Backup/Trauma Teams working scheduled cases

[Loxam10]

I work in a pediatric OR and we have recently upgraded to a level 2 trauma center (we are also the only pediatric hospital within a 60 mile radius). So we know have 24/7 in house staffing as well as a backup team on call for traumas. Our department has gotten into the habit of allowing surgeons to add on non-urgent/emergent cases on the weekends which ties up our in house team. If several cases are added on then they will call in the backup/trauma team to run a second room. But what happens if a true trauma comes in?? The response I get from management and anesthesia is - you would have to quickly wrap things up in one of the ORs, well that's only happened once in the last 10 years, or the ED should be able to stabilize them enough for us to finish the case currently in the OR. This is crazy to me! This is the only facility that I have worked at, is this normal??

I want to look at them and say what if it's your child in the OR, would you want us to "quickly wrap things up" and possibily make a mistake or even worse what if it was your child that came in as the trauma and needed emergent surgery. I don't understand how people are willing to just roll the dice and hope it doesn't happen.

How does other facilities handle situations like this?

[Guest374845]

I work in a level 1 and there are trauma team response standards that have to be met depending on the activation level. So if your facility has a bunch of high(er) level activations in which the team is late (or the attending isn't present, etc), come ACS review time, your certification can be in jeopardy.

[Rose_Queen, BSN, MSN, RN]

We simply can't open additional ORs for non-urgent/emergent cases. Per our staffing and anesthesia policies, there are 2 rooms on weekends for scheduled cases. Those scheduled cases will be bumped should an emergency or trauma come along. If both rooms are running, there is 1 free circulator, 1 free scrub, and the circulating anesthesiologist who will start the case while the call team is en route. But we always have capability to run a trauma or emergency, except in cases of things like mass casualty events, where we run out of surgeons at the same time as we run out of staff (scheduled and call). That is when we go on trauma divert. Just had to do that on Monday with a mass transit bus accident.