Having a h ard time processing something that happend yesterday

Published

:bluecry1:

To make a long story short. Patient delivered a non-viable baby in the doctors office 18-20 weeks. Paramedics were called to transsport patient and baby to labor and delivery. Paramedics separated the two had two ambulences took mom to l and d attempted to reseccitate the baby and it died in the ER or in my arms when I went to retrieve the baby from ER. I'm not upset about the baby dying (well i am but that is not the point) baby should have been with mom the entire time!!!!!!!!!!!!

I'm trying to tell as many "big wigs" as I can so some education or something can be done so this doesn't happen again

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Specializes in CCU,ICU,ER retired.

Why would the baby stay with the mother? If I had a nonviable baby I wouldn't want to keep holding it.

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Some mothers might want to hold the baby. Some mothers might want to travel in the same ambulance with someone else holding the baby. Some mothers might want the baby taken away.

THE THING TO DO IS ASK THE MOTHER, being honest with her and assuming she's not critical herself.

Trying to resuscitate a 18-20 weeker - why? It's cruel. I guess if the medics couldn't/weren't allowed to estimate GA and futility and were leaving that for the docs.

Mugwump, thanks for advocating for parents who've lost a baby. And for the baby.

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Specializes in Oncology/Haemetology/HIV.

Perhaps the EMTs wanted to be able to focus on trying to save the baby, and were worried as to not stressing Mom more (viewing their actions). And as far as I know they are not legally able to determine viability or death...that is the purview generally of an MD. As well as if Mom had medical issues, putting two pts in one rig w/one team might not be legally acceptable...and two teams, there were not be room to do anything.

A bigger question....if Mom was at an MD's office (possibly an OB/Gyn?)...who more likely than the EMTs knows the viability /age of fetus, or could have determined that Mom did not need medical stabilization...why did they not declare the fetus not in need of resuscitation and transport and why did they call and indicate need for two rigs? That would be a more appropriate call for that MD than the medics to make.

Medics have strict legal guidelines to follow and they should only be used for an emergency. If called, they have to respond as an "emergency"....stabilization and trying to maintain life and viability with what they are presented with. This is why DNRs should have a copy for someone to give to EMS if something untoward occurs....otherwise, in many parts of the country, they must attempt resuscitation unless overwhelming evidence of death.

(as an aside, during the Oklahoma bombing, there were medics that transported seriously injured children from the obliterated child care center, that several HCWers thought had no chance of survival. Some of them did.)

It is not their job to make certain decisions...especially when a physician more aware of the overall pt picture determines a need to call them. And psychosocial care is not their first priority - physiological care is.

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I am wondering why a squad was called at all? If there was some issue with mom (pre-eclampsia, hemorrhage) then she wouldn't have been able to hold the baby anyway. If there was no issue why wasn't she stabilized and taken by car?

Certainly the physician office staff or the physician himself should have intervened and made it clear to the squad that the baby was not viable. As newcomers to the scene I can see why they would have attempted saving the baby if they didn't know GA.

I totally agree that the baby should have been kept with mom if she wanted. I hope she got a chance to see baby after all was said and done.

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I agree the MD should of made it known that the baby was non viable but I am going to throw another view on the situation as I used to be a paramedic. In medic school we were taught to try and resuscitate any infant unless it was obvious that the baby had expired. So here they are:

1. It may give the mother comfort knowing "everything was done to save her baby." She may always wonder why they "chose" to do nothing.

2. As stated above, paramedics always try to save a pt. as it is not within their guidelines to determine who is salvageable and who is not. This is a situation they had probably not faced before and had seconds to determine what to do.

3. To keep skills up, they must be practiced. By attempting to resuscitate this baby, they learned what they will do when faced with a viable baby. It is one thing to book learn and do scenarios, but when you run the real thing out in the field, you gain real experience and will remember what to do differently the next time.

They probably used two rigs so they could concentrate on both patients. It can get hectic with a sobbing, post partum mom, 2 paramedics and a dying baby all in a 6 foot by 8 foot space.

I feel for the mom,and you too, for having to go through this situation.:redbeathe:redbeathe

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Specializes in NICU, Infection Control.

I'm w/Birdgardner: ASK the mother. The doc should already have told her the baby was non-viable (I hope). We do encourage the mother to hold the baby--it's supposed to help the "grief process"(hateful term ) and can help her come to terms w/the baby's death.

And, please, please, please--don't practice "skills" on a 20 wk fetus--or any other dead person, for that matter. We don't let residents and med students do that any more. It's barbaric and you might injure the baby in some way that would be difficult and embarrassing to explain to the parents. jmho

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Awsmfun, I lost a baby at 20 weeks. If she had been born alive, I would have gotten up to kill anyone who wanted to practice his skills at anything more than blow-by O2 and swaddling.

Tubing, compressing and sticking a neonate with no chance at all is CRUEL. Do no harm.

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Awsmfun, I lost a baby at 20 weeks. If she had been born alive, I would have gotten up to kill anyone who wanted to practice his skills at anything more than blow-by O2 and swaddling.

Tubing, compressing and sticking a neonate with no chance at all is CRUEL. Do no harm.

:yeahthat: amen!

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I wonder if there is a law regarding transporting two patients. My bet is that you had very frightened ambulance crews. As a Hospice nurse the death of a child heightens everyones anxiety a hundred fold. If this should ever happen again make sure that you have a Hospice referral number handy...our crews jump in and do some amazing things very quickly including creating hand prints in plaster of paris etc...

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Specializes in OB, NICU, Nursing Education (academic).
Why would the baby stay with the mother? If I had a nonviable baby I wouldn't want to keep holding it.

Many mothers do. We see it all the time with our IUFD's and non-viable preemies.

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I was not defending the training of "practicing" on anyone. It was what I was taught, but was never comfortable with it. I am sure the medics treated the baby with upmost care and concern, and it affected them afterward also. Medics are NOT taught to assess GA, and follow guidelines that do not allow them to determine who is savable or not out in the field.

Shame on the doctor for not intervening and assisting during this incident. This is who you should be angry at.

I too, would want to hold my non viable baby or fetal demise if faced with that situation.

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