10. Operating Room Duties
*Check your OR case assignments after PM rounds on the Census*
READ ABOUT YOUR PATIENT before going to the OR
Attendings will NOT tolerate you operating on a patient if you do not know their basic history. EPIC makes this very easy!
- For inpatients, you should verify that all “Intra-op” orders are correct – local anesthetic, stress steroids, etc. – ensure that orders are in the “Intra-Op” Phase of Care.
- Antibiotics should be in the “Pre-Op” Phase of Care.
- A Brief Op Note must be written on all patients before they get to the PACU.
- Enter “Brief Op Note” into “Type” box at top of a blank note and it will auto-populate
- Post-op orders should be written on all patients before they get to the PACU
- Be sure that all postop orders are placed in a “Post-Op” Phase of Care
- We have pre-made Order Sets for common operations (Pectus, Appy, Pyloric)
- If patient returning to another service, CALL THAT SERVICE after the case
- A brief handoff in the PACU is required for all operative procedures
- If patient is going to ICU postop, the ICU will write the orders but a “safe-handoff” needs to be performed, by a fellow or attending
- Communicate intra-op findings with our team so we can perform timely post-op checks, keep census accurate, and review relevant postop labs/imaging
- You MUST dictate or type a full Operative Report on all cases you scrub for unless the attending says that they will do the dictation. Many attendings have templates for their cases – ask your co-residents and Fellows.
- Complete dictations on your cases ASAP – should be completed the day of surgery.
Booking a case for the OR – call #64527 with the following information:
- Planned operation
- If any contact/isolation precautions
- Patient location
- Requested post op location
- NPO status
- Anticipated length of stay
- Attending and their availability
- Special OR equipment (fluoroscopy)
When on call overnight, it is a good idea to know which attending is SOW and which attending is is on call the following day. Non-emergent cases can be scheduled under both attendings’ names (as it is often not known who will be available to cover the case until the following day).
On weekends, the attending that is on call Friday night is to be available to do 730 start cases on Saturday. Clarify when you are booking a case for the following morning that they will do a 730 start.
SOW is not usually available to staff cases until ~ 1000 on weekdays and 930 on weekends given rounding responsibilities. When in doubt, ask about availability and desired start times!