Rough day at the office

tallaght01

What a horrible day today was.

We have, coincidentally, 2 babies in ICU at the moment who have both suffered possible brain damage at birth. Both had their MRI scans and EEGs this morning, and the reports were with me by late afternoon.

Both babies had abnormalities on their MRI and their EEG. So, myself and the neurologists had to go and speak to both sets of parents in turn. It took about 3 hours in total, and was horrible.

One of the problems (when I say "problem", I mean in the sense of giving information) is that both these kids could well be fine. They may well have no poblems at all. But they may suffer seizures, learning difficulties, or visual impairment at some point int he future.

So, basically, it's a case of talking to the parents and telling them that, because the extent of the damage is difficult to assess accurately, we can only say that their child may run into problems. We can't give percentages, or even ball park figures. Basically, keep watching them until they go to school! I mean, how stressful is it to face into that! 6 years of being on edge all the time.

These were 2 very upset sets of parents. But, to their credit, they were very understanding about what info we could give, and what questions we simply couldn't answer.

I always feel crap after these types of conversations. But it goes witht he territory, I guess.

On the flip-side..to keep sane, i always convince myself that, in the world of neonatology at least, there's a ying and yang effect. For every bad thing that happens to me, a good thing happens.

So, just as I was leaving work, the emergency buzzer went off in theatre. They were doing an emergency caesarian section. Our excellent, but very inexperienced, resident was there for paediatric input. The baby came out purple, and she very sensibly pressed the emergency buzzer, and assessed the baby.

The baby wasn't breathing, and had a heart rate of only about 20. The resident tried to initiate bag+mask ventilations, but couldn't seem to get air into the baby's lungs (ie she was pushing air through the baby's mask, but his chest wall wasn't moving).

I arrived in, she explained the story as I was putting on my gloves. Baby was only 50 seconds old at this stage. I readjusted the airway, started bag+mask breaths, and thankfully the chest started to move. The heart-rate came up. Baby became pink, and started breathing himself. Happy days.

So, we have a totally well baby, who will stay with us in NICU for a couple of days of IV antibiotics, and a chest x-ray, just in case. But no harm done.

I've said it before, sometimes medicine can be the best job in the world. Sometimes it's the worst. Some days it's both!

Thanks for listening. Just wanted to vent

Mr Magnolia

What you guys go through in a day amazes me. Myself and the Mrs had a healthy baby 18 weeks ago, stories like this make me realize how lucky we are. Thanks for posting that.

tallaght01

Cheers Mr Magnolia.

Thankfully every day isn't like that...though sometimes they are. Congrats on the new addition, by the way.

And many thanks for your post on th efeedback thread about getting a sig done. I'll look into it.

I'll lazily use this post as my blog entry for this week. Cut and paste special. I'll leave it a few days, though. I always try and post blog entries out of synch with when the events actually happened, just to put an extra layer of patient confidentiality protection up.

siochain

Massive respect to you for the job you do, I can only barely imagine the highs and lows you guys go through. I count my blessing ever day for our 3.

Again I can’t praise enough the work you guys do.

siochain

tallaght01 wrote: »

I arrived in, she explained the story as I was putting on my gloves. Baby was only 50 seconds old at this stage. I readjusted the airway, started bag+mask breaths, and thankfully the chest started to move. The heart-rate came up. Baby became pink, and started breathing himself. Happy days.

Just sat back and though about that and all I can say is WOW

Chunky Monkey

siochain wrote: »

Massive respect to you for the job you do, I can only barely imagine the highs and lows you guys go through.

+1 Especially working with babies.

tallaght01

Thanks for that, Siochain. That procedure that I was talking about isn't as difficult as it sounds, though. I'm sure it sounds more dramatic than it is. It's just scary more than anything else!!! I'm loving your sig, btw. You've got one of my fave Ghandi quotes in there!

Thanks to you, too, chunky. Though I imagine my babies are a lot easier to work with than the huge people you have to deal with as a HCA!

Chunky Monkey

Aye my poor back! Not emotionally though. At least, with the elderly, they've lived their life and many are confused and happy in their own worlds. I know this and the relatives in general seem to as well. But kids, that's hard. Was specialling one with CNS lymphoma once. They banged the bed rails every five minutes and when I went over put their little hands together beside their head and typed out that they wanted sleeping tablets