Room for improvement

I take call from home most nights. Last night I was called “STAT” to the delivery room for a baby born with no breathing or pulse. The obstetrician and midwife believe the baby was likely dead for more than an hour in the mother’s uterus, but they were not completely sure.

I raced to the hospital. When I ran in the door, there was an awkward scene. There was a breathing tube placed, but it was so deep (at 15 cm), it could have easily been in the abdomen. Chest compressions were being done, but the force was so small it would do little more than annoy a living baby. It was more like a light massage.

I quickly pulled the breathing tube back, instructed the non-pediatric doctor giving chest compressions and placed a catheter in the umbilical vein. After a few minutes of resuscitation, a discussion with the obstetric team and a complete exam of the baby, it was obvious he had zero percent chance of survival. I pronounced him dead at 20 minutes after delivery.

Afterwards, I did a bit of teaching. The mistakes made no difference in this case, but could have disastrous consequences in the future.

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