4/11/2017 In the NICU
April 11th, 2017 by Isaac Billings
Posted in Uncategorized|
Currently on NICU. Started covering last Saturday. An infant passed away within 10 minutes of starting my first day, which was a reality check. The infant was an ~1-week-old, born at home with what sounds like was meconium fluid. He had come in overnight because of lethargy and pore feeding for the last several days. Unfortunately, the infant’s percent oxygen saturations were running in the 50s at admission, with bradycardia and hypothermia. Broad spectrum antibiotics were started and the patient placed on CPAP (they don’t have ventilators here). According to nursing staff the infant’s oxygen saturations never exceeded the 70s overnight. Dr. Becca made the decision to discontinue the CPAP as the infant very unlikely to recover (oxygen saturations still running in the 50s-60s and bradycardic) and if it did would most likely have a serious anoxic brain injury, which would be a sentence to a prolonged and miserable death in this setting.
Typical patient load is 25-30 neonates. About 1/3 are truly critical. Lots of malnutrition, dehydration, sepsis, hyperbilirubinemia, and congenital malformations/weird syndromes.