Time restraints for cardiac surgeons...

[elliot777]

Is there a time restraint for arrival to the ER for cardiac surgeons?  Resonse times?

[ed34]

I think if I was in your situation, I would not have survived. When I arrived at the hospital while having heart attack, I was told I may not survive and had to be transferred over 20 miles by ambulance to a heart specialist hospital. My hospital at the time had no cath labs either. Luckily I survived the trip, and got stented. If I needed constant ballooning then I would be dead.

[elliot777]

Dear Ed,
Thank you for your reply.  I am recovering from emergent quadruple by-pass surgery.  I live less than 10 minutes from the hospital and was taken by ambulance.  I was taken into the ER and the cardiologist on call was contacted.  He arrived within the hour.  I was taken into the cath unit.  The ONLY cardiac surgeon was contacted by the cardiologist.  He told the cardiologist to "increase heparin" and he would attend to me in the morning.  15 minutes later the cardioloist contacted the surgeon telephonically a second time.  The medical reports are extrememly vague at this point.  However, the surgeon did arrive at th hospital.  3 hours and 48 minutes later.

During this time (3hrs. 48 min.) the cardiologist had multiple leads in each chamber.  He would balloon each one with the balloon only for the major artery to completely occlude in less than 15 minutes.  He stood there and did this for hours...waiting for the sugeon.

By the time the surgeon arrived I was in acute cardiac shock.  My heart stopped tewicw in the cath lab.  Saphaneous veins from both my legs were removed.  There was no time to take arteries fro my breasts which are known for lasting a lifetime.  The leg veins are statistically known to frequently begin having problems at 5 years.

I am alive by the grace of God.  After surgery it was touch and go for many hours.  I required 36 units of insulin an hour.  

I have learned all of this after requesting the medical records.  I knew something was amuck when the cardiologist came in and apologized to me.

I am asking this question as I ponder suing the surgeon.  I am seeking information regarding contracts make with hospitals when a surgeon that is a life o death specialist is hired...i.e. is there a time restraint?...are they expected to live within  "X" number of miles from the hospital?  This would seems logical to me.

Perhaps some of the specifics will give you food for thought and you can make additional comments.  However, I am grateful for your input.

Kindest regards,

Elliot777

[ed34]

This is very difficult for me to answer because I live in the UK and over here it depends on the trust running the hospital. It varies. However, I do know that a cardiologist will be on call and they stay in the hospital over night, sleeping in any available room. The hospitals which have a cardiac ward are strict on this. Usually it will not be a consultant cardiologist, but they are in the hospital for many hours every day, early hours until late evening. In my local hospital, there is a general surgery unit, but nothing for heart surgery. Even though there are a number of cath suites and a cardiac ward, surgery is done at other hospitals which are within a 20 min drive by ambulance. The cardiologist can stabilise the heart to allow for this. I witnessed a man die of arrhythmia is a bed next to me. The Cardiologist had just told him that he needed a pacemaker, and he will be sent to another hospital in the hour. Within 5 mins, the cardiologist was called back because the patient had crashed. He was fully recovered within another 5 mins and sent immediately for a pacemaker. A senior cardiac nurse travels with such patients, and has contact to a cardiologist if needed during the trip.Probably not the ideal situation, but works for over 99% of cases.

[elliot777]

I am asking several things actually.  1)Is there a gold standard or contractual time line from when a cardiac surgeon is notified by a cardiologist that a patient requires his expertise immediately at the hospital?

2) If so, is there a standard?  i.e., response time must be within "x" number of minutes, hours?

3) Is there a standard clause in a surgeons contract that they must live within "x" number of miles?

4)  Suggestions on hoe to determine the facts on a specific individual.

[ed34]

I'm not sure what you are asking. Are you asking how soon a cardiac surgeon should arrive there to deal with an emergency? or are you asking how long the patient has when having heart attack?