One heck of a day(s)

Tuesday night was hard. I had abdominal cramps and fluttered in and out of sleep.

When I arrived at work on Wednesday morning, we admitted a child with entire body swelling, kidney failure, jaundice and fever. She was very ill and required our attention for the entire morning.

Just around noon, I received a message that a pregnant woman who had high blood pressure and seizures was going for a cesarean section. The gestational age of the fetus was not accurately known so I rushed to the operating room.

Soon, I was handed a blue, floppy, extremely tiny infant that was not breathing. After 5 minutes, we got the patient stabilized and transferred him to the neonatal unit. Unfortunately, over the next 3-4 hours, his oxygen levels continued to decline, so we were forced to place a breathing tube.

At 9PM, he seemed stable, so we decided to go home for food and sleep. Within minutes of walking in the door, I got a frantic call asking me to return. We ran back and as I walked in the door of neonatology, the child appeared dead and had no heart rate. After a quick assessment, it was obvious that they accidently pulled out the breathing tube.

We re-intubated, did chest compressions and gave adrenalin twice. Ten minutes later, we had normal oxygen saturations and a good heart rate. (For another blog post, I will tell you about the other neonate who began having seizures during this episode).

As I was preparing to leave around 1AM, the nurse accidentally pulled out the breathing tube again. We intubated quickly and got him stable within minutes.

Finally, as morning was approaching, we left to go home and get a few hours of sleep before the regular workday. Promptly, at 7AM, the phone rang “saturations 50%, come now”.

We sprinted to the hospital. This time the breathing tube was in the right place, but the lung had collapsed and was pushing on the heart. I stuck a needle in the chest and had a transient improvement. We then put in a chest tube but the air pushing on his lung reaccumulated and he died.

At 8AM, as I was finishing a conversation with the parents of the infant, I was interrupted by a medical student, “Doctor Chris, we need help in the intensive care unit”.

I hurried over and found a 3 year-old with HIV in hypovolemic shock and the child from the day before with total body swelling had slipped into a coma. Ahhhh!

We immediately began working on both patients and I called for intellectual back-up. My brain was functioning at minimal capacity.

Finally, by 7PM Thursday night, both patients were stable. We walked home in a zombie-like state, ate quickly and fell quietly asleep.

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