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Re: 17 minute rule put into practice.From: DoctorJoe@aol.comTue Dec 8 06:33:28 1998
In a message dated 12/8/98 3:33:22 AM, ThomasInd@compuserve.com writes: << 1 - Got IV access (x2) 2 - Took bloods and arranged cross-match 3 - Catheterised and shaved 4 - Gave Zantac 5 - Consented her (for what it is worth) 6 - Spoke to the anaesthetist and theatre sister 7 - Put her on a trolley 8 - Took the trolley to theatre myself after waiting for the lift (LW on 1st floor, theatre on 2nd, all lifts on 7th floor). 9 - Wheeled her into the theatre 10 - Got changed and scrubbed 11 - Waited until the anaesthetist & paediatrician were ready. 12 - Knife to skin at 19:39. 13 - Delivery at 19:40. 14 - Abruption confirmed at C/S and happy outcome. That's 16 minutes so I just made it. >> You did a great job. The only way to do it faster is: 1 - you already had IV access because you do it routinely on everyone 2 - you already sent blood in for crossmatch when you started the IV 3 - no difference 4 - probably no difference 5 - everyone gets consented when they walk in the door 6 - don't talk to anyone - just yell orders as you go 7 - institutional specific... some places just roll the labor bed to the OR 8 - institutional specific... many places do C/S in Labor & Delivery 9 - see #8, #9 10 - usually need to scrub, at least quickly 11 - the anesthesiologist is the limiting factor.. peds just needs to be "on the way" 12 - same 13 - got the baby out in 1 minute... cool 14 - good job The only way this could have been "better" is to have Labor & Delivery situated differently (a c/s room actually IN L&D), and to already have the IV in and etc. Of course, if the lady walks in off the street with an abruption, you're starting from zero anyway. So you did a good job, and your point about the "17 minute rule" is quite well made. Joe P.
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