Vivid dreams of a terrible shift... working, working. So busy, patients everywhere, bad heart tones in every room. I must have been in charge... I found myself running from one room to the next, putting out fires, starting IV's, calling docs. Remember struggling for a while with IV lines that were hopelessly tangled, and not compatible with our pumps, so I must have dug up an ancient pump from somewhere and figured out how to get the IV running and attached to a pole. Ran to another room to help with an IV, and a newer nurse was poking her with a 20 gauge... thinking, "What are you doing?! We need an 18 gauge!"
In the midst of it all, my kids were there with me, except it was my friend's kids, but they were mine, and the baby was so small, and I had to hold him while he slept. It really pulled at my heartstrings as the chaos swarmed around us.
So strange.
And I haven't even worked my first night this week.
Showing posts with label babes in trouble. Show all posts
Showing posts with label babes in trouble. Show all posts
Thursday, March 01, 2007
Tuesday, January 16, 2007
This is So Cool.
Pun intended.
(WARNING: highly educational and seriously UNfunny post to follow.)
In this age of technology and gadgets, it's not often that a revolutionary breakthrough utilizes basic physiology to make a miraculous difference.
Brain cooling is an amazing new (relatively speaking) technique being offered by several NICUs across the nation, and unfortunately, we've had a few babes over the last year that have needed it. Fortunately, it can work.
I was thinking about these kiddos the other day, which led me to do a little surfing in search of further information.
Brain cooling is intended for infants that have undergone hypoxic injury related to labor or delivery, with events such as abruption, ruptured uterus or cord prolapse or occlusion. This article, from Georgetown University Hospital, discusses the pathology of hypoxic-ischemic encephalopathy (HIE) and how brain cooling is used to try to avoid what was described to me as the "second wave" of brain damage that occurs following the hypoxic event.
While specific processes differ slightly, most sources agree that the cooling must be initiated within six hours of birth and bring the infant to a hypothermic state (around 91 degrees Fahrenheit!), slowing down the body's metabolic processes to avoid further chemical and inflammatory damage to the brain tissue. After 72 hours, the infant is then slowly rewarmed.
It is by no means the perfect miracle cure. This article, from the BBC, suggests that it results in significant improvement in outcomes for only one out of every six to eight babies that undergo the treatment and is unlikely to make a difference for those with the most severe brain injuries. However, that is still 12-16% of these deathly ill infants who may now have a chance for recovery.
Here is a short video documenting one such case.
What can I say?
So cool.
(WARNING: highly educational and seriously UNfunny post to follow.)
In this age of technology and gadgets, it's not often that a revolutionary breakthrough utilizes basic physiology to make a miraculous difference.
Brain cooling is an amazing new (relatively speaking) technique being offered by several NICUs across the nation, and unfortunately, we've had a few babes over the last year that have needed it. Fortunately, it can work.
I was thinking about these kiddos the other day, which led me to do a little surfing in search of further information.
Brain cooling is intended for infants that have undergone hypoxic injury related to labor or delivery, with events such as abruption, ruptured uterus or cord prolapse or occlusion. This article, from Georgetown University Hospital, discusses the pathology of hypoxic-ischemic encephalopathy (HIE) and how brain cooling is used to try to avoid what was described to me as the "second wave" of brain damage that occurs following the hypoxic event.
While specific processes differ slightly, most sources agree that the cooling must be initiated within six hours of birth and bring the infant to a hypothermic state (around 91 degrees Fahrenheit!), slowing down the body's metabolic processes to avoid further chemical and inflammatory damage to the brain tissue. After 72 hours, the infant is then slowly rewarmed.
It is by no means the perfect miracle cure. This article, from the BBC, suggests that it results in significant improvement in outcomes for only one out of every six to eight babies that undergo the treatment and is unlikely to make a difference for those with the most severe brain injuries. However, that is still 12-16% of these deathly ill infants who may now have a chance for recovery.
Here is a short video documenting one such case.
What can I say?
So cool.
Sunday, December 10, 2006
Sweet and Bitter
Today it's not so much bone tired as totally wired.
There's nothing quite like the feeling of helping a patient who is completely out of control because her labor is barreling like a runaway train towards delivery. A very anxious first-time mom who delivers a couple of hours after feeling the first contraction is going to be understandably agitated by the fact that her uterus chooses to contract every one minute in order to expel the baby, wham-bam-thank-you-ma'am! However, screaming at the top of your lungs for your mommy does not (contrary to the popular belief of many patients whose labors progress this quickly), NOT help to get your baby out.
While a delivery like that can be completely draining, it is also exquisitely intense... working and coaching with the patient to breathe and to push, allowing her body to do its work, forcing her to look into my eyes so that she can stay focused and not let the fear take over. I certainly cannot take credit for what these patients accomplish... it is awe-inspiring.
Unfortunately, the babe was not at all impressed with the process of slamming through the pelvis and into a cold, bright and, according to this babe, rather tiresome world. After working with babe for a few minutes, we got pinkness and a few squawks, but the dusky color quickly returned as babe decided breathing isn't all it's cracked up to be, and after working with babe for almost an hour... got tranferred to Neo. Disheartening. Hopefully babe will turn around after basking in the O's for a while, but it was sad to separate mom from her sweet child after all that.
That's the Sweet and the Bitter in my world this morning.
Nighty-night.
There's nothing quite like the feeling of helping a patient who is completely out of control because her labor is barreling like a runaway train towards delivery. A very anxious first-time mom who delivers a couple of hours after feeling the first contraction is going to be understandably agitated by the fact that her uterus chooses to contract every one minute in order to expel the baby, wham-bam-thank-you-ma'am! However, screaming at the top of your lungs for your mommy does not (contrary to the popular belief of many patients whose labors progress this quickly), NOT help to get your baby out.
While a delivery like that can be completely draining, it is also exquisitely intense... working and coaching with the patient to breathe and to push, allowing her body to do its work, forcing her to look into my eyes so that she can stay focused and not let the fear take over. I certainly cannot take credit for what these patients accomplish... it is awe-inspiring.
Unfortunately, the babe was not at all impressed with the process of slamming through the pelvis and into a cold, bright and, according to this babe, rather tiresome world. After working with babe for a few minutes, we got pinkness and a few squawks, but the dusky color quickly returned as babe decided breathing isn't all it's cracked up to be, and after working with babe for almost an hour... got tranferred to Neo. Disheartening. Hopefully babe will turn around after basking in the O's for a while, but it was sad to separate mom from her sweet child after all that.
That's the Sweet and the Bitter in my world this morning.
Nighty-night.
Subscribe to:
Posts (Atom)
