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When a Baby Arrives Dead in Your Emergency Department

Discussion in 'Emergency Medicine' started by Hadeel Abdelkariem, Feb 17, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

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    When a baby arrives dead in your emergency department …

    … the world stops. You stop breathing. You are gasping for air. She is limp; she is cool; she is pulseless. Chest compressions on the tiniest six month old I have ever met are done with the finger pads of my index finger and middle finger. Quick, synchronized beats. I look at her blue, blue lips. It should never be like this.

    Her eyes are fixed and dilated telling me that she has been like this for quite some time.

    We stop and check for a pulse. No pulse. Chest compressions resume, we work to put a tube in her mouth to help her breathe. It is how I imagine a doll’s airway must look like. Stiff, tiny, a small pink flap over the throat.

    There is a cool calm, a cool horror, a cool this-is-never-how-it-should-be. We work deftly to bring her back. But she is gone. She was gone before she arrived. She is gone now. She is gone.
    There is hysterical sobbing heard by the family. Our insides are gutted. Our hearts, shattered. But the emergency department keeps pulsing, and we need to keep it afloat.

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    I meet my nice gentleman with the irregular heartbeat in the 160s. I check on my patient with the migraine headache. I discuss at length with my patient with the extraordinary high blood pressure and horrible headache the need to do a lumbar puncture to rule out a head bleed. She ultimately leaves against medical advice despite my coaxing and persuading. I evaluate a diabetic with intractable vomiting and abdominal pain. I see a sweet woman with severe pain who is now wheelchair bound and whose 80-year-old husband can no longer care for her at home. His shoulders relax and his eyes sigh in relief when I tell him I am going to admit her to manage her pain.

    Throughout all of this, the weight of a dead six month old suffocates me and holds me captive. My heart is in pain, and I am devastated, and this is too catastrophic to set aside to mourn later, but I do. I do, because this is what I do. This is what we do.

    I’ll never forget walking into this. That sweet purple, lifeless, limp 10-pound baby on a huge white stretcher. The tiniest of chest compressions giving her heart an external beat. For those suspended moments in time, she was all of our child. We loved her; we ached for her; we didn’t want anything to harm her. We will all weep in our own ways over the days, weeks, months to come. Not even the usual armor that we constantly garner will keep these feelings at bay. This is one that will rattle us. Keep us jarred.

    Because there is nothing natural …

    … when a baby arrives dead in your emergency department.

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  2. Rick Robbins

    Rick Robbins Young Member

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    I am a retired Paramedic in Louisville, Kentucky. I have been a Paramedic for 32 years. I cannot count how many babies who have been placed in my arms, working hard to get them back knowing it would all be futile.
    The one that really bother me are the abused, an eight month old thrown down a flight of stairs, a mother who intentionally drowns her one year old. There has many accidents I have attended. There are times when I had to make the decision that there is nothing I can do and I had to tell that to the parents.
    It is a horrible thing, and if you did not feel like you did after your experience That would be worrisome. Hang in there, do what you can then let them go. It takes a while for the sting to go away but that’s Ok....Hang in there Doc..
     

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