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Let's say you work in a group and everybody has gone home but the on call person. An inhouse lap cholecystectomy case gets posted for 7:30am the next day and the on call attendings pre ops it. Pt has some moderate ill defined cardiac disease(angina, poor ef, moderate AS, moderate MR- whatever you want) and refers he has a cardiologist which has done a whole gamut of tests. Your cautious partner talks to the surgeon and both agree to delay the case until these tests can be faxed from the cardiologist's office, 1 or 2 hours...
You arrive the next day. The attending who saw the pt is home post call. You get assigned to that room by the anesthesiologist in charge and get explained what the plan is. "A'right" you say. You talk to the patient and he looks "iffy". Your OR has been on hold until the much awaited fax with the tests arrives at 10am. There isn't any tests. Never have been done. Just an ekg.
Surgeon wants to operate. The anesthesiologist in charge is coercing you to get the case done.
What now? You have been waiting for Godot. Do you go go ahead and tell the pt, the family, and the surgeon you never really needed the tests, you wanted to delay his operation just to get warm fuzzy feelings from looking at them?
Do you insist these tests be done now since your partner put you on the spot?
Should the decision to wait to look at test ever been made?
What if he gets an MI, or worse kicks the bucket? What's your defense for proceeding if something bad happens?
I had something like this happen to me.
You arrive the next day. The attending who saw the pt is home post call. You get assigned to that room by the anesthesiologist in charge and get explained what the plan is. "A'right" you say. You talk to the patient and he looks "iffy". Your OR has been on hold until the much awaited fax with the tests arrives at 10am. There isn't any tests. Never have been done. Just an ekg.
Surgeon wants to operate. The anesthesiologist in charge is coercing you to get the case done.
What now? You have been waiting for Godot. Do you go go ahead and tell the pt, the family, and the surgeon you never really needed the tests, you wanted to delay his operation just to get warm fuzzy feelings from looking at them?
Do you insist these tests be done now since your partner put you on the spot?
Should the decision to wait to look at test ever been made?
What if he gets an MI, or worse kicks the bucket? What's your defense for proceeding if something bad happens?
I had something like this happen to me.
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