ICU Surgery?

[JuJo]

Most of my patients die in the ICU because they need urgent surgery but there is no way to send them to another department and they keep collapsing and dying after a while.

Is there a way to force them to do surgery?

[JuJo]

So my doctors keep getting stuck with "reserved for procedure" for days. But when a patient in ICU that's waiting for a surgery dies they get fixed. Same thing happens if I control a patient that's in the ICU and I remove the procedure for surgery.

There are a lot of bugs with ICU and Surgery.

[dorianmode]

If you're getting 'reserved for procedure' try hiring another nurse - usually it's a backlog of patient transfers.

[dorianmode]

Maybe also add another stretcher - no idea how much redundancy you have in your hospital.

[Kousuke]

Guess I'm not the only one, I can't seem to get patients in ICU to go to surgery. And its not an issue with backlogs or stretchers either because there's two vacant and all the nurses are happily on their PCs.

[SeniorPZ]

Originally posted by KousukeP:

Guess I'm not the only one, I can't seem to get patients in ICU to go to surgery. And its not an issue with backlogs or stretchers either because there's two vacant and all the nurses are happily on their PCs.

same here.

[JMW58]

Is this happening at the day time or night? Do you know how large of staff that needs to scrub in for a surgery?

[dorianmode]

What is their status on the PC? Are they 'reserved for procedure' or 'idle'? The second one means it's a bug. The first one means you've got a bottleneck.

[dorianmode]

Originally posted by JMW58:

Do you know how large of staff that needs to scrub in for a surgery?

One operative surgeon, one assisting general surgery doctor, one anaesthesiologist, one surgical nurse, one assisting nurse, one nurse to transport the patient, one stretcher.

[JuJo]

they fixed this in one of the last Patchs. The devs told me a fix to this was to add a stretcher to a corridor next to the ICU.

[iamnick]

If you go to one of the premade hospitals it gives you a general idea of how everything works which is good for making your own hospital, atleast i find!

[happyscrub]

people can go from ICU directly to surgery. ur issue is with your surgery department

[Oceansize]

Assuming you have sufficient doctors and nurses in ICU, ICU actually works really well as a fast-track to surgery. Edit: this also assumes your patient is likely to collapse.

The main trick I've learned to keeping surgeries running smoothly is to have a dedicated surgery team that doesn't do anything else. This means five staff per Operating Room who do nothing else. Your surgeon should only have "Surgery" checked. Your Anesthesiologist should only have "Anesthesiology" checked. Your Assisting doctor should only have "Assist at Surgery" checked. Your Medical Surgery nurse should only have "Surgery" checked. You'll need one more nurse as well but I wouldn't mess with his/her default checkboxes, the fifth member of your surgery team can be a garden-variety low skill nurse.

Let's say an ambulance patient comes in with unstoppable bleeding and needs heart surgery desperately: once they're stabilized I won't even bother sending them to Cardio first, I'll send them direct to ICU. Why? Because they're likely to collapse at some point, which ALWAYS results in the patient immediately being transferred to ICU, interrupting whatever exams and treatments they had scheduled (including that surgery they so desperately need). If they're already in ICU when they collapse for the first time, that's a huge bonus. Assuming you have a dedicated surgery team, they should be whisked away to surgery within moments of arriving in ICU.

Let's put it this way: if you expect your patient is likely to collapse at some point during their time in your hospital (flashing hidden symptoms that still aren't revealed after preliminary exams, or flashing symptoms that are only treated with surgery), I would recommend sending them to ICU right away and avoid the time wasted by assigning them to a specialized department first. Because they're going to end up in ICU anyway and this way you save a lot of time by not transferring them to more beds than necessary during their stay.

[happyscrub]

Originally posted by Oceansize:

Assuming you have sufficient doctors and nurses in ICU, ICU actually works really well as a fast-track to surgery. Let's say an ambulance patient comes in with unstoppable bleeding and needs heart surgery desperately: once they're stabilized I won't even bother sending them to Cardio first, I'll send them direct to ICU. Why? Because they're likely to collapse at some point, which ALWAYS results in the patient immediately being transferred to ICU, interrupting whatever exams and treatments they had scheduled (including that surgery they so desperately need). If they're already in ICU when they collapse for the first time, that's a huge bonus.

Let's put it this way: if you expect your patient is likely to collapse at some point during their time in your hospital, I would recommend sending them to ICU right away and avoid the time wasted by assigning them to a specialized department first. Because they're going to end up in ICU anyway and this way you save a lot of time by not transferring them to more beds than necessary during their stay.

I don't see how you are "saving time" doing what you are doing.

1. They will ALWAYS be sent to a bed from trama. It will be surgery bed or ICU your way.

2. From there they collaspe at some point.

3. From being collaspe they go to ICU or trama regardless of where they are.

There is no extra step you are bypassing.

The only time saving is if they collaspe before they manage to get to anywhere else past the first bed they make it to.


But I will say ICU does save time by the fact that they can do a lot of things to a patient in the bed where other doctors need to do those things in another room. The same with emergency.

[Oceansize]

Originally posted by happyscrub:

The only time saving is if they collaspe before they manage to get to anywhere else past the first bed they make it to.

Which happens very frequently with the more critical patients. After awhile you start to get a sense of which cases are likely to collapse before they get to surgery. These are the ones you send direct to ICU. This means only one bed transfer between TC and surgery (TC>Collapse>ICU>Surgery), not two bed transfers (TC>Cardio>Collapse>ICU>Surgery).

[Oceansize]

Another cool trick involving ICU is when you get a patient who needs surgery but they're just waiting and waiting in TC for an available bed in their preferred dept. Assuming you have available beds in ICU but not in the preferred dept, sending them to ICU instead means they get a bed sooner and thus to surgery sooner. When I get a warning that somebody is waiting a long time for a bed AND they're in bad shape, I don't build more beds & hire more staff, I just assign them to ICU.