A long thirty hours

At 10 pm on Friday evening, I was called by the on-call doctor. He said “Come to neonatology now”. I threw on my scrubs and ran over.

When I arrived the infant had a breathing tube and looked horrible. We worked vigorously for an hour and got him stabilized. Unfortunately, at that time, he started convulsing. Not your typical subtle neonatal seizures, but jerking so violent that he was springing off the table.

We gave one standard medicine for seizures, but they did not stop. Other first line agents were not available. After a while, I hesitantly asked for a medicine that is not approved for infants. It was our only option and I knew it could kill the child. A few doses later, the seizures stopped (and the child was in an intentionally induced medication coma).

For the next 25 hours, we took turns squeezing a bag to pump air into the unresponsive patient. I was very proud how the hospital staff rose to the occasion and assisted. Our goal was to support the child until the medicine was completely metabolized and we could do a complete neurologic exam.

A few hours ago, the medicine wore off and it was obvious the patient was neurologically devastated. We were considering withdrawing care but the patient spontaneously died.

In retrospect, we were all happy the baby lived so long. We were able to evaluate him in a more calm setting and the parents had time to hug, kiss and hold him.

Unfortunately, I just learned that the mom was in labor for 48 hours and presented to another local hospital for delivery. She was immediately prepared for a cesarean section, but when the family failed to pay, the hospital discharged her without care. Critical time was sacrificed because they lacked financial resources.

One Response to “A long thirty hours”

  1. Francisco Acosta Says:

    That is so sad from start to finish! You atleast gave them a few hours more!

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