add on cases for kidney stones

[soccergal14]

Hello, I work in a smaller facility with one Urologist (city is approx. 65,000in population). In your facility do you do kidney stone cases after hours? We are staffed for one line after 1700 till 2215. Then we are on-call. Our urologist insists that his cases "need" to be done as emergencies and not on his elective list. I can see if both kidneys are blocked, but in 98% of the cases they are not. Just wondering if anybody does them after hours?

Thanks

[Rose_Queen, BSN, MSN, RN]

Much larger facility, but we will run add ons of any specialty until the schedule is cleared. Three teams until 1930, two teams until 2330 with two additional teams on call but reserved for traumas/level A emergencies (must be in the OR within 30 minutes is how we define those). Order goes by triage level- level A emergency, level B urgent (within 8 hours), level C add on (within 24 hours) at time of booking. Cases with the same triage level go in the order they were booked, although surgeons can discuss with each other about switching spots. Some surgeons will look at the list already booked and then add it for the next day instead.

[soccergal14]

So would your anesthetists ever agree to do a kidney stone after 1700?

[Rose_Queen, BSN, MSN, RN]

They have- it's not really a choice. If it's booked, we do it.

The way we are set up is that there is always a CRNA in house because we are a trauma center. So most of then would rather be working anyway.

[brewerpaul]

An obstructed kidneys, one or two, is always an emergency. Leaving it til the next day could lead to damage, especially if the patient has a history of recurrent obstructions. Luckily, as call cases go, they're pretty short.

[Argo]

Yeah. It's an emergency add on. We do them at all hours...