… I’ll actually make it to a blogger bash.
I’m really not dissin’ you guys, I swear. I know, I know … I’ve been blogging for close to a year now, and I still have yet to attend a bash. Unfortunately I had a meeting at work that started at 5:30 and lasted until after 9 tonight. It was important, honest. I had to intubate and do chest compressions on a plastic baby doll.
OK, let me explain …
Part of my meeting included renewing my Neonatal Resuscitation Program (NRP) certification. Being born is one of the most dangerous times in your life, and someone with the proper resuscitation skills needs to always be available in case something goes wrong. Sick newborns are scary as hell, even for pediatricians, so it’s good to keep your ducks in a row and stay up on current guidelines.
So one of these days I’ll share libations with my fellow bloggers. Tonight, however, was filled with exploring the wonders of the Neopuff and the intricacies of emergent umbilical vein catheterization.
Aren’t ya jealous?
4 responses so far ↓
1
Shannon
// May 30, 2007 at 8:24 pm
Actually, I am jealous. I would love to know much more about this sometime… as you may or may not already know, I was with my best friend at her birth last summer when her baby died at birth, due in part we believe to a failed resuscitation. Sometime you’ll have to tell me how it is supposed to go.
2
Shannon
// May 31, 2007 at 2:47 pm
Wow, I just re-read that and it sounds so… weird.
It didn’t happen around here so it wasn’t a colleague of yours or anything… but I really would like to sit and pick your brain about it sometime. I’ve talked to my MIL (an ob/gyn) about it extensively but you would have a much different perspective I think.
Anyway… leave it to me to bring down a perfectly nice post about neonatal resuscitation! LOL!
3
knightindragonland
// Jun 1, 2007 at 4:25 pm
It’s one of the most frightening things we do as pediatricians, but the NRP guidelines help to give us a framework to fall back on in a high stress situation. It’s a lot different that adult resuscitation, where the primary focus is the heart (because most adults needing resuscitation are older folks that have had heart attacks). The main focus for the neonates is ventilation – opening up their lungs so they can breath.
10% of all deliveries require some resuscitative effort, although frequently that only involves warming and stimulating the baby. Sometimes they need a few breaths with a bag and mask or some extra oxygen. Rarely do term kids need the full monty … intubation, chest compressions, and resuscitation meds like epinephrine.
I actually have never had to do chest compressions or give epi to a neonate … yet. It’s a pretty rare event, even at tertiary care and high risk delivery centers.
It sounds like you found yourself witness to one of those rare circumstances, Shannon. That can be incredibly devastating, especially when no problems were expected.
4
Shannon
// Jun 6, 2007 at 12:42 pm
I used to have DONA certification and I’ve done a lot of studying and training in the field of lactation – particularly in the first few moments after birth, so I’m familiar with what you say about resuscitation and neonates. Since Natalee died, I’ve also done a lot of research on the connection to early cord clamping as an expert who reviewed Natlee’s case felt that could have been a contributing factor. I’m not a doctor of course, just have a vested interest in learning all I can…
Natalee was never successfully intubated, nor was an umbilical IV line (or any IV) ever started on her. The efforts seemed to focus on administering epinephrine directly to her heart through the chest wall – a total of 7 doses when I stopped counting. The hospital is a Level 2 but they do have a NICU. The respiratory therapist came into the room 30 minutes into the code, no neonatologist ever came in. The person running the code was the house pediatrician… which brings me to the point of why I found it so interesting you were doing that training. I don’t think the pediatrician was to blame for what went wrong, but I do feel he was probably put into an unfair position for which he was not properly prepared. I know he took it hard, and I feel really bad for him. When this happened, we were under the impression that he was a neonatologist. The hospital staff was understandably not very forthcoming with information, so we didn’t learn about his actual position until many months later when we got the records. I’ll never forget the look on his face when he walked out though.
Natalee was 40 weeks gestation and weighed over 7lb. – the autopsy found nothing to explain her death, so now, nearly a year later, we still have lots of questions. My friend is going to have another baby at the end of August and I think I just mentally need to learn all I can and work through Natalee’s birth so I can be better prepared to “clean the slate” so to speak and be the support she needs for this next birth.
Thanks for listening!
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