Re: Cord Blood Gas and Placental Exams
From: art fougner, md (evsono@pipeline.com)
Mon Oct 11 10:38:11 2004
This discussion pre-supposes that the pathologists are quite experienced
in examining placental pathology ... quite an assumtion IMHO.
art
At Sun, 10 Oct 2004, Garry E. Siegel, M.D. wrote:
>
>Robert and I serve on the same Perinatal Services committe and I echo
>his comments 100%. I was opposed to be "told" when I had to set gasses,
>or send placentas, but. . .
>
>You can't fight city hall :).
>
>As Robert said, pick your battles, and someone else said they've never
>seen a defense hurt by this data.
>
>Garry
>
>At Sun, 10 Oct 2004, RModugno@aol.com wrote:
>>
>>In a message dated 10/9/2004 9:00:17 PM Eastern Daylight Time,
>>zygote@icsi.net writes:
>>
>>On 9 Oct 2004 at 18:40, Dr. Ainsworth wrote:
>>
>>> The risk managers for our hospital chain is requesting that the
>>> perinatal committee adopt standards that require physicians/CNMs to
>>> order blood gases and placental exams on high risk patients: low
>>> APGAR, meconium, etc. My position as the Chairman is that we already
>>> have suggested circumstances for these to be ordered, however I object
>>> to the idea of making them mandatory. I would rather audit patient
>>> charts to see how many fall out that would have received the tests
>>> under the guidelines, but were missed and focus on outliers.
>>> Additionally, educate the medical staff regarding the benefits, i.e.
>>> medico-legal protection. I have no problem with guidelines and
>>> protocols that protect our patients, I do have a problem with
>>> micromanagement by corporate bean-counters. Does anyone have other
>>> thoughts?
>>
>>Our hospital will now require this on high-risk deliveries.The L&D nurse will
>>remind the MD/CNM and if they refuse an incident report or something similar
>>will be generated. This has been sanctioned by our OB/GYN Executive Committee
>>( Yes, we have one because the hospital has about 150 ob's on staff and will
>>top out at about 18,000 deliveries this year). As the hospital is usually a
>>co-defendant in a lawsuit they want to have it be as defensible as possible.
>>
>>My advice. We have to fight so many battles - let this one go, Ron! ;+)
>>
>>Robert Modugno MD MBA FACOG
>>Marietta, GA
>>_www.novaobgyn.yourmd.com_ (http://www.novaobgyn.yourmd.com)
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
art fougner, md
ich bin ein New Yorker
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