True Life is Stranger than Fiction

True stories from the ER, and the streets of EMS.

Sunday, October 08, 2006

Too close to home

I was on my way to lunch, passing through the ER as usual on the way to the deli. I noticed a significant number of Fire/EMS personnel standing around the Nurses' Station. I know from experience that something serious was going down.

I went through the doors and over to the 1st set of Trauma Bays and the entire ER staff was working on an 11-month-old girl in severe respiratory distress. I immediately got sucked-in. At the time I went in one of the MD's was attempting an I/O and one of the RN's and I started to look for venous access. (I'm proud to be one of the "go to" folks when it comes to difficult IV's). She got a peripheral line so we went w/that and abandoned the I/O.

We pushed the RSI drugs and the MD's began intubation attempts. I helped set-up the ventilator, but then we realized she didn't weigh enough-it only goes down to 10kg and she was 7.5. I ran to get some equipment and when I came back I noticed one of the RN's that used to work w/us coming through the Ambulance Bay doors. I thought to myself that she had come back on staff but then she walked over to the Trauma Bay and she flipped out, and I put it all together in my head. She had left our staff to give birth 11 months prior. It was her baby. The stress of a Peds resuscitation now became a major (controlled) freak-out b/c it was the child of one of our own.

The intubation took a long time. Her belly got a little distended and her heart rate kept dropping. I'm @ the head of the bed assisting the MD w/intubation and I notice her heart rate went down to 50. I said "We need to start chest compressions!" and someone did. I was really scared @ this point b/c when kids get to the need for CPR they usually don't come back. Thankfully, the MD got the tube in and I taped that damn thing down so it wasn't budging. We got her SPO2 to start going up and her heart rate followed, thankfully. Major relief!

We got the CXR to confirm the tube placement, and she had bilateral PNX's. Damnit! We placed two 16g IV catheters to decompress her lungs for transport to the PICU. They did the trick and her SPO2 was 100% when she rolled out the door.

We heard a lot of reports the first few days about her condition, and it wasn't looking good. We also had a CISD in the days following. The staff was all very upset. The last report we got was that she had hemiparesis.

Last week, the mom brought the baby by, and she's moving all her extremities after 2 weeks in a Rehab Hosp. She's alert & appropriate, w/only a tiny little brace on her hand. It's amazing that she's doing so well, much less alive at all. We're all so grateful that it turned out so well when things looked so bleak. As a total aside, she's also completely adorable. =)