A day I would not like to repeat

This morning, Dr. Marlene and I were called emergently to neonatology. Dr. Denise’s premature baby developed very low oxygen levels and horrible blood flow to his skin.

Dr. Marlene and I quickly discussed a plan. She would give the child more oxygen and fluids. I would arrange for an ambulance to transport us to Kigali.

At noon, we were prepared to leave. As we crossed the border into Rwanda, our monitor stopped working, so we could no longer measure the heart rate and oxygen saturations. We would have to base all of our treatment on the physical exam.

During the first hour of the bumpy journey, the child’s breathing tube clogged. We quickly pulled the truck over and replaced the tube.

As we were approaching Kigali, I noticed the child become pale. Immediately after, his heart stopped. Rather than start chest compression as is the normal protocol, I had epinephrine in my hand and just gave it. He responded.

At 5PM, we arrived at the hospital in Kigali and handed them a child with his eyes open, trying to cry. His oxygen saturations were 90% and he had a normal heart rate. Under the extreme circumstances, our team did a nice job.

Despite our efforts, the child died after only two hours at the Rwandan hospital. We are all in a state of grief and shock.

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