Recently, one of our plastic surgeons is repairing complex wounds in small
children in the ED rather than take them to the operating room. Several of
these cases have lasted 4 hours (one case was 6 hours). He has been
resistant to having these patients sedated for their procedure. I don't take
patients to the OR so I don't know everything that goes into the decision
making process. My gut tells me that a case that takes longer than 90
minutes or so needs to be done elsewhere (OR). Besides the care issues,
tying up my PCA/nurse for hours (or ED MD if he would let us sedate these
patients) is detrimental to our patient flow.
I am trying to get a feel for what is done in other peds EDs.
Do you have a limit on the length of the case that can be done in the ED?
How do you handle these type of cases in your institution?
Thomas Krzmarzick M.D.
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