What's your most interesting/scary case? - page 3

We all know that working in this field can be exciting, touching, heart warming as well as heart wrenching. We know that strange and exciting things happen everyday. But every now and then something... Read More

  1. by   33-weeker
    Quote from LizzyL&DRN
    Okay, some has to tell some funny stories too. We don't want to lose our loyal readers......due to all depressing stories.....
    The OP did say 'scary case'.
  2. by   Gompers
    Quote from 33-weeker
    The OP did say 'scary case'.
    She also said interesting.
  3. by   kate1114
    Quote from Gompers
    She also said interesting.
    OK, a nice, interesting, heartwarming case from the NICU side.

    I took care of a baby who was a 24 weeker. His parents were wonderful people and had tried fertility treatments to have a baby, but were never successful. After a few years, they stopped and decided to live their lives without children. The wife was 44 when she started having some breast pain. She was a little paranoid (by her own admission) about breast ca since a coworker had recently been diagnosed. She went to her doctor who asked if she could be pregnant. She had a laugh at this, but the test came back positive. She was diagnosed around 16 weeks, so she had a whole 8 weeks of known pregnancy to enjoy LOL. They were just the most delightful couple and they doted on that baby
  4. by   OB_or_NICU_hopeful
    Quote from kate1114
    OK, a nice, interesting, heartwarming case from the NICU side.

    I took care of a baby who was a 24 weeker. His parents were wonderful people and had tried fertility treatments to have a baby, but were never successful. After a few years, they stopped and decided to live their lives without children. The wife was 44 when she started having some breast pain. She was a little paranoid (by her own admission) about breast ca since a coworker had recently been diagnosed. She went to her doctor who asked if she could be pregnant. She had a laugh at this, but the test came back positive. She was diagnosed around 16 weeks, so she had a whole 8 weeks of known pregnancy to enjoy LOL. They were just the most delightful couple and they doted on that baby
    Did the baby make it?
  5. by   BSNtobe2009
    I'm wondering what the chances of a 21 weeker are...has anyone seen this?

    When I brought my daughter home from the hospital in Sept there was a 21 weeker that had been there since June 21 (my birthday, ironically). He was born at a hospital the next city over (it was labor they couldn't stop), and the doctor told the mother the baby would die, well, it didn't, so they rushed it to a level IV NICU.

    I have thought about that baby most every day.
  6. by   Jolie
    Quote from BSNtobe2009
    I'm wondering what the chances of a 21 weeker are...has anyone seen this?

    When I brought my daughter home from the hospital in Sept there was a 21 weeker that had been there since June 21 (my birthday, ironically). He was born at a hospital the next city over (it was labor they couldn't stop), and the doctor told the mother the baby would die, well, it didn't, so they rushed it to a level IV NICU.

    I have thought about that baby most every day.

    For the baby to have survived 3 months, I suspect that it was probably NOT a 21 weeker. The baby was probably an older, SGA baby that "looked like" a 21 weeker.

    At 21 weeks, there is essentially no alveolar development in the lungs. Without these air sacs where 02 and CO2 exchange take place, there is no way to oxygenate the body. No amount of ventilation or oxygen therapy will be effective.

    By 24 weeks, many babies have sufficient alveoli to oxygenate their bodies with the assistance of available technology. The trick is to support their bodies' needs without damaging these alveoli. (Both oxygen and the pressure needed to deliver it into the baby's lungs are damaging to the delicate alveolar tissue.) Babies can "outgrow" lung disease because they continue to develop new (healthy) alveoli until about the age of 12.

    It's impossible to know what this baby's outcome will be, but bless you for caring so much about that child.
  7. by   Gompers
    I've never seen a true 21 weeker survive. I have seen two 22 weekers make it, but both had horrible lungs - one went to a nursing home vented with a trach, the other was on over 1 liter of oxygen. Both had g-tubes for feedings and significant brain bleeds.

    Sometimes they can confuse the dates, thinking a baby is 2 weeks younger than it actually is. Many moms think that you start counting from the day of conception, but you really count from about 2 weeks before that at the beginning of the cycle. So even though the mother may have only been pregnant for 21 weeks, the baby would be officially a 23 weeker. I know it's really weird and I have issues myself with counting that way, but that's just how it is. And 23 weekers have less than a 50% chance of survival, so that sound more realistic for that particular baby. If they expected him to die, but he didn't and kept himself going long enough for them to decide to try and save him...then I really don't see any way how he could have truly been 21 weeks. Between the undeveloped lungs, decreased respiratory drive, and lack of body fat...I don't see how he could have survived more than a few minutes on his own.
  8. by   BSNtobe2009
    Quote from Jolie
    For the baby to have survived 3 months, I suspect that it was probably NOT a 21 weeker. The baby was probably an older, SGA baby that "looked like" a 21 weeker.

    At 21 weeks, there is essentially no alveolar development in the lungs. Without these air sacs where 02 and CO2 exchange take place, there is no way to oxygenate the body. No amount of ventilation or oxygen therapy will be effective.

    By 24 weeks, many babies have sufficient alveoli to oxygenate their bodies with the assistance of available technology. The trick is to support their bodies' needs without damaging these alveoli. (Both oxygen and the pressure needed to deliver it into the baby's lungs are damaging to the delicate alveolar tissue.) Babies can "outgrow" lung disease because they continue to develop new (healthy) alveoli until about the age of 12.

    It's impossible to know what this baby's outcome will be, but bless you for caring so much about that child.
    Thanks. My daughter was in there about 3 weeks when the mother was going to hold him for the first time...she was crying, I gave her a big hug (my eyes are welling up just thinking about this), I just told her that God didn't hold his tiny hand this long for nothing...she had an amazing spirit. I would give anything if I could contact her and see how it went, I can't so I just keep her in my thoughts.

    Now, the only reason I thought the baby was a 21-weeker was the mother told me she was 21 weeks when she gave birth, but it could have been a miscalculated due date.

    I do remember her saying the baby was very much like a burn victim when he was born b/c the lack of sufficient skin layers (thickness?). The doctor that delivered him was so sure the baby was going to die, he didn't have a heated isolette just in case or anything, he didn't call in the neonatologist, nothing...he set the baby in a regular isolette (not sure what they did after the baby was born, b/c surely he couldn't breathe on his own?), and that is when they made the transport.
  9. by   LizzyL&DRN
    Quote from BSNtobe2009
    The doctor that delivered him was so sure the baby was going to die, he didn't have a heated isolette just in case or anything, he didn't call in the neonatologist, nothing...he set the baby in a regular isolette (not sure what they did after the baby was born, b/c surely he couldn't breathe on his own?), and that is when they made the transport.
    We had this happen once in our OR. I don't remember the gestation, but it was very early (22-23weeks???). After the c section the doc put the baby and the placenta in the basin and set it all aside. They thought the baby was already dead, during the closure someone in the OR happenend to walk by the basin and saw the baby move. NICU was called, baby lived and went home with mom. Thank God that baby moved when she did.
  10. by   babynurselsa
    Got code pinked to a delivery one night. Shoulder dystocia, stunned baby. As we blew in the door we saw the ob resident doing mouth to mouth on the baby......
  11. by   EmerNurse
    Quote from 33-weeker
    Yes. For some reason ER doesn't get the baby thing very well. I haven't seen our's go so far as to bag a pink baby, but they don't keep them warm very well.

    I did go down once to find them intubating bad baby between mom's legs with a warmer sitting 3 feet from them. However, considering that the cord was still pulsing, and the placenta can remove CO2 that we can't do with bagging alone (reducing the risk of brain damage) this was probably not all bad. I did promptly move the baby to the warmer when they cut the cord.
    Now hang on thar hoss! I delivered a baby in the hospital hall way on the way rushing a woman to L&D. Yes I held baby down a tad to help clear her airway (no bulb suction in my pocket sorry), yes I stimulated and rubbed her back and yep she howled, and yes I wrapped her as best I could in a sheet for warmth, holding the baby bettween mom's legs cause she was still very much attached to mom, all while running down the hall with a freaked out security guard and an (excellent) tech pushing the stretcher!

    Mom and baby were fine and L&D said we all did very good. We thought the baby should be named Holly (HALLWAY). Not all ER nurses are afraid of babies LOL.

    Ok - I've had 4 so I may have had a little idea of what to expect LOL.
  12. by   SmilingBluEyes
    Quote from babynurselsa
    Got code pinked to a delivery one night. Shoulder dystocia, stunned baby. As we blew in the door we saw the ob resident doing mouth to mouth on the baby......

  13. by   fusster
    My sister has three children. All her pregnancies went fine until it was time to deliver. First one she was in labor for over 30 hours and pushed for 5 hours, and then her baby's heart rate started decreasing. At this point the doctor was finally called into the room (yes, after pushing for 5 hours and the baby pulling back to where it started after every push), discovered that the baby's head was tilted funny, used a vacuum to pull the baby out and then found out that the cord was wrapped around her baby's neck twice. This baby ended up in the NICU for several days.

    Second baby was born with fluid in his lungs (meconium perhaps?), developed pheumonia, was in the NICU for a week.

    Third baby she had a placental abruption, husband rushed her to the ER, was transferred up to the maternity unit for about a half an hour before the doctors/nurses decided it was an abruption (I guess the huge pool of blood she was sitting in wasn't a big enough hint), and then went for an emergency C/S. Ended up having to get blood transfusions. This baby was in the NICU for only a few days.

    Luckily all her babies have turned out fine, no long term effects. Needless to say her husband went in for a vasectomy after the last one.

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