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Friday, June 13, 2014

Baby

Part of my job description is to attend the resuscitation for high risk baby delivery. The obstetrician will deliver the baby by means of either normal, instrumental or caesarean, and I have to be there to catch the baby and manage accordingly. 

It is a time-critical care, and you would endeavour to do things correctly in the first few minutes of life, or otherwise the consequences could be detrimental, or God-forbid; fatal.

Often, it requires good management of the airway and ventilation of the newborn. To achieve this, skills like opening and securing patent airway, and delivering adequate amount of oxygen to the lungs are key element to ensure a good outcome. 

It always has been a rewarding moment for me if I can hand back a good, crying and active baby to mom immediately after birth, but sometimes when I had to wheel them up to special care unit or to be retrieved to ICU, it can be heart-breaking.

I probably shall never forget this one particular case:

An emergency code was called on one fine evening for emergency caeser for a poor baby heart-tracing on CTG and scan. Actually, it was an almost flat line. Baby's heart is not pumping.

My colleague from the Obstetric was screaming on the phone to book the case in theatre and rushed her in. 

I came in and they were just about to make the first cut. I prepared my resuscitation cot and waited anxiously.

"*Thick mec, Fitri!" his voice boomed. And shortly after, a flat, 'blue-as-bluehyppo' baby was pulled out, without any signs of movement or effort-to-breath.

The nurse cut the cord and brought the poor baby on the resus cot. I shoved in the laryngoscope inside the baby's mouth and cranked it up; and there it was, mouth-filled with meconium/infant's poo.

Suction was made, but I can't still see the upper part of the air-pipe, and there was a lump of meconium stuck on it, obscuring the view. I can't intubate the child. 

The nurse shouted 'I can't feel the heart beat', and at that point of time, I started the CPR and gave a positive airway pressure, hoping it would push the obstructing mec away.

And it did.

Baby started to move at around 2 minutes of life, and heart rate stable around 5 minutes of life. The baby started to cry and **pink-up shortly afterwards. 

Alhamdulillah. 

We need to take him to special care for IV lines, medication and nutritional support.

As I wheel him up from the theatre, his little hands extended upward and, by God, his cute little fingers were wrapping around my right hand (which, at that point of time, holding the oxygen mask on his mouth). He opened his glistening eyes briefly, and looked straight at me. 

As if, he was trying to say, "don't give up on me".

I can not describe to you the feeling.

I just can't.

I thank Allah SWT for granting me, a lowly slave of Him, such a wonderful opportunity to help others in need.

Alhamdulillah all is well for the baby. He was stable, feeding well soon after and gained good weight. Discharged after a week.

I pray for your good life ahead, dear baby. 




*meconium: infant's poo.

*pink-up: returning to normal skin colour. 





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