Old argument, needs new life

brownbook · Jul 7, 2011

Are you talking about scheduled c/sections? Or emergency c/sections?

My limited exposure to having OB do emergency c/sections was a hand full of OB nurses would get trained then invariably on emergency c/section day (or night) none of them would be working. Or they would leave for another job and a whole new group would need training. Or they would be too busy, they all had patients in labor and could not be pulled away to go to OR.

But hopefully somewhere, somehow, there is a way to make it work. I think it is a good idea.

staceyp413 · Jul 7, 2011

Thanks for the reply. Just talking any csections that are done on the maternity unit where the c-sections are. Right now the OR staff covers the csection room (1-2 techs and 1 rn) as well as anesthesia. Our main efforts would be for the nurse and techs at this time.

4_Sq · Jul 7, 2011

I work in a small OR, and I wish that L&D did do the C Sections. I can argue for & against depending on the situation however. In our small OR, we occasionally are in the midst of another surgery when we get called about an urgent C Section. This puts a lot of pressure on as there is not a 2nd surgical team on call, and we have to scramble & hope that a team will be found. ( A good reason for L&D) to do our C Sections.

Reason not to do C Sections in L&D, an example might be in a case where the C Section patient has an unconfirmed placenta accreta where the situation is life threatening.. I would question that a small L&D would be able to carry on & do a hysterectomy etc. to save the patient in this type of situation.. So.. I guess I am saying there are many things to consider.

Is the Case Room adequately staffed & are the staff adequately trained.. this is my only concern.

Editorial Team / Admin · Jul 8, 2011

Unique situation here as our L&D unit is a separate hospital that also does gyn surgery. 5 ORs, 3 are dedicated to CS with one being left open for emergencies. Not sure whether L&D is the OR team or is just there for baby. I know that with high risk (difficult airway hx, needs ICU afterwards, lots of medical issues) is done at the main hospital. L&D sends a nurse for the baby, but the main OR staff is in the room, and the L&D nurse will go with the baby by ambulance to the other hospital. Personally, I'd like it if L&D also came and staffed the room as it's a completely different world that we see maybe once every couple of years and they deal with on a daily basis.

SandraCVRN · Jul 8, 2011

All our c-sections are done in L&D. NO babies in the OR (thank you very much)

cdsga · Jul 23, 2011

We are a high risk perinatal hospital and the general OR does the accreta percreta cases. These involve lots of team members. We do a C-section first followed by a hysterectomy and other organ repairs at the time. It is a cluster. Lots of bleeding and lots of people in the OR suite. L&D does most of the c-sections and if they find they get into a complication the OR may provide assistance as needed. L&D operating rooms look similar but the training is not the same and you have to remember that those operations are considered clean cases not sterile, even though sterile technique is utilized. You find a lot of difference in maintenance of sterile technique when mixing the two. With the amount of c-sections at our facility we have to have a separate unit for this because that would be tying up too many OR's where elective or even emergent cases would not be able to be performed in a timely manner.