Thirty-two to One
Emergency department staff deal with a lot of stressful situations. We kind of get used to it, after a while, so most of it doesn’t get to us. Only rarely is something so emotionally traumatic that it really rocks the whole department and each staff member personally. Let me tell you about what I think if one of the most stressful things we encounter in our job.
As I was walking in for my shift, there was a huge commotion going on in Room 6A. I quickly learned they were trying to resuscitate a nine-month old baby boy who had been found unresponsive at home by family members.
I put down my ice chest and Timbuk2 bag and slipped in to see if there was something I could do to help. It is hard for me to adequately describe what was going on. This is as stressful a situation as arises in the emergency department. A baby is dead or trying to die. Everyone is doing everything possible to save a little life with so much potential. Every thing that needs to be done on such a little thing is more difficult than in most adults. IVs are hard to start. The breathing tube is hard to get into such a little windpipe. CPR is difficult to do correctly. It is really challenging and the stress brings appropriate emotions to the surface.
At the bedside were two emergency physicians, an emergency medicine resident (specialist in training,) and two pediatricians. In addition, there were nurses, emergency department technicians, clerks, radiology technicians, and other curious staff. At one point, I counted thirty-two people in the room. I then walked out into the hall and counted sixteen more there, mostly cops and paramedics. You can imagine what a crazy scene that is and that nothing else was going on in any other part of the emergency department.
The team worked well together but, in spite of all of their efforts, there was no response and no signs of life. The resuscitative efforts were ended. That left the emergency physicians with the painful job of telling the family their baby was dead, which is one of the hardest things we ever have to do.
After the shift ended, those caring for the baby had a debriefing session where they could talk about things a bit and make sure everyone was OK. Since we almost never find that necessary, this illustrates how unusual and stressful a baby’s death is for us in the emergency department.
In deaths that are obviously from natural causes, we encourage family members to come see the patient before the body is carried off to the morgue. But in situations like this, there is always the suspicion of non-accidental death so the police treat everything like a crime scene. They won’t let any family members near the baby. That makes it really hard for the family and also for staff to start to come to a resolution. It is really tough.
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Comments (4)
Ruth Anne
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Tad,
Your description of 32 health professionals and 16 first responders fiercely focused on the life of one baby is like a surreal scene where the chaotic and frantic sounds fade away as you, a veteran ER physician, absorb the impact and emotion of your colleagues’ efforts.
My admiration for you and the staff who have dedicated your lives to save others; and I’m hopeful each one can receive comfort and reassurance when the situation is beyond medical and mortal intervention. Please share this comment with any who might need it.
And sadness for the baby’s family.
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Tad
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Thanks for the nice comments. I didn’t know if I was able to do adequate job of passing on the feeling that was present.
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Kim
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Tad, was an autopsy done on this little baby to tell the cause of death. One of my most memorable cases as a nursing student was when I was rotating through the ED. A 4 month old came in with SIDS. My instructor asked if I wanted to go look at the baby. Everyone was gone out of the ED room by this point; it was just me and my instructor. I was a little treppidatous as you might imagine. I had Alex at home around the same age. I was surprised to find the corpse looking like a doll. The spirit was obviously gone, leaving only the shell of a baby, a cold little body. She appeared like a translucent grey, stiff doll. So very tragic for the parents!! I love your newest bags. I’m afraid they will show the dirt more than your colorful ones though. You are so creative. Mom indicated you’ve picked up the cello. We love hearing Emma play the cello in the house. Even the “bum” notes sound great! Please keep sharing all your talents with us!! How about sending a video once in a while??
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Tad
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I have no idea about an autopsy. I just went to work and had nothing more to do with the case. As is kind of the way we live in the ED.
Thanks for your nice comments. You want a video of me playing the cello? You must be a glutton for punishment. Isn’t one beginning cello, scratching away, enough for you?
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