Sta C/S

JaneyW · Jun 21, 2006

In my last hospital we had this situation. We had a state box with disposable scalpels and lidocaine/syringes for local. We also had a half-day inservice class where we went over exactly what to do and where everything was. We did learn how to open the OR instruments and begin without a count. This was only for emergency STAT and not emergent.

Marie_LPN, RN, LPN, RN · Jun 21, 2006

We have pre-made C-section carts. They stay parked outside of the L and D ORs. When a cart gets used (emergent or not) a new cart is called for. This way L and D or OR is never w/o a cart.

If a count is not possible, Xrays are taken before the pt. is movedvoff of the table at the end of the case.

htrn · Jun 21, 2006

We have an OR in L&D that is always set up for C-sections. Usually we call surgery and they come up and open packs etc.... If we have time, but are in a real hurry, the MD will open packs while we get the patient to the back. If we don't have time, we have a special cart with the 'emergency' c-section tray - scalpal, retractors, etc.., bare essentials - plus the lidocaine and syringes to go in fast if we have to.

Only had to use the emergency tray one time, pt already had an epidural and CRNA was in house to dose it. The OB and I got the baby out and by that time one of her partners made it in from home to finish. We were just about done with the surgery by the time the crew got here.

We have been pushing to get training on scrubbing in for c-sections, especially us night nurses as we don't have surgery in house 24/7. But for now, this is what we do - and when we're done, we all go change our pants. :eek:

RaeT,RN · Jun 21, 2006

We always have kits in the OR ready to open up for emergent cases. As part of our orientation in L&D we have a week of scrubbing . . . not that that means we are completely comfortable doing it if we ever have to. We always have a scrub tech in house, and we feel comfortable at least opening up if we had to.

I wish that we did have a tray or kit of some kind close to the nurse's station if we needed it. . . we had a mom code about a month back and nurses were running back and forth from the labor room to the supply room (which is in a central location, but still. . .) to get the MD and the scrub tech what they needed beyond just the C/S tray with the instruments. Thankfully that did not happen on my shift, or on night shift for that matter, but the story scared me all the same - the whole idea of being caught unprepared.

babyktchr, BSN, RN · Jun 21, 2006

We are totally at the mercy of waiting for an OR team to come in for any stat c/s (any c/s for that matter) It gets very nerve wracking waiting while you watch a strip or a bleed or whatever emergency is going on at the time. It is one part of my job I do not like at all.

imenid37 · Jun 22, 2006

We are totally at the mercy of waiting for an OR team to come in for any stat c/s (any c/s for that matter) It gets very nerve wracking waiting while you watch a strip or a bleed or whatever emergency is going on at the time. It is one part of my job I do not like at all.

This is why I want to get something together for us which is doable. Many of the people I work with may be overwhelmed by the multitude of instruments in the regular C/S set up, esp. when they would be in an overwhelming situation anyway and probably getting ready for a bad baby or premie before peds arrives.

babyktchr, BSN, RN · Jun 22, 2006

We thought of that at one time, but honestly we don't have the staff to go up to the OR (we don't even have an OR on our unit) and set something up, especially during an emergency. It seems we cannot get the OR teams to understand the gravity of the situation when we do call a stat section. I remember once, we called a stat section for 30 week twins (one baby with terminal bradycardia and dying before our eyes). After about 10 minutes the phone rang and a nurse from the OR was calling from home asking if it was really a stat section. As the dying baby was pulled from the uterus, I asked her if she thought this was stat enough.

Our new unit will have an OR or two, and that will make it better for us, and for a set up like you are talking about. Why don't you get together with your physicians and an OR representative and create a stat section set up just for emeregencies. The surgeon can certainly tell you what is definitely needed.

mhall76 · Jun 25, 2006

We keep our standards to 30 min "decision to incision" for most stat sections we always have an ORT present and our own OR. We never use the main OR. Our holdup may be no OB in house or anesthesia. We have a stat pak ready to be opened and used . If no count we get x ray before the pt is extubated or final incision closes

imenid37 · Jun 27, 2006

The OR for C/S is on our unit. We do not have OB, PEDS, or Anesthesia in house 24/7. I am leaning towards a stat pack.