I wonder how they bill for it too?
How is it malpractice? What makes it malpractice?
I can’t believe they are actually available. I thought there was also a shortage of ICU docs.
If its not malpractice it's definitely pushing the boundaries...
Every place is so different. That is why we can’t argue it’s malpractice because some places let non anesthesia staff use propofol . And if they are ICU docs as well (most are) for sure have privileges to push the stuff.
They're a physician. It's not malpractice. No evidence to show. We don't own the rights to propofol as anesthesiologists.
Correct. But, If you are using it in a non-intubated patient you damn well better be trained in airway management and be equipped, ready, and attentive to manage the patient's airway and for hypotension/resuscitation, etc.
From a billing standpoint-I don't know.
They are board certified physicians in critical care. I'd say they are plenty trained in that.
If that’s accurate and not just some old pulm doc who is credentialed for vent management calling themselves an ICU doc, They should be good to go.
If they deviate from the SOC in regards to sedation (our standards most likely in a court of law as plaintiffs attorney will use an anesthesiologist expert) AND they harm a patient, then it would indeed be malpractice.
Maybe they can’t move as fast as we can but they know how to intubate. Maybe brutally but they do. And if they are smart they get the suxx already drawn up or at least on top of cart w syringe ready to go as well. And can direct the nurses to draw up the drugs.
NPO guidelines are easy to Google and ICU docs should also know this basic info as well.
I remember this. And I agree with you. At least they are trained in airway management and somewhat in induction drugs.While I wouldn't want a Pulm-CC doc doing anybody I care about's endoscopy, there's theoretically nothing illegal about it. Lots more scope creep to worry about than the ICU guy pushing propofol.
A Florida ob/gyn played anesthesiologist for fatal Brazilian butt lift, state says
The only disciplinary action on the ob/gyn’s license is from 2019, but it also involves the death of a patient.www.tampabay.com
Yeah, I’m not a fan of the idea of it but agree that there are far worse things going on. There was a place somewhere that a pulmonologist was remotely “supervising” CRNAs at a hospital from over a hundred miles away.While I wouldn't want a Pulm-CC doc doing anybody I care about's endoscopy, there's theoretically nothing illegal about it. Lots more scope creep to worry about than the ICU guy pushing propofol.
A Florida ob/gyn played anesthesiologist for fatal Brazilian butt lift, state says
The only disciplinary action on the ob/gyn’s license is from 2019, but it also involves the death of a patient.
Anesthesia people without cc training were running icus during covid. There is apparently a shortage and now ccm is doing sedation. Whatever the billing isn't worth it to you guys and I wouldn't do it but if someone out there does something stupid/crazy who am I to care. People do wild **** all the time--there is literally a guy putting in PPMs where I work with a ****ing weekend training course on septic patients.
Yes. What’s the standard of care for a pulmonologist? I’m pretty sure it’s not that, and I don’t think it would be hard to find accomplished experts to agree.
Not sure, it always seems like the standards of care are looser for non-anesthesiologist in regards to sedation. For example, emergency docs giving sedation on full stomachs. But I would think that if something went to trial, they would argue that this is a situation where anesthesia is typically performing the sedation, and we are the experts, and therefore our standards would apply.
No different than the GI folks who can do “most patients” with rn administered sedation usually Demerol/versed or the opthos than can do “most cataract patients” with a similar cocktail. Trying to save on resources where ever they can. Just like our supervision ratios have gone up and our excess staffing capacity has gone down.
And at one place they ask for us even for an external cardioversion. It's mind-boggling. I don't know why the anesthesia chief allows this absolute nonsense and waste of resources.
Children? Are these pediatric pulmonologists? Wait.....is there such a thing?
This is hilarious. Can't fault a guy for knowing his limits and not setting himself up for failure with too much sedation.!!! The cardiologist could have used more local anesthestic. I wonder if patient was intubated though🤣🤣. Hopefully not.
lol wat we do them all the time
Yeah us too. Easy money
Where I trained, PICU doc did majority of peds sedation. We did peds Endo, and a bunch of LPs with intrathecal methotrexate under MAC. Most other stuff went to him. He also did a lot of sedation for peds MRIs. We obviously did all the GAs. He was never pushing propofol.
And you don’t think this is a complete waste of time? Especially when everyone is crying about the anesthesia shortage?
It’s not about the money when everyone wants a piece of anesthesia. We are spread too thin and these are 2 versed type of cases.
Never seen it except at this hospital. Waste of resources to me.
Wut? Single slug of propofol. 70-100mg -> apnea -> shock -> breathe -> done.
Except you still need the staff!!! How is this difficult to comprehend? And personally for me, short cases on the computer are painful.
We just add them in between pacemakers. We use the existing staff. It’s a 10-15 commitment.
