Wednesday, April 1, 2015

22 minutes 14 Feb 2015

22 minutes 14 Feb 2015
Limp and lifeless. It didn't seem like a fair Valentine's Day gift for this mother. We just delivered her baby boy via C-section and he looked awful.
Just one hour earlier I had been enjoying a pot luck Valentine's lunch when my phone started ringing. Generally that's an unwelcome sound. We rarely call each other for social things because cellular minutes are expensive. When my phone rings, its nearly always something urgent.
After a quick chat I excused myself from lunch and dashed home to throw on my scrubs & head to the hospital for 2 potential C-sections. Fortunately the first was delivered with forceps and we hurriedly cleaned up & set up to deliver the second patient.
This would have been the 7th child for a mom who has had multiple C-sections in the past. The baby was delivered quickly but was completely limp and lifeless. Unfortunately I've grown accustomed to seeing newborns who need resuscitation.
Suction. Stimulate. Oxygen with an Ambu bag. We repeat this cycle again and again. This baby boy is going to die. I've seen it many times. Here in Chad, if a newborn doesn't breath in the first 10 minutes of resuscitation, they typically never do. We don't have a mechanical ventilator. I have kept babies alive in the past by hand ventilating for extended periods of time but eventually have to make the difficult decision to stop. Without respirations, a newborn's heart will slow and then stop in just a few minutes.
I was approaching that point today. This baby's pulse was strong but he just wouldn't breath on his own. Nothing. 5 min. 10 min. 20 minutes went by.
We paused our ventilation and watched him. At first it was just a small gasp but it was something! More ventilations, more stimulation and finally after 22 minutes we got our Valentines gift. He was breathing & he cried. LOUDLY! I truly had already given up on him
and I was just going through the motions.
We wrapped that baby boy in some fabric from his mothers dress and carried him over to her. She looked exhausted and didn't seem to respond to seeing her newborn son. I know she had watched much of our effort to resuscitate him and I wonder if she had given up hope as well. This is Chad, Africa. Babies die. She had seen 2 of her own children die before and I guess she was braced for that reality. But in a matter of seconds...her face softened and tears filled her eyes. Her baby boy is alive...and she loves him.
Happy Valentines Day.

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