c/s with ONLY local

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    One of our l&d RNs (I work pp) left us to become a director at another hospital. After just a few months she came back. Apparently, while she was at that hospital there were 4 c/s in which they did not get anaesthesia & only gave her a local injection.....4 rns were required to hold these pts down during the procedure. Does this really happen anywhere else????!!!!! Apparently, only one case was emergent. During the other 3 that occurred while she was there, the staff just didn't want to wake the anaesthiologist (sp?). This sounds completely crazy to me! Those poor pts!!!!
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  3. 12 Comments so far...

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    One hospital I worked for did not have anesthesia in house 24/7. They would come in, put in an epideural, then leave. When we had a C/S at 2 AM, you had to argue with one of them to come in for it. They wanted to know dilation, effacement, station, reason for C/S, then why does C/S have to be NOW, is doctor there, blah blah blah, all while we're trying to get an unstable mom and baby ready for the OR. There were four C/S I remember there where we had to do C/S under local anesthesia because anesthesia took an hour to get there and the baby was DYING. MD injected lidocaine, cut the baby out, threw a wet lap over mom's gaping belly, and waited til anesthesia came to close up.

    I have NEVER seen a C/S done without anesthesia unless the baby was in danger of dying, and as soon as the baby was out, the surgeon stopped as long as the bleeding was under control. That anesthesia group got dropped eventually thank God.

    I think ANYONE who is willing to do a C/S with only local anesthesia for the sake of not waking a doctor up should have to suffer the same treatment. Unreal.
    Race Mom and crazylilkelly like this.
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    But this means you would have to have an OB that is OK with it. ????
    Quote from crazylilkelly
    One of our l&d RNs (I work pp) left us to become a director at another hospital. After just a few months she came back. Apparently, while she was at that hospital there were 4 c/s in which they did not get anaesthesia & only gave her a local injection.....4 rns were required to hold these pts down during the procedure. Does this really happen anywhere else????!!!!! Apparently, only one case was emergent. During the other 3 that occurred while she was there, the staff just didn't want to wake the anaesthiologist (sp?). This sounds completely crazy to me! Those poor pts!!!!
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    I also worked in a hospital that did not have anest 24/7. we had a prolapsed cord and the doc had to do a c/s with local until the anest arrived -it was horrible. one of the reasons I left that hospital -the liability of of no in house anesth is not worth my license.
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    We don't have anesthesia at our hospital 24/7 either, but their response time is amazing. They respond PDQ when we need them for emergent C/S's. I have to admit that most stay in house during their call time since we often call them anyway, but they're under no obligation to stay. On the rare occasion they do go home, they're there within 10 minutes when we need them. I have never cared if I had to wake one. That's what they're there for.
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    Did not want to wake the anesthesiologist? That is farking insane! I've personally seen it twice, and both times were what we call "splash and slash" - highly emergent "get this baby out now or mom and/or baby will die in the next three minutes" kind of thing where we didn't have an anesthesiologist in house and it was 2am. Both times were highly traumatic for everyone involved and required extensive debriefing for staff afterwards. For what you describe in the OP, I would call that malpractice.
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    Quote from klone
    Did not want to wake the anesthesiologist? That is farking insane! I've personally seen it twice, and both times were what we call "splash and slash" - highly emergent "get this baby out now or mom and/or baby will die in the next three minutes" kind of thing where we didn't have an anesthesiologist in house and it was 2am. Both times were highly traumatic for everyone involved and required extensive debriefing for staff afterwards. For what you describe in the OP, I would call that malpractice.
    I can only imagine the kind of debriefing these patients needed. WHAT A NIGHTMARE!! Fear of c/s is one of the reasons why I refuse to have another child. I am approaching 35 and have past pre enclampsia issues, so I am too afraid I would be "forced" into a c-section.
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    That's truly disgusting. Those poor moms...I can't even imagine!

    We don't have 24/7 in house anesthesia, but in the 5yrs I've done OB, we've had only one c-section under a local. She did have an epidural, but the baby crumped, and needed to be delivered NOW. Luckily 2 OBs were in house but yeah..scary. My coworkers said the look on the anesthesiologist's face when he walked into the OR and saw the baby already delivered was priceless. He did give Mom some Versed so she didn't really remember anything, thank goodness.
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    Thanks for all of your responses. If it's an emergent case & anaesthesia can't get there in time definitely makes the situation more understandable. But to hear that only 1 of the 4 were emergent is very disheartening. I am very thankful I work at a hospital in which we have anaesthesia & obs in-house 24/7!
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    I work at a hospital that has in-house anesthesia, but one night we couldn't find him when we needed to do a stat section. We paged, called, went to call room, etc. but no luck. Doc had to start using a local and it was terrifying for everyone. The patient was screaming and we had to hold her down. Finally the CRNA arrived and quickly put her to sleep. I hope I never have to see that again.


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