Friday, August 06, 2004

"Let's Just Change Stethoscopes"

I had just gotten to Casa for my second stint there (I had been there in 1993, but returned in 2002) and was just on my first shift as an Intern (under a Certified Midwife). The baby had been born and I was in doing vitals and the kid was clearly in respiratory distress. Tachypnea (fast breathing), retractions (the chest caving in), and nasal flaring (the nostrils spreading wide with breaths)... all signs of respiratory distress when, if left alone, can cause a baby to crash.

I snatched up the baby and took him to the midwife on duty who looked at the baby... took my stethoscope (a Littman, top of the line cardiac stethoscope) and listened to the baby. She heard the rattles I did in this baby's lungs... counted the respirations as incredibly fast... but just said, "Let him nurse, he'll be fine" and pushed him back to me. I was a tad distressed and blinked my disbelief at her.

Another hour went by (I never left the baby's side) and now the child was grunting (audible struggling for breath) and I took him back to the midwife. She took my Littman and listened and then said, "Get me a sethoscope from the room" and, confused, I told her this was a Littman... that she would hear much better with this than the $15 ones in the rooms. She said she knew what she wanted, to go get it. So I did.

When she listened with the $15 stethoscope, she couldn't hear the rattles or the grunting anymore (she said). "That's better! He's fine. Take him to his mom." I couldn't believe what I was hearing.

The baby did get better with time and oxygen (that I begged another midwife to let me use on the baby), but it was frightening watching a baby struggle for breath that way.

I am still amazed at the desire of some people for inaction in the face of danger or necessity... just to cover their butts.

1 comment:

Anonymous said...

not ideal but the other option may have caused the mother and baby to be seperated
reductions in resp distress in neonates have been identified with the use of skin to skin contact, o2 can be applied while the mother holds her baby