Middle of the night echo?

[Shine_on_Syd]

Having had severe aortic valve regurgitation and AVR surgery I have had more echoes than the average bear. Currently I am the director of employee benefits and compensation at a hospital that does not do OHS (they do cardiac caths however).
I was just presented a proposal for 2nd and 3rd shift call in pay for echo tech. Although I am not a clinical person I can't imagine why anyone would need an echo in the middle of the night and we would have to call in staff.
I would appreciate responses from this board as to why this would be necessary.
Thanks!!!

 

[Yaps]

I can tell you this much... I left work at 9pm.. home by 10..in horrible pain, sob..etc.. hubby takes me to ER, by 3 am I had an ekg, echo, lung PFT by 6am, by 8am ambulance run to another hospital, 9am, heart cath..1pm heart surgery..that fast,....

 

[Mary]

Good to see you James!

My husband's hospital, and the one I've used for my echos, is staffed to do scheduled echos 8-4pm M-F and they take turns on Saturday, Sunday, and holidays. They also run the carotoid ultrasounds (the hospital does do OHS.) I think they work 5 days a week; whomever draws the week-end has two days off during the week. It seems to me that you wouldn't need to staff second or third shifts, but someone needs to staff week-ends and Holidays--especially if you have a busy ER. You could use "on call" pay for emergency call ins.
Two years ago I was admitted through the emergency room Memorial Day week-end after experiencing a TIA. I was able to have an echo and a carotoid run, but ended up staying until Tuesday, because X-Ray wouldn't do the MRI unless it was considered an emergency. I was more than a little ticked since the ER admitting physician stated I would be able to get one done on Sunday, but the neurologist overruled it once I was admitted.

 

[Nancy]

When Joe was in the hospital a few weeks ago, he went into the ER with flank pain and shortness of breath. It was late in the afternoon, when they decided that he needed a CAT scan of his thoracic area, and after normal hours. There is a CAT machine right in the ER. It turned out to be splenic infarctions.

He was admitted to the hospital, and had a sonogram at 9:30 at night a couple of days later to see if there were any more clots in the spleen. He has also had portable echoes done right in the room after hours. So, yes there is a need for that sort of thing.

The hospital that Joe was in is very large, and has an active heart department, doing transplants and other surgeries and procedures. Doing all kinds of testing throughout the night is done there. It's just when the machinery and techs become available. They pack them right in at all hours.

I'm not sure if a smaller hospital would be doing this. Perhpas there is a need for those coming in through the ER to see if they need emergency caths for diagnosis and stabilization for transport elsewhere.

 

[Cris N]

I had a middle of the night echo... Had MVR on Monday, went home on Saturday, back to the hospital on Monday afternoon with a-fib (and complaining that when I went for short walk my calves felt like they were on fire). They started me on heparin drip (INR was at 1.3) and since hemoglobin was low started me on FFP. After I was settled in with the IVs running, my husband left to go home for some rest. Then nausea set in - I started vomiting. Then a bit later I complained of terrible, sudden headache. They gave me Tylenol. They stopped the FFP, thinking there might be something in it that was bothering me. I finally drifted off. Some hours later (around 2:30- 3am now) nurse came in to help me to bathroom. That's when I complained that my left arm & wrist felt "floppy. I was awakened at 4:30 with tech doing echo of heart & valve & doppler of legs. Obviously, they wanted to catch any problems before they got worse. Fortunately, no other clots, just the 5mm one that got me earlier. I asked the tech if they really had people around the clock to do echo - she said no, they called her in.

Cris

 

[BAV Pt's daughter]

The hospital where I was (today was my last day there, by the way, going to start the new one in Charleston after mom's surgery) does not have echo's after like 10pm. We would have to page someone as well. And what a pain that is, and also depends on how far away the on-call lives. I think a lot of it also depends upon the size of your hospital and the normal demand for services. The response time is very important!!! I can see not having someone in-houe 24-7, but available nearby is a must, especially for other vascular needs that they would probably be equally responsible for.

 

[Nan]

The very small community hospital where I generally receive my care does not do OHS, but do have staff available to do echos if needed....perhaps not 24 hours, but on a call in basis as well as covering weekends and holidays on regular shifts (as mentioned previously, staff working weekends would get 2 days off during week).

There is clearly a need here for this service. Otherwise we would have to drive for at least an hour to get care. Not good if you are having cardiac issues!