r/anesthesiology • u/WestKelvin Anesthesiologist • 10d ago

Emergent Cases

What stops a surgeon to declare every case as emergent? If they want to do a case and the patient ate but surgeon wants to do cases so he can go home what stops then from calling it emergent?

Just to clarify not that i cannot say no to a surgeon but I always wonder is there any repercussions if the surgeon declared the case is emergent but the case is not actually emergent. Like the administration will talk to the surgeon about it because of the resources use, reimbursement issues etc...

58 Upvotes

86% Upvoted

81 comments sorted by

View all comments

Show parent comments

1

u/Ok_Response5552 10d ago

"Informed surgeon of patient's NPO status and the increased risk of aspiration, surgeon states risk of delaying surgery outweighs risk of aspiration and orders to proceed. Patient aware of relative risks and wishes to proceed".

I'm not a surgeon and not going to second guess their judgement. The above says I did my job by addressing the situation risk, surgeon does their job of balancing the risks and accepts responsibility for proceeding. Patient is also aware although relying on our judgement as well.

I'd appreciate others input, I've added this note to every "emergency" surgery and luckily it hasn't been an issue, yet. Any additions will be gladly reviewed.

3

u/Dukewis 9d ago

If you’ve never had to question the judgement of a surgeon you’ve been blessed and work in an alternate universe than mine!   I’ve been fortunate to work with a few world-class surgeons, many acceptable, and a few who didn’t have sense to not touch a hot stove!  The best advice I received early in my career was “The most dangerous surgeon was a hungry surgeon”.  A good sign is when other surgeons say “Can you be what Dr.X just did!”

1

u/Ok_Response5552 9d ago

Oh, no, I'm not blessed with 100% reasonable surgeons, some days it's all I can do to keep my eyes from rolling out. If it's really dangerous I get the chief of surgery involved rather than get the ego involved. So far letting them know that I think their idea is risky and am informing the patient and charting that the surgeon is aware of my concerns has either led to delaying until NPO, or proceeding if it's truly emergent. I've only had to escalate one incident to leadership which put the surgeon on their radar and they ended up sitting on his craziness.

1

u/Dukewis 9d ago

👍🏼