Our neonatal intensive care unit is filled to capacity and all of our oxygen equipment is being utilized. While we were rounding this morning, another sick child was born. He was delivered through amniotic fluid that was described as “pure pus”.
The child was initially not breathing but had a strong pulse. After we gave a few artificial breaths, the child became more awake, but still after 10 minutes, I could not get his saturations higher than 70%.
It was time for one of the most difficult decisions of my life. This child was ill but had a good chance at survival; he just needed some antibiotics and oxygen. Where was I to get the oxygen?
I asked the nurse to remove the nasal cannula from the infant with evidence of the most severe brain damage and she placed it on our new patient.
Within 60 seconds, the new patient had oxygen saturations of 95%.
Within 5 minutes, the other child was dead.
Decisions such as these will haunt me for years to come.