My Valentine's Day wasn't romantic in any way, but it certainly was exciting.
Here's the background info you'll need to understand most of the events I'm going to detail:
1)The NICU has several different teams that are named by color:
Red, Blue, Yellow, Green and Purple.
2)Each team is made up of any of the following: Attending Physician, Fellow, Resident, Intern, Physician Assistant, and/or Nurse Practitioner.
3)A "term" infant, or normal newborn is 40 weeks gestation.
4)At the Univ. of Penn hospital, one team is in charge of the critical deliveries in addition to their own existing patients in the NICU. Example: The pagers go off and say "32 week infant delivering by STAT C-section." The team responsible drops everything and runs down to the OR to receive the infant and begin any resuscitation necessary.
Okay, onto the stories!
Valentine's Day:
After a long day of fixing babies, my team finds out we will be delivering 29 week gestation twins by c-section at 3pm. We all go down to the special resuscitation room outside the OR early in order to set up the beds and equipment. Babies that premature often do not breathe on their own very well, so we are prepared to intubate these babies and put them on ventilators. As we're setting up I ask my attending if there is anything I can do to participate. It is my first real resuscitation of premature babies so I'm dying for the experience. She tells me that the fellows will be intubating and the residents will be putting in arterial and venous lines this time, so it's best just for me to observe. I'm not too bummed out, but I really want to try intubating because I never have. So I stand aside to at least get a good view. So time goes by and the OB/GYNs are still not ready to begin. So there are about 20 of us crammed in this room, standing around, checking and rechecking everything when a nurse comes bounding into the room and says "There is a 33 weeker delivering now! Mom has severe preeclampsia (that's really high blood pressure during pregnancy and is an emergency for mom and baby). I am closest to the door so I run in the OR with my attending. As we open the door nurses and docs are wheeling mom in on a bed with the baby's head nearly already out. I KID YOU NOT, the mom coughs hard and the baby pops out! The nurse and doc grab the baby, clamp and cut the cord and give her to us. Immediately I see the baby is blue, limp and not breathing. My attending scoops her up and pushes us back into the resuscitation room. Now remember that all 18 other people are waiting for the twins to come out any second. The other attending steps over and says "Who is intubating?" I immediately say "I will." He and my attending give the okay and there I go! I insert the laryngoscope and visualize those teeny vocal chords and try to pass the little endotracheal tube in. It was so much harder than I thought it would be! The warmer over the bed was cooking the baby and I on HIGH and everyone was crowded around me watching. I tried twice to get it in but the tube kept going posterior to the esophagus instead of the trachea. After two tries the fellow took over. RIGHT as she's getting the tube in, the twins are delivered! One right after the other and now we have threee resuscitations going on at the same time. It was unbelievable. I got to pump the oxygen bag on my baby and hold the tube in place while we rushed her out of the room, down the hall and upstairs to the NICU until we could get her hooked up on the ventilator.
It was a CRAZY, awesome experience. I got to help save a little life! It was great. Next time maybe I'll get the tube in all by myself. It is the hardest procedure to do in the NICU, so all I need is practice. The attending said I did a great job for my first time though.
Anyway, the baby is doing fine now. She is no longer intubated, and has perked up nicely over the past few days.
So overall that craziness was a nice distraction from the worst holiday ever declared. I hope you had a fun day too.
luv,
duckie
Here's the background info you'll need to understand most of the events I'm going to detail:
1)The NICU has several different teams that are named by color:
Red, Blue, Yellow, Green and Purple.
2)Each team is made up of any of the following: Attending Physician, Fellow, Resident, Intern, Physician Assistant, and/or Nurse Practitioner.
3)A "term" infant, or normal newborn is 40 weeks gestation.
4)At the Univ. of Penn hospital, one team is in charge of the critical deliveries in addition to their own existing patients in the NICU. Example: The pagers go off and say "32 week infant delivering by STAT C-section." The team responsible drops everything and runs down to the OR to receive the infant and begin any resuscitation necessary.
Okay, onto the stories!
Valentine's Day:
After a long day of fixing babies, my team finds out we will be delivering 29 week gestation twins by c-section at 3pm. We all go down to the special resuscitation room outside the OR early in order to set up the beds and equipment. Babies that premature often do not breathe on their own very well, so we are prepared to intubate these babies and put them on ventilators. As we're setting up I ask my attending if there is anything I can do to participate. It is my first real resuscitation of premature babies so I'm dying for the experience. She tells me that the fellows will be intubating and the residents will be putting in arterial and venous lines this time, so it's best just for me to observe. I'm not too bummed out, but I really want to try intubating because I never have. So I stand aside to at least get a good view. So time goes by and the OB/GYNs are still not ready to begin. So there are about 20 of us crammed in this room, standing around, checking and rechecking everything when a nurse comes bounding into the room and says "There is a 33 weeker delivering now! Mom has severe preeclampsia (that's really high blood pressure during pregnancy and is an emergency for mom and baby). I am closest to the door so I run in the OR with my attending. As we open the door nurses and docs are wheeling mom in on a bed with the baby's head nearly already out. I KID YOU NOT, the mom coughs hard and the baby pops out! The nurse and doc grab the baby, clamp and cut the cord and give her to us. Immediately I see the baby is blue, limp and not breathing. My attending scoops her up and pushes us back into the resuscitation room. Now remember that all 18 other people are waiting for the twins to come out any second. The other attending steps over and says "Who is intubating?" I immediately say "I will." He and my attending give the okay and there I go! I insert the laryngoscope and visualize those teeny vocal chords and try to pass the little endotracheal tube in. It was so much harder than I thought it would be! The warmer over the bed was cooking the baby and I on HIGH and everyone was crowded around me watching. I tried twice to get it in but the tube kept going posterior to the esophagus instead of the trachea. After two tries the fellow took over. RIGHT as she's getting the tube in, the twins are delivered! One right after the other and now we have threee resuscitations going on at the same time. It was unbelievable. I got to pump the oxygen bag on my baby and hold the tube in place while we rushed her out of the room, down the hall and upstairs to the NICU until we could get her hooked up on the ventilator.
It was a CRAZY, awesome experience. I got to help save a little life! It was great. Next time maybe I'll get the tube in all by myself. It is the hardest procedure to do in the NICU, so all I need is practice. The attending said I did a great job for my first time though.
Anyway, the baby is doing fine now. She is no longer intubated, and has perked up nicely over the past few days.
So overall that craziness was a nice distraction from the worst holiday ever declared. I hope you had a fun day too.
luv,
duckie