Obstetrical anesthesia--Does anyone know best practices for response time of anesthesiologist to order for epidural? We are doing a quality improvement plan because of the lengthy period we wait for ...
I have a hunch that you are a Labor and Delivery RN. I am a Labor and Delivery RN and have worked in New York, California and presently Washington State.
We have CRNA's and one Anesthesiologist in our hospital. They are expected to be in the hospital between 30 minutes to one hour. All of them live within 5 miles from the hospital. What I do when I have a patient in labor, I call the on call person and let them know what's going
on with the patient, if the patient is a Primip or a multip and if the patient wants to have epidural anesthesia, how many centimeters the patient is dilated to. We always order CBC on admission to in-patient status so we have the result within one hour from admission. When the patient asks for epidural at 3-4 cms., I immediately give a bolus of 1 liter of Lactated Ringers and I call the Aneshesia on call person that the patient is being hydrated and tell them to be at the hospital soon. If the patient is hurting so bad, I usually medicate her with the IV medication ordered by the OB doctor so that she will get some relief while
I'm waiting for the CRNA or Anesthesiologist.
So I think that your hospital should let the Anesthiologist know about the expectation of the the OB doctor and the RN's as to the time they should be at the hospital. All of the Anesthesiologists I've worked with pretty much know that they should be easily reached when they are on call.