my Biggest fear.....

Specialties Ob/Gyn

Published

Ok so i feel like im pretty confident with most ob emergencies after having worked in high risk OB for about a yr now ....however the one thing i completely dread is having a baby come out lifeless needing resuscitation...at the hospital iam at now the pediatrician and nursery nurse dont attend the delivery unless there is a complication like meconium etc..so when they arent in the room and its just me i get really nervous....i have taken NRP....but ive never had to deal with a neonatal code or even a situation where the baby appears to be in distress but breathing...the worst ive had is a baby needing a little blow by 02 for color....

so who has been in that situation and can you share your experiences about what you've done in various scenarios where the baby is in distress??

i guess i have so much anxiety about it because it hasnt happened to me yet....ive had tons of crash c sections, PPH etc but never a baby in distress....so any advice will be helpful!!

Thanks guys!!

Specializes in OB, ICU, ER, MS,.

I work at a small rural hospital and all the RN's take NRP. I had to resuscitate a newborn about 2 years ago and I was scared to death. But really using the steps from NRP everyone has talked about made it ok. My biggest fear was giving the baby a pneumo. But that is fixable. The doc handed me the limp blue baby and I immediately began PPV. It only took about 15-30 seconds and the babe pinked up and began breathing. It seemed like forever. I always check my equipment if I am the baby nurse at a delivery. Make sure you are comfortable with the BVM set up that you have. Our RT's have two kinds on each warmer. I like the traditional and not the anesthesia bag. So I always switch and make sure my oxygen and suction are all ready to go. The baby did ok, no pneumo had low blood sugar but pretty uneventful...

anticipation is always worse than the real thing. Knowledge is power. NRP is awesome. I really like the disk you can watch of resuscitation showing intubations and PPV. I am a visual person.

Good Luck.

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To address the fear of causing a pneumo, a lot of infant warmers have an airway pressure guage that you can hook up to the ambu bag to help you regulate how much pressure you're giving while bagging. You might check your warmers and/or ask RT about this gauge. Obviously, every baby's lungs are different and occasionally you will end up with a pneumo anyway, but a baby with a pneumo sure as heck beats a dead baby.

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Specializes in Community, OB, Nursery.

Watching for chest rise & fall helps too. I know sometimes it's easy to be so focused on bagging them, but you're only supposed to watch their chest & only squeeze the bag until the chest rises a little. Pressure gauges are nice too.

Bagging works wonders for so many babes.

Something I learned in NRP that helps me remember what to do (the less I have to the better) if you have to do chest compressions:

1-2-3-bag, 1-2-3-bag OR

please-don't-die-BREATHE, please-don't-die-BREATHE.

Learned it from NICU nurses, who, if anyone, would know.

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Specializes in LDRP.

we always have a nursery nurse present at deliveries (we have a "birth team" that is called in for delivery, and if it is a high risk person -mec, known birth defect, less than 37w, etc they bring a nicu practitioner as well).

though, a baby was born in distress before the nursery nurse arrived, and the doc/mom's RN worked on teh baby.

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Specializes in Telemetry, Nursery, Post-Partum.
please-don't-die-BREATHE, please-don't-die-BREATHE.

Learned it from NICU nurses, who, if anyone, would know.

I think i can remember that!:)

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