One of my duties as a tech in the Emergency Department is to occasionally transport patients to surgery. These transports are generally one of two types. The first is what’s often called a “red-sheet” surgical procedure. These are usually traumas where we’ve done all that we can in the trauma room and have to race them to the Operating Room for emergency surgery. These require a nurse or two, often a provider and generally a tech or two to help drive the stretcher. This isn’t always the case. One night an assistant manager nurse and I were the only two to transport a dying patient to the OR. We were moving fast. I was pushing and she was monitoring his pulse the entire time, basically running backwards as I pushed. At one point in a hallway a column was in our way and she nearly got clipped as I wasn’t about to slow down. Knowing her, I think she’d rather I had clipped her than slow down the transport. As a side note, I can’t recall if I’ve mentioned it, but personal space often isn’t a priority during traumas or situations like this. As we turned a corner I felt her reach down to my leg and grab my stethoscope out of my side pocket so she could quickly check his breathing. There wasn’t a request or warning, simply the grab. In cases like this immediate patient care is more important than the personal space.
The second type of transport are far less urgent, but still more urgent than waiting until a convenient time during the day. The patient isn’t within minutes of dying like the above, but the situation is serious enough that the surgeon wants to start cutting within the next couple of hours. That was the case the other night.
This patient had come in with a small, but growing growth inside her. It was causing them incredible pain. But more serious, if it continued to grow, it would certainly burst the tissue it was growing in, causing severe bleeding and possibly cause sepsis and in 9-14% of cases the death of the patient. This was a surgery that perhaps could have waited until the next day, but the surgeons decided it was more prudent to do it as soon as possible.
As I wheeled her up to the OR I reflected on how it had taken no longer than 1-2 hours from the initial diagnosis to getting her consent and then getting her to the OR. All in all there wasn’t really anything remarkable about this.
And there shouldn’t be anything remarkable about this. If I were describing a patient with appendicitis or some cancerous tumor threatening to burst it wouldn’t be remarkable in any state.
However, in this case, it was an ectopic pregnancy.
Now, let me be clear, a quick search of the literature does not find any state that outright bans treatment for ectopic pregnancies (and to be clear, treatment in this case means either a chemical or a surgical abortion). However, that hasn’t made doctors and hospitals nervous over the lack of clarity at times. This can lead to a delay in treatment. This is unacceptable.
In cases like this, medical treatment should be determined by competent medical personal and their patients.
https://www.healthline.com/health-news/ectopic-pregnancy-and-abortion-laws-what-to-know
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