Straight Talk - "Miracles, Part One"

February 20, 2014

Dear Friends and Colleagues,

It is not an overstatement to say that at NCH, we perform “miracles.”

Wonderful deeds in healthcare happen more often than you might expect. These stories don’t always start out well. This is one such story, so compelling and uplifting that I wanted to give due credit to all the caregivers involved. As a result, I’ll make this a rare Straight Talk two-parter, beginning this week and concluding next. The story speaks to why having local, centralized, high-volume, critical services makes a real difference. Of course I will respect the privacy of the patient and family involved; but all of the miraculous details here are true.

Early one recent Sunday afternoon, I received a cell phone call from Dr. Tom Cook, a senior anesthesiologist in town. He started practice about one year after me in 1978, and we have been friends since. Dr. Cook called to inform me of an incident from the day before, in the middle of Saturday afternoon, in the Labor and Delivery suite of The Birth Place on our North Naples Campus.

Dr. Cook told me that a woman was about to have her third child and was receiving a routine epidural anesthesia block to lessen the pain of childbirth when she went into sudden and unexpected cardiac arrest. Her lungs stopped first and then her heart. The baby was not yet born, still in the uterus, and would not be receiving oxygen from the mother. It was every OB/GYN’s worst nightmare.

The Certified Nurse Anesthetist, Wendy Sparks, along with Sybil Ashby, RN, immediately started successful cardiopulmonary resuscitation. Dr. Wally McLean, the longest practicing obstetrician on NCH’s staff, happened to be in the North Naples Hospital ER and was called instantly for a stat (super urgent) caesarian section. As the mother’s chest was being compressed and breathing supported by placing a tube in her airway, she was whisked into one of the three C-Section ORs (one is always available even when elective C-sections are being performed). There, the always-ready Labor & Delivery operating team started to assist Dr. McLean to save the baby.

Meanwhile, our 24/7/365 in-house neonatologist team, represented this day by Dr. Hugo Navarro, Ana Valle, RN and Rebecca Giberga, RN waited to resuscitate the baby, who was delivered in under five minutes by a team including Obstetrical OR scrub nurse Cathy Stevens, RN; circulation nurses Sara Marsino, RN and Sybil Ashby, RN; respiratory therapist Cynthia Flowers, RRT; and L&D RNs Nikki Fiore, RN, Jaci Sieben, RN, and Brooke Dubock, RN. All played an integral part in resuscitation, stabilization and facilitation of this emergency delivery, along with ICU RN Jeff Sander, RN, and RRT Julio Mendez, who mentored and coached the L&D team to perform at their optimum level.

At the same time, of course, we still had other Birth Place patients who needed care. Elizabeth Gonzalez, RN, and Alicia Brophy, RN, resumed care of all of the other laboring patients to assure their safety during this one difficult situation. Meanwhile, Jodie Jensen, Unit Secretary, dutifully monitored the desk and call bells as Administrative Coordinators Melody Bacon, RN and Michael Spence, RN facilitated all of the fast moving and critical clinical activities.

The new baby’s initial condition and Apgar scores were concerning. But in 10 minutes, the neonatal team had successfully placed the newborn on a respirator; this was removed after six hours, with the baby out of danger. But what of the baby’s mother, at this point still in precarious condition? What caused her cardiac arrest and how could she be saved? Those were the critical questions confronting Drs. Cook and McLean and the rest of the team. That diagnosis, which had to be made immediately, and the resulting treatments, will be the subject of next week’s Straight Talk.


Allen S. Weiss, M.D., President and CEO

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