I'd done all the rotations, ran traumas, codes, etc., watched surgeries, epidurals, central lines, you name it, I'd prob. seen it or done it at one time or another.

The gas doc starts doing my wife's epidural at bedside, and I start sweatin', get a little cool, the vision starts getting dark. I excuse myself to "pee", feel like a complete dip****, walk out of the bathroom, and everyone's giving me that "You okay? Need some crackers?" look.

Completely embarassed.

Just a good example though that it doesn't matter who or what level you are, sometimess it's different when you're on the "patient" side.

Might be a good reminder to not assume that just because the daddy's an attending, resident, medical student, etc., that it's no biggie if they hover by your sterile field.

I'm planning on doing what I've seen work the best. That is, having them sit on a stool face-to-face with mom to help her focus, remember to stay bent over properly, and not have them pass out and embarass themselves.