Sunday, June 19, 2011

30 and counting

No I am not talking about my age...

I am happy to announce that we have had 30 training sessions since January of this year.  Whoo hoo.  Most of our trainings have been centered around resuscitation.  We now have 6 nurses trained as BLS, PALS, and PEARS providers, and one nurse trained as a PEARS instructor and two volunteer staff members trained as BLS, PALS, and PEARS instructors.  I am hoping to have another PEARS, BLA, PALS training in August with another 6 staff members.

PEARS class
Sharrie Tall, helping out setting up for trainings.

And Two Were Added

Tuesday night a man came into the hospital asking for help for his newborn twins, a boy and a girl.  I had just finished recovering a patient in the PACU and though that my day was done...Oh little did I know.  Those that are in the hospital would appreciate this.  We know that there are two words that one never says, those words being equal to a curse word... yep you guessed it the Q word or the S word (quiet or slow).  Those two words can spell the end of a beautiful day or night.  Well here in Haiti since we actually live in the Hospital those two words should never ever be uttered... Apparently there is another word that should be added to the list "I'm done"  Never...Never say that word!!  Saying I am done indicates that you are asking for the craziness to start.  Ok...back to the story .

As I was leaving the PACU I began to talk to a friend of mine and decided to go to her house with her to pick up some clothes (she was the doctor on call for the night).  As we were leaving  to go with her to her house, no sooner were the words "I'm done for the night" out of my mouth when this man comes up in frantic but calm manner (hard to explain) saying that he needs help for his twin babies.  Apparently his wife went into premature labor gave birth at another hospital/clinic.  They stated that the hospital did not have an NICU to provide care or  a pediatrician available that could take care of the babies.  The hospital heard that we had an NICU ( which has been closed for over a month now until we can train our nurses), and we also don't have a pediatric physician at night nor could we call one in.  Seeing the mans face when we told him that we did not have physician there to take care of the twins broke my heart.  I began calling the other hospitals that had an NICU, either no one answered the phone, they were full or they did not have the personnel.

Dr. Spendie remembered that Dr. Regis had a maternal child clinic down the street so we went there to ask if the would accept the babies (by the way the family had no idea what heir gestational ages was, according to the dad, mom was either 6 or 7 months along).  So... off we went down the street to Dr. Regis's clinic... guys if you know Haiti crossing the street is like taking your life into own hands... anyways, when we arrived at the clinic we were able to call Dr. Regis at home as asked him if he would accept the babies.  Thank God he said yes (whoo, off the hook)... however only if we would admit them to our hospital (back on the hook :).

Dr. Spendie went to her house to change and I went back to the hospital to prepare the NICU for the babies.  I write this post in sort of a joking way but all through this I was praying and still am for the babies.  Our NICU has two incubators, neither one works.  They do not have mattresses, they do not hold any heat and the access ports do not have any coverings... essentially the incubators are empty shells.  We placed folded bed blankets to make a soft padding for their beds, a spot lamp that functions as a heat lamp when brought really close, and for coverings we tore a plastic bag and taped it over the ports.

About an hour later the babies arrived, the first one a boy, weigh 1.36 kg the second baby, a girl, weight .65 kg. Both babies arrived on oxygen at 2 liters via nasal cannula wrapped  like little mummies in cotton.  Both had increased work of breathing, the baby girl's temp was 35.6 C and she was pursing her lips blowing puffs of air out.

Dr. Regis was able to place an umbilical catheter in the baby girl so she could receive fluids while we were able to get a peripheral line in the little boy.  Since mom was still at the other hospital and dad was not around I decided to kangaroo the baby girl  (well a modified kangaroo) I had a T-shirt on. Her temp finally came up and her breathing began to stabilize .

On Thursday night  in the middle of bible study one of the nurse called me to the NICU the little boy began to have some problems breathing. His sats were in the low 50's I was able to use a bulb suction to do somewhat of a deep suction and remove some really thick secretions (Thank you Sinai/Rainbow team for thinking to bring them) .  After about an hour his breathing began stabilizing.  I had asked the nurse to call Dr. Regis to come in as soon as I came into the room when I noticed the baby's breathing... I have to officially say that he is now one of my favorite docs.... He came in less than 15 mins to assess the babies ( which in Haiti traffic is amazing).

It is now Sunday night and the babies are still holding on.  Please keep praying for them.