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Re: Assistants at CESAREAN SectionFrom: Frank Thibault (fthibaul@alumni.uark.edu)Mon Aug 5 09:44:50 1996
At 01:30 PM 8/2/96 -0500, you wrote: >To List members: > >How do listmembers feel about the use of physicians as first assistants >at Cesarean Section? While other operations may be performed without >other physicians in attendance, it has been our position that another >physician, competant to perform the Cesarean, be present in order to >adequately assist in the operation. > >sincerely, > >Douglas Krell MD FACOG >Santa FE, N.M. USA > It is imperative to have a second physician in the room at the time of Cesarean. I know that with good assistants one physician is all that is necessary for the surgery. However if the baby has problems, some one has to be available for it's resusitation. Long ago in a dark and dreary place, I delivered a baby by c-section that was not breathing. I had the scrub nurse compress the uterus while I resusitated the baby. As I started to regown the nurse anesthetist informed me we had no BP. I told her to speed up the iv. She informed me it was out. I did a quick subclavian vein stick and we were back at work. Mother and baby did fine. There were some immediate policy changes at our hospital. I still see the mother, but she decided that child was all she wanted. You need adequately trained people to take care of anesthesia, surgery, and baby. Usually that means 3 physicians. Pediatric intensive care nurse may be fine for baby, and a good nurse anesthetist is fine, but a weak link can give ulcers and lawsuits. We usually have an instrument tech and a nurse assistant scrubbed. I have one of my partners assist if we plan a Cesarean hysterectomy.
-- Frank Thibault, MD, FACOG Benton, Ark. USA
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