The advantage of sitting around at work for two hours with nothing at all to do, on a one room, short, day, is that people want to share neat stuff. This is the most awesome and frightening video.
Last patient added on, because, having been scheduled earlier in the week, but showed up drunk, case was cancelled. Individual drunk today as well. Still drunk, possibly. Took over 90 minutes to get the blood to the lab and the lab to run ethanol levels, while we sat on our hands. Anesthesiologist very against doing the case, for safety and legal reasons. Surgeon is digging heels in and insisting. How can a person obviously inebriated give legal consent? Well, it can't happen, although in an emergency it can be waived. Not at all at a specialty hospital for what is termed an elective procedure. If it can wait five days, it's not urgent nor emergent, by our definition. When we got results, three times the legal limit, 0.24, meant, no we can't do this. Oh, and patient denies having any alcohol today, and only a "couple of beers" yesterday.
Plus, if this person is this dependent, then it gets dangerous for them to NOT drink. DTs are not just a risk for staff, patients can go into seizures and die. It's safer to go cold turkey off heroin. Alcohol withdrawal can kill. And who would be held liable? Not primarily the pushy hand surgeon, but the anesthesiologist and the nurses who accepted the consent and sedated or anesthetized the patient without adequate back-up. Especially when our trauma center is just up the street, and regularly handles this kind of complicated situation. We have to treat the whole patient, not just the injury, and the alcohol dependence is a huge part of this situation. This person needed to be handled at a higher level.
6 comments:
So that's what it's like to be a flying Apache Hampster ... nifty keen!!
Awesome video.
So a drunk person normally shouldn't be operated on. How about a drunk surgeon or a drunk nurse, can they do their job? Do they do their job while inebriated? I should think not, but you would know the truth.
Rou,
I have to agree.
Phil,
A drunk showing up in the ER needing surgery would be treated. A drunk showing up at a day surgery/specialty hospital for a scheduled elective procedure is a different matter.
If I showed up at work under the influence, I would likely be fired and may well lose my license. Mandatory treatment would absolutely be a part of any attempts to save my job. A surgeon doing the same would be harder to censure, but the same certainly could, and should, apply. No hospital would knowingly allow an inebriated surgeon operate, although I'm sure some have been known to be willfully ignorant for numerous reasons.
I have never seen a surgeon or nurse work while obviously drunk, or having been drinking. Some probably have been under the influence of drugs, but never apparently so.
I went to the funeral of an alcoholic yesterday. Only 68, would never accept that he was so, just a lifetime of low level steady drinking and the occasional binge.
He'd probably never been entirely sober for fifty years, and a "couple of pints" never just meant exactly that.
Alcohol is more powerful than it is given credit for.
gz,
It's hardwired into some people, and it saps their life.
Oh, that was the other issue, being NPO, nothing by mouth for at least six hours before surgery. An unreliable report, "two beers yesterday" might actually mean a "bottle of whiskey right before I walked in." Can't do elective surgery safely under those conditions. Take him to the Main Hospital, and they can deal with it, and any possible consequences.
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