Tragedy

There was a birth 2 nights ago. It did not go well. The nurses deliver the babies. The mother was pushing for a long time. After 15 minutes, it is the protocol to call the OB. It probably took him 15 minutes to get there. The nurse said she wasn't properly dilated. I think the babies head was facing the wrong way, and the cervix was probably mis-shaped. The did an episiotomy (they always do). They cut it bigger, but no progress. Dr Mikwana came, the mother was tiring but kept pushing. The baby was finally born after probably 50 minutes of pushing. There was a lot of blood and the baby aspirated and didn't start breathing. They have been taught neonatal resuscitation, so I was auditing to see how they did. The problem was, the equipment wasn't checked ahead of time. I had made sure there was a bag and mask there. But, the oxygen tank didn't work. So, we did what we could. The doctor asked me to prepare a room in the ICU. I ran there, but the oxygen did not work there either. We had to get oxygen from the ED. This all took 1/2 hour. So, 1/2 with suboptimal oxygenation to the brain. And, once the baby got oxygen, we still was really struggling to breath! I was so worried. I stayed with the patient until 1am. And, the nurse in ICU was brand new. Not ideal. I knew the baby had suffered from anoxia, but I was hoping it would be minimal.

 

That doesn't seem to be the case. Yesterday, he started having seizures. Today, I was in the room working on the emergency cart we are putting together. The alarm went off. The baby wasn't breathing. I stimulated the baby, but the baby would not start breathing. I called to the other nurse and asked her to get the bag and mask ready. I called to someone else and asked them to call the doctor. The baby did not breath for 1 full minute. He was very grey. He was breathing when the doctor came, but then stopped again. The doctor had to resuscitate. We ended up sending the baby to Baroda. This is beyond what we can take care of here. It's very sad! :(

 

We heard later that night that the patient passed away at 11pm. It's a tragedy! The hardest part is, knowing this patient would probably have had a better outcome if we had equipment that worked!