Emergency C-Section

At my facility, we use the term STAT sections for sections that need to be done now - intubate mom, no count, get the baby out ASAP. Urgent for sections that need to be done, but the docs will allow for a little wiggle room - some late decels, but you can bolus an epidural and have time to count. Code OB for sections that we have a code on mom or loss of heart tones on baby. Similar to a STAT section, but many more people usually show up. Unfortunately, we have some docs that abuse the term STAT. Wanting to make it home for dinner rather than wait for a case in the OR to finish does not make a section STAT, IMHO.

Thank goodness I don't have to do these any more but when we did we used STAT section, kind of obvious, failure to progress, urgent but not immediate, CPD, never really an emergency but nice for the mom and the scariest one, fetal distress! Most OBs will most likely make it seem it is an emergency but mostly it is for their convenice. This really ticks off the general surgeons, so that is why the OR doesn't have anything to do with them anymore. HOORAY!

I work in a LDRP/Women's OR setting. I am strictly in the OR. But in our hospital, an emergent C/S (as someone else said, Mom is put to sleep, no count, etc) is called a crash. An emergency, by our hospital policy, must be done in 30 minutes. But a crash is a horse of a different color.

wanted to ask what your hospital uses to determine the urgency level of a c-section when on call. do they use the term crash, stat, urgent, or what ? please let me know what the universal term is being used for your or and what they each mean.

thanks

i just finished a 2 year stint working in the ldr/hrmc of a major midwest metro hospital. three ors, two for c-sections, one for minor cases like btl, cervical cerclages and d&cs post loss. basically, it worked this way for us.

stat is when the patient (in her bed) is being pushed down the hall by her nurse, the del tech, the anesthesiologist, and whoever else is available to manhandle that huge bed right behind you as you run in the room to open the case and the baby is out in three minutes because the cord is dangling or other drastic situation occurs. most often happens with a non-english speaking multip who just rolled in the door off the street, npc, and is hollaring her head off and you don't speak a word of spanish. :uhoh21:

urgent is when you get a head start and get the case open before she hits the door.

emergent is when you have the chance to actually get half the case set up before the patient rolls in the room.

and then there's scheduled, when you get the room set up, every possible thing ready, and you have time to sit and drink a pop and eat a few crackers while you wait on everyone else to gather themselves together and get into the room to start the case. :icon_roll

In the hospital I just left(resigned from) we had scheduled Sections in the Main OR(LandD have 3 of their own). We have seen them called "emergency C-sections). So the patient came from home, is pre=opped, gets a regional block, then the OB doc decides to show up within an hour or 2 of the emergency, then it is done in a slow and timely fashion. The emergency is the doctors convinience and they get more $$$ for the surgery. Bonus if a BRL is done.

Made me sick to see all these unecessary Primary and repeats when not indicated, and to top it off, scheduled then documented as emergent!

The only distress was the OR nurses who never have time to even get their paperwork started due to the "get this do that" and the "hurry up" turnover the room stuff.

Glad I don't work there anymore. They sucked.