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Re: 30 minute ruleFrom: Joanne Bulley (jbulley@cheshire.net)Mon Feb 16 21:42:19 1998
Robert J. Carpenter, Jr. MD wrote: *SNIP* The smalal hospital where everyone must be called in should have the potential for longer than 30 minutes. The university or other teriary center where VBAC's are laboring do require a revision of the 30 minute stand. Leung's paper clearly states what happens when that most untoward of circumstances occurs. It may be 0.9 to 2.3% depending on prior c-sections but the outcome if the team is not prompt is more often catastrophic than good. *SNIP* I am at a "small" hospital - but the tertiary center is about 1 hr 15 min - under the best of circumstances. We use the thirty minute "rule" "guideline" (or whatever) to keep track of promptness in response and to remind the OR team - anesthesia, techs and RN's - that if we can't make the incision by 30 minutes - they will have to take call in house. As a result - if we say STAT we get STAT - and nothing else. If it is as super STAT as you can get - the anesthetist has given the anesthetic in street clothes - once when it was "over" the anesthesiologist realized he was not the one on call. The call said STAT so in he came. If he had recalled he was not on call, he would have assumed the "on" team was in the OR and an second team was needed and still would have come in STAT, no questions asked. Work: Home: Joanne E Bulley, MD, FACOG Joanne E Bulley Hitchcock Clinic - Keene jbulley@cheshire.net Joanne.E.Bulley@Hitchcock.ORG
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