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Re: VBAC immediately available policyFrom: D. Ashley Hill (dahmd@cfl.rr.com)Mon Feb 6 18:02:56 2006
At Mon, 6 Feb 2006, Efrain Ramirez wrote: > >Lawyers will be laughing at us -- us trying to define "immediately >available" --Jesus!!!! - if ACOG wanted it another way - it should say - >within 15 minutes - 30 minutes, 2 nanoseconds -- I no longer do VABC's >--it is not wort it..period.. > >At our hospital, although it has in-house anesthesia - if there is a >VBAC - the Ob, and everything that surrounds him--OR crew, etc , must be >in house...any other way would be ---somebody said "suicide"? That's probably the safest course for the patient (and the risk managers) but the least attractive for the ob and anesthesia team. I wonder how hospitals that no longer "allow" VBACs handle patients who refuse a repeat cesarean. Does the on-call team have to come in and stand by for the entire labor trial? Can you imagine how hot the on call ob and anesthesiologist would be if a patient previously unknown to them showed up, refused a repeat section, but hospital bylaws mandated that they stay in house the entire labor? I think VBAC advocates are unaware of the number of patients in the office or operating room who may go unattended while the physician is on the labor unit with one patient who demands a VBAC. Sure, it's great for her, but not so hot for the several dozen patients awaiting care for what may be equally important health care needs. Ashley
-- D. Ashley Hill, MD Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency and Loch Haven Ob/Gyn Group Orlando, Florida
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