Express Delivery

Recently i came across this and was reminded of my own experiences delivering babies. My first delivery during house surgeoncy happened while i was posted in gen surgery. 
      There was this young lady who was admitted with about 50% burns to her body and she was about 7 months pregnant. About 2-3 days after her admission she complained of vague abdominal pains. An O&G consultation was sent and the obstetrician examined her and was of the opinion that the abdominal pain was not related to the pregnancy.
  That night I was the house surgeon on duty and at about 11pm the duty nurse called me up informing me that the lady was in full blown labour. Now the last time i'd taken a delivery was way back in 4th year! So i gathered up my wits, called the house surgeon from the next ward and went to the patient. 

      On examination i found that the baby was already crowning. Things happened very fast and i found myself holding this tiny baby! It wasn't moving or breathing. I hadn't expected a baby this preterm to survive. I clamped and cut the cord, kept the baby on the bed and turned back to the mother to deliver the placenta when suddenly I heard a noise and turned to find the baby struggling to breathe. I asked the nurse for a suction catheter to clear the airway. Since it was an adult ward there were no small sized suction catheters and the one I got wouldn't fit the tiny baby's nostril. 

      At that point i realised that if the baby was to survive i would have to get it to the NICU. So i handed the mother over to the other house surgeon, bundled up the baby in a sterile towel and ran. Our O&G and pediatric depts were in another building across a road from the med and surgery building. I ran about 200 metres with the kid's father following me and handed over my precious cargo to the neonatologist in the NICU, where they successfully resuscitated him. I collapsed in to a chair and couldn't speak for 10 minutes, at which point my fatigue was replaced by a warm glow of success. My first unsupervised delivery as a house surgeon was a success!

Resuscitation

Large Bore cannulae in both arms

Saline infusions started on both cannulae

Inj Atropine iv stat

Inj Adrenaline iv stat

Checking airway

Head tilt, chin lift, jaw thrust

Positioning larygoscope

Suctioning airway

Inserting no.8 endotracheal tube.

checking air entry

ET cuff inflated, ET tube fixed

AMBU ventilation commenced

chest compressions started

Defibrillation at 200J

.

.

Defibrillation at 300J.

.

.

Defibrillation at 360J.

.

Sinus rhythm

BP recordable 

This blog has been successfully resuscitated.