Procedures on Relatives?

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Do NOT treat your family! Besides being discouraged by the ethical guidelines of the AMA and every medical society which has considered it, it is also illegal in some states (you will be putting narcotic in that epidural, won't you?). You are not doing her a favor, exactly the opposite. Let your attending do the procedure.

You cannot overestimate the stress response and the risk for mistakes when doing procedures on a close family member. I have no problems taking care of people I know, but not people close to me or somebody in my family. It's a recipe for disaster. Same reason one should not lend money to or do business with these people.

To answer your question, I would not place my wife's epidural unless the alternative would be a clearly unqualified person (e.g. trainee with minimal epidural experience, attending with rare epidural experience and poor manual skills). If you don't trust the people on call, get one of the chiefs to come in and do it.
 
Last edited by a moderator:
twoliter said:
Do any of you know of any laws barring anesthesiologists performing procedures or providing anesthesia to family members, particularly spouses? Or any ASA or other medical recommendations against it?
More specifically, I'm on my OB rotation these next couple months and my wife is due within the next few weeks. If she delivers when I'm on call, there's a fair chance I will be the only resident in house with epidural experience. Would this be a situation where I would/should have to legally/ethically hand this off to my attending? I'm sure it's a state by state issue regarding the laws, but would any of you place your spouse's epidural? (I feel more than comfortable placing epidurals, or I wouldn't be thinking about it.)
Click to expand...

Call your attending.

What's wrong with you?
 
If you are considering treating your wife for the reasons you describe, that means you are on the hook to treat another persons wife right as your baby is arriving. Talk about material for a divorce. I think even my understanding wife would flay me if I even suggested that. Not to mention that it is a bad idea overall.
 
On a more similar note. I live in a small city the size of mayberry. I am the only anesthesiologist in my geographically isolated town. I see my patients everywhere, work with my patients, on average I see a few patients a day. Back in the states I have NEVER ran into my patients back in the states. Its very different and sometimes very awkward to be out enjoying a cold beverage and running into patients. I am married too and if my wife were pregnant I would be pressured into placing an epidural on my wife. I would do it if I had to but would never want to be put in that situation. Be glad you have others around to help you out.
 
Only if I was the only one nearby to save their fanny. Otherwise:

tumblr_n32wezVes41tw1vhco1_500.gif
 
How can you be the only resident on call on OB during this situation? Does your program not have a contingency for covering for you if your wife who is due in 2 weeks comes in for delivery?

Do they honestly want you to cover OB and be present for your child's birth at the same time?

"I know you are pushing and all, sweetheart, but they just called me for a stat section"

In all seriousness I have always felt it is best to be the supportive family members and let others do procedural interventions.
 
I really can't believe you are considering this, either. Ironically enough, I had to resuscitate my wife as she lost half her blood volume following her vag delivery.
 
Private hospital. Wife had normal labor. I caught the baby with veteran OB at my side. Baby was having some minor respiratory troubles so that had my attention for a while. Ended up fine just a little " delayed transition". Noticed a lot of bleeding.
OB - "more sponges"
SCRUB - "here"
OB - "more sponges"
SCRUB "ok, you have already used 60"
OB - "methergine" commences manual d and c
WIFE - "I don't feel so good. I'm nauseous"
ME - recheck BP. Turn off epidural. Start bolusing LR.
new pressure in the 60s systolic
OB - "where is the methergine?? Get hemabate now"

I get a liter in her very quickly. Give her a squirt of phenylephrine. A new syringe of it was at her bedside. Get her back closer to flat. Hemabate arrives. Bleeding stops. Room looks like a murder scene. HgB drops from 12 to less than 6. She feels like **** for days after. New baby, running on half your blood volume isn't fun. Got 3u prbcs after delivery. I was a CA1. Just finished two months of OB.

the anesthesiologist was in a section so you gotta do what you gotta do.
 
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