SIDS Pediatric Code

Specialties Emergency

Published

So I'm a new nurse, I just passed my 6 month mark. I took a job at a smaller, but very busy ER right out of nursing school. We have a great time there, I love my coworkers. There's just something special that you can't relate to people that don't work in stressful environments. It reminds me a lot of the camaraderie you find in the military.

When we got the call that a 5 month old was coming full arrest the tone in the entire ER shifted immediately. Everyone was instantly all business. Now I may be a new nurse, but I was a tech through nursing school in an ICU, and I'm no stranger to codes. In fact I love them. I love the adrenaline, the pace, the teamwork, the interventions. I'm what you would call a code junkie. Everyone kept telling me, "It's different with kids." Well I didn't know what to think about that. I've got young children, and every time I tried to think about it from my own perspective I wound up nauseated and just pushed it down into the pit of my stomach and went on about my business.

When they brought this baby in she had been down for at least 20 minutes. (When they called report we didn't have much to go on. We knew they were working hard to save this baby, so we just prepared for the worst.) When the came through the bay the medics were obviously frantic, but had intubated her. We were shuffling for an IO access when my best friend rocked a 24 in a single stick in her little hand. I was calling out dose calculations, our charge nurse was drawing meds, techs were alternating on compressions, and another talented newer grad was record keeping.

Our doc was "emptying the cart on her."

We tried everything.

PEA.

After 20 minutes, Mom got there.

We told the doc - "She needs to be in here." She needs to see that everything possible was done for her child. The chaplain guided Mom in and sat her next to me so she could hold the baby's hand. We just kept going.

Probably 20 rounds of Epi. Doc finally called it. And I just hit my knees.

I could feel everyone else around me doing the same. And we just prayed. We prayed for that baby, and we prayed for her family. It was a moment that will be forever with me. It is different with kids. Right or wrong, it just is.

In that moment I felt like I was EXACTLY where I was supposed to be in this world. I just took a PRN job at a lvl 1 pediatric ED.

I just needed to share that.

I lost a child to SIDS in 2004. It was a grueling and horrible experience but one I have learned from. That mother has some dark days/week/months/years ahead of her but hopefully she has a strong support system. Reading the latest genetic research on SIDS there really isn't anything we can do. There is no such thing as "near miss SIDS" and once a child starts down the SIDS path there is no turning back. The latest link from Hopkins has to do with defective genes and serotonin which honestly makes a lot of sense. My child was a winter baby in a cold climate but was always sweating.

By the time we awoke to find my child it was far too late.In a way I am glad I didn't have to wrestle with the trauma of a code as well. As the mother to a SIDS baby, thank you for feeling the importance of the child. More often than not, because our children die so young no one feels their loss in the same way the immediate family does, much in the way no one knows what the mother of a stillborn or miscarried mother goes through. In the end it is the same, the death of promise.

Specializes in Transitional Nursing.

God bless you. I have no idea if I could do what you did or if I'd ever be the same afterwards. People like you are angels and I thank you for sharing your story. Now if I could only dry my eyes.

"No day but today"

Just beautiful. Made me cry. I felt like I was in that room with you.

Specializes in Emergency Room.

I may not be a nurse yet but I have had my fair share of pediatric codes working as an ER Tech. When I read this I was reminded of a particular code where the patient had been seen in our ER the day before and discharged but returned due to no improvement in symptoms. The patient had labs drawn and within normal limits as far as I could remember but the patient was still not getting better. We finally did a CT scan and I believe they had found some sort of cellulitis in the neck and we decided to transfer the patient. The Dr. initially wanted to transfer the patient to a general peds floor at a hospital that had a PICU just in case the patient got worse but then the nurse recommended a PICU after reassessing the patient.During this time the patient got progressively worse and then eventually started coding. We coded this patient for at least 30 minutes and did everything that we could but to no avail. A few of the nurses were in tears, especially those that had young children. As deeply saddened as I was by what had just occurred, I felt like I needed to stay strong for not only the family but my fellow coworkers. There was an autopsy done to determine the cause of death and I believe the patient had MRSA and became septic. It must have been a fairly rapid onset since the blood cultures that had been drawn initially were negative (though this particular patient had spent a very long time in our ER, they had gone through 3 different doctors) I have been through many codes but pediatric codes are most definitely different.

I was involved in another code in which the mother spoke Spanish and I was the one who had to tell her that there was nothing more we could do for her child so we were going to stop resuscitating. I think the hardest thing about pediatric codes is when the families ask you why? Why did God take my child away? My inability to give them an adequate answer was probably one of the most humbling experiences I had ever had.

Thank you for sharing your story. I will reiterate what one of the experienced nurses I work with told a younger nurse who was distraught from the first code described but had held her composure drawing up medications even though she initially did not want to. "We may not have been able to save this one but you will save thousands of kids with the skills you learned today"

incredible experience--may u always remember the power and skill u had and the power and skill god has. when i was getting my master's and had to take a course in death and dying, the instructor-a ph d herself--shared that there really is no known black and white reason for a sids baby. it was felt that the infants-who are truly just arriving from heaven-see their future before them and choose to go back to the other side.... bless u!

Specializes in being a Credible Source.

I had my first (and only) SIDS code about a year ago. It still stays with me... we were working this kid though it was clearly a show-code for all of us... poor kid had moved on long before we got him.

Mom and dad were there and dad just flipped out - punching the wall, throwing things, howling. I'm a dad and I've faced some scary moments with my kid and I could sooo identify with the guy's raw grief and rage.

This family had tried so hard and so long to have this kid. It was just... wrong.

I've coded lots of folks (and picked up my share of cadavers in a prior life) and pronounced a few DNRs but, for the most part, they were 'right.' This (and a couple of similar experienes - a young father killed in an MVA coming home from work, specifically) have just been 'wrong.'

For the most part, I like the drama and trauma... with the kiddos, though, I have to go home and just hold my own kid for awhile - until I get the, "Daaaad...." and 'my' life comes back into full focus.

Thank you so much for doing a job many (including me!) cannot do. A natural death at the end of life is one thing, but unexpected and traumatic at the the beginning of life, for all caring for the patient.

We hear "it takes a special kind of person to do what you do," all the time, but for Peds, it really really does.

You did a good job, and you were a kind and caring soul during the most difficult time in a families life.

Your story and your compassion brought me to tears, and I thank you for sharing it.

You are and will be an excellent nurse.

Specializes in Emergency, CVICU.

Thanks again for all the kind words and shared experiences.

I did want to speak to one point that was made. Bobmo mentioned not having an adequate response for why this happened. I don't pretend to have the answers, and I think sometimes, as humans, we spend too much time trying to make sense out of tragedies. I'm not sure that divining "a purpose" from these situations would help at all. Here's what I believe, and therefore know. There is a God, and I'm not Him. For sanity's sake I've seen God take awful situations and make miracles. We see things in a very linear, cause and effect type way. God sees things from every imaginable and unimaginable perspective.

My daughter asked me about tornadoes the other day. "Why does God send those storms?" She's 5. It made me pause. I asked her to look around at the destruction and tell me what she saw. "Everyone's picking up and helping each other." It's amazing how children view the world. (That's another reason why ped's are so hard I think.) Sometimes God let's storms come to give us an opportunity to serve each other.

I know I need to be a better servant to be a better nurse.

Specializes in ER, TRAUMA, MED-SURG.

OP, that was such a touching story. Made me feel like I was working it with you.

The worst peds code I worked was when I was the ER nurse at a small rural hospital. The ER was staffed with RN, and there was an additional RN on the floor that floated when she wasn't busy. Any time I needed, the other nurses came almost immediately when i called.

A mother brought in a baby, her little girl who was less than a year old. There wasn't any telling how long baby had been down, but she was cyanotic, cool to the touch. Got her in the trauma room and hooking up to the monitor - noticed her scar. Turns out, she was born with a congenital cardiac anomaly and didn't have a positive outcome. The doc told mom that baby would not survive another year at the most.

Mama said she noticed baby started having trouble. Mom fed the other kids (she had 3 older ones) and put all in the car. Stopped at MIL's house and dropped off the older ones. She told us later that she knew baby was dying, but she couldn't bear to have the baby die at home. We worked it for a while, but we knew there wasn't going to be a good outcome. We did bring Mom in and gave her a chair - she thanked us later - this was almost 15 years ago and it still sticks in my head.

OP, you rocked at that code - it takes a special person to do peds trauma/codes. You are an amazing nurse and will be a treasure in your ER.

Anne, RNC

As a nurse, and a Mom who sat through her own child's code almost 5 years ago, I know the heartbreak that the parents were feeling. I will NEVER EVER EVER forget finding my son in his corificeat, not breathing, and blue, with blood pouring from his nose. I will NEVER forget falling to my knees in the ambulance bay of the hospital and screaming until my mother scooped me off the ground. And I will NEVER forget the dedication and hard work of every single nurse in that room who did their best to save my son's life. I will never forget the compassion that was shown to us in the worst time of our lives. We had lost a son 13 months before, and faced losing our 2nd. He spent 5 days in the PICU after the code, but never came back to us. He died in my arms, as his Daddy held both of us. We are now parents to two beautiful little girls, ages almost 4 years and 11 months. Our boys will forever have a place in our family, in my heart, and in my life.

Specializes in Emergency, CVICU.

Thanks for sharing calaab and sissiesmama. Those were both touching stories.

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