Wednesday, September 28, 2011

The Worst Shift of My Career - Prologue: The Birth

Autumn - 1992

Ben and Paul normally didn't work with us. They worked on a privately owned ambulance in the center of town, at station #3, two districts away. As A shift had wrecked our squad, Paul and Ben's  ambulance was moved into our station. We were glad to have them, the presence of paramedics meant that ALS capabilities were available to our customers that much quicker.

The call came in during the afternoon. It was for a woman in labor, one who was in a car, parked on the side of the freeway. The engine and ambulance were dispatched from our station, an additional engine was sent from sta. #3. Ben and Paul would have been there anyway, their temporary assignment just got them there faster.

Ben and Paul arrived first, we a few moments later. The ambulance spotted in front of the car, I spotted the engine behind it, shielding it and us from the onslaught of freeway traffic. As an engineer, I had to secure the engine and the scene before walking toward the patient and the crews.

Typically, childbirth calls result in a quick assessment and transport to the hospital. As I approached the car, I could see through the rear window. Frankly, I was not quite prepared for what I saw.

Our first patient was naked from the waist down, laying on the back seat. Our soon to be second patient, was only partially visible to us, part of him was still inside our first. Unfortunately, the part of him that was hidden from us was the most important part, his head. I couldn't help notice that the infant was a deep shade of blue as he sort of dangled limply from his mother, all of him out except for his head. I silently compared his skin color to that of our uniform pants.

Either Ben or Paul (sorry, I can't remember which) was in the back seat along with one of our firefighters, while Captain Hatchet began to get information from the family. I, as ever the perfect engineer, stood by and wrung my hands.

The focus of the medic's efforts were to relieve pressure on the umbilical cord, as it was wedged tightly between the vaginal opening and the infant's head. The problem was, there was absolutely no room to work gloved fingers into the opening next to the cord and relieve the pressure. The medic tried for several minutes with no success. It rapidly became apparent, that the best action for us to take was to get the patients to the hospital and quickly.

The two crews manipulated the mother and the limp, blue partially delivered infant onto the gurney and into the ambulance.

Off to the hospital they went. I said a quick prayer as they left, sure that the infant's first vision would be that of his maker. I was pretty sure that baby wasn't going to make it.

As none of our people went to the hospital with the ambulance, we had to wait until the private ambulance crew returned to the station before finding out the baby's status. Ben and Paul were in a state of disbelief, as the story only got better after they left the scene and went en-route. They had continued to try to relieve pressure on the umbilical while en-route to the hospital, again with no success. The intensity and the pressure of the situation continued to build, until they pulled into the E.R. parking lot and drove over a speed bump. It was at that point that the infant popped completely out.

Again, I don't remember the details, but I believe that the cord had stopped pulsating long before and so it was cut as soon as the head delivered. I also believe that resuscitative efforts were begun as the ambulance rolled to a stop. Regardless, as soon the ambulance stopped, the rear door was flung open and a nurse from the ER grabbed the infant and hauled ass into the ER.

She made it through the door, then promptly dropped the baby onto the floor of the hallway. Paul saw it happen as he looked up while unloading the gurney. He was shocked, but could do nothing as he was busy with the mother. The infant was scooped up off of the floor, still limp and blue and was whisked into a treatment room. The mother was taken to another room and treated there. Ben and Paul returned to the station and told us what had occurred. We were as shocked as they were.

We were even more shocked eight hours later when Ben and Paul came back from the hospital after running another call. They had asked the ER staff about the status of the infant and were shocked to hear that the baby was very much alive, breathing on his own and was actually in pretty good shape considering the shape that he was in.

Two shifts later, I called the NNICU and spoke with the charge nurse, who told us that the baby was doing very well and would be going home in a few days. Heppa was not on the horizon yet, so patient follow-up was pretty common.We decided to take a trauma teddy down to the hospital, so we bought a card and went visiting. The nurse let us into the room and we got to see him. He really looked pretty healthy, I kind of viewed him as a miracle.

The mother wasn't there at the time, so we dropped off the bear and the card and took off. I received a thank- you card a month or so later, she was kind enough to send the above photo.

This call kind of stuck with me, for a few reasons. First, was the strong will to survive that this kid seemed to have and his apparent toughness. I related this story a number of times over the following few years and always referred to Jake as the toughest baby that I ever met.

At the time that this occurred, My wife and I were expecting our second child, a son, who was born a few weeks after Jake. I remember thinking as I watched Jake endure his birth, that under the wrong circumstances, that could be our kid, born on a freeway with a bunch of firemen and paramedics serving as midwives. But for circumstances and fate, that could have been us.

To be continued......

Thanks for reading,

1 comment:

  1. In 16 years as an EMT, I never had to deliver a baby. And that was a good thing. I was present for the birth of both my daughters, which were wondrous occasions...but that little blue or pink stork is one award pin I have ZERO desire to add to my uniform, thankyouverymuch.