Urgent cases

[Crabbygas]

I won't bore everyone with the details. Suffice to say I am in a situation where I often have surgeons arguing. Imagine Sunday night an appy, an enruptured ectopic, and an open tibia all hit the ER at more or less the same time in a place with one OR available. Truth be told if everyone cooperates all three cases could probably be done within 6 hours or so. We also routinely have lots of empty rooms during regular hours. Since we do mostly ortho at my place they are the most likely to risk getting bumped. So the question is what ortho cases truly need to be done within 6-12 hours? The only one I can think of is maybe compartment syndrome and I have been at a place where fasciotomies were done at bedside if it was that big of a deal. Open fractures would seem to be one but somehow they magically are ok with antibiotics for 12 hours if the surgeon has something else to do. Anyway, thoughts on what truly needs to go right away would be interesting.

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[OrthoTraumaMD]

Compartment syndrome
Grade 3 open fractures
Limb threatening injury
Native hip dislocation


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[FutureDoc1088]

Cauda equina
Evolving neuro deficits in setting of spinal column injury or epidural hematoma (not a complete spinal cord injury)