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Discussion

same surgeon, second room

where does the surgeons first patient have to be ie closing, on the stretcher, extubated, in pacu, before we bring the next case into a different room - trying to save time without putting either patient at risk. we have started flipping cases to open rooms and want to lay out some guidelines before we have a problem

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We do this for a physician and its when her PA is closing.

  • Admin

If surgeon has PA- about 10 minutes before he/she breaks scrub (mostly neuro, so lots of time with anesthesia induction, lines, positioning, getting x-ray in the room, etc). If no PA, usually when they start closing subq. They all must give us the go ahead, it's not a decision we make on our own.

Is There a second Anesthesia provider? We do it regularly with no issues When the surgeon says he is ready for us to go. We have two separate Anesthesia providers typically though.

We have surgeons who regularly run two rooms at the same time-both patients are in rooms next door to each other and each have their own anesthesiologist and separate circulators. The surgeon and PA leave one case for the next as soon as they can leave a RNFA to finish.

What is the AORN & JAHCO's position on multiple rooms? Our management has allowed a surgeon to have 3 rooms, cause he's fast and had a lot of cases. I requested a different assignment, I didn't want my lisence to be at risk.

No issue as long as he is finished with the first one before starting the next one.

Two things come to my mind.

First is paperwork, we must have consents, h&p, and site marked before going to the room. Sometimes that can be difficult, but doable.

Next, it really depends on the type surgery, Anything with a possible bringback, (immediate bringback) you really need to make sure everything is ok, thyroids, carotids, hearts, etc. before the next one is asleep, Sometimes we will have a pt in the room with things that can be done while the pt is awake, art line, get a bair hugger on them to keep them toasty until starting. Just being in the room all hooked up, not having to wait for anesthesia (our anesthesia walks with us & pt to room) can save some time. Good luck.

We usually go back about 2-3 minutes before he is finished which gives him 5-6 minutes to talk to family, see next pt an sign everything. We start the say with the first two patients in our holding room.

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