Death in the OR vs. ICU

Lasoniamacaroni · Mar 25, 2011

I would love to hear the answer on this....cause it is quite apparent that death in the o.r. is not cool. Whenever someone is going "bad" they want to ship them asap to icu.

morte, LPN, LVN · Mar 25, 2011

Simply so the death doesnt appear on THEIR census....

Editorial Team / Admin · Mar 25, 2011

There are several reasons for this. For one, it's mostly the surgeons who are pushing to get the patient out of the OR- it does affect some sort of stat/rating they have. It's also to try to enable the family to be with the patient for one last time. Our policy states that if we believe the patient will expire within two hours, they are to bypass PACU and go directly to the unit with family at bedside. We also have another unique situation where I work- the coroner does not allow us to move a patient once they have died until they determine whether or not it is a coroner's case. In a trauma, that means we have lost use of our dedicated trauma room, which is set up to do every type of trauma surgery- mediansternotomy, thoracotomy, ex lap, crani, ortho, vascular, whatever else. So having a patient expire in that room means we have to scramble to try to get all those supplies (rapid infuser, cell saver, CPB machine, etc) set up in another room- and most of them are not conducive to being set up for trauma.

canesdukegirl, BSN, RN · Mar 26, 2011

I was in a situation once where a pt had come in with a ruptured AAA. We kept him alive long enough to tx him to the SICU so that his family could be with him.

That is the only experience I have had regarding your question. Hope it helps to clarify somewhat.

Argo · Mar 26, 2011

All three of my times with death in OR/SICU was the same as canes, ruptured AAA , major closed head injury, ruptured uterus during delivery.

AAA dude had dead bowel also, double edge sword with the end being death for the guy anyhow... sent to the unit to be with family for his last few hours.

closed head injury was a lady that fell head first off a ladder putting up christmas lights with her kids.... she was brain dead and there was nothing more to do so they closed her up and sent her on the way with a vent until they wanted to pull the plug.

ruptured uterus, she was brain dead because of the time between the rupture and bleeding to the time it was fixed. They coded her for 45 minutes. She gave birth to twins that survived and were sitting with the father as we rolled passed into the OR. pretty sad, sent her to SICU on vent also....

*nydctx*RN11 · Apr 12, 2011

I was always told it becomes a Medical Examiner Case in the OR... so as to avoid it even if it meant heading to PACU.

Mr. & Mrs. RN · Apr 16, 2011

ruptured uterus, she was brain dead because of the time between the rupture and bleeding to the time it was fixed. They coded her for 45 minutes. She gave birth to twins that survived and were sitting with the father as we rolled passed into the OR. pretty sad, sent her to SICU on vent also....

Argo, this is so sad!!!

fusionfire32 · Apr 18, 2011

I was in a situation once where a pt had come in with a ruptured AAA. We kept him alive long enough to tx him to the SICU so that his family could be with him.
That is the only experience I have had regarding your question. Hope it helps to clarify somewhat.

similar situation however, patient died on the table very sad for the family and very traumatic for me

BridgetJones · Apr 21, 2011

I've had one patient code and die in the OR (s/p AAA repair, general surgeon wanted to do a "decompressive laparotomy"). I had only been off orientation a short time and the nurse in charge was not an experienced charge nurse. The next day she told me that I should have sent the body back up to ICU so we didn't have to deal with the paperwork and calling Gift of Life! (Even though the family didn't want to see him-they had already said goodbye.) Good grief! :rolleyes: