News at NCH
Straight Talk - "Miracles, Part Two"

February 27, 2014

Dear Friends and Colleagues,

Last week, we began the story of the heroic efforts of NCH’s Birth Place team to save the lives of an expectant mother, in sudden cardiac arrest, and her baby.

After miraculously stabilizing the newborn, the attention of Drs. Wally McLean and Tom Cook and their team turned to the immediate diagnosis needed to save the life of the child’s mother. Immediately, the doctors and CRNA Wendy Sparks compressed the chest and ventilated the patient. Blood flow was restored, and heart and lungs were again working. Fortunately, both physicians rely on years of clinical acumen—anesthesiologist Dr. Cook teaches at the Wolford School of Nurse Anesthesia—and they never hesitated.

Next, Critical Care Physicians Drs. Ismael Martin and Bruce Roy were consulted. Dr. Martin did a stat bedside ultrasound, ordered a brain CT, consulted with colleagues, and made the diagnosis. Everyone acted quickly with the ICU team to cool the mother’s temperature to 93 degrees, minimizing damage caused by lack of oxygen.

The patient had suffered a serious complication of pregnancy, known as placenta abruption, combined with another uncommon pre-existing condition—a hole in her heart. While normally such an affliction can be dealt with and usually doesn’t cause any problems, in this case, there was an extraordinarily technical complication—an air embolus, caused by the placenta detaching prematurely, released air into the venous system which then traversed the hole in the heart, making its way to the coronary arteries and then to the brain.

One significant remaining problem: Air in the circulation system to the brain. This is a similar to the condition deep sea divers develop if they stay under water too long and surface too quickly. Social worker Cathy Watt along with Dr. Roy spent the next eight hours locating a hyperbaric chamber to remove the air from the brain. At midnight, Florida Hospital in Orlando graciously accepted the patient, but weather necessitated ground transportation. Crystal Correll from Ambitrans safely drove through the fog with lights and sirens. Shortly thereafter, the mom was successfully “dived,” air was dissolved from her brain, and she was returned to the ICU at North Naples Hospital. The ICU nurses asked Mother and Baby Nurses to assist in another OB patient’s assessments and care. Two Mother-Baby nurses walked over to ICU, and Mother-Baby RN Robin Tucker picks up the story:

“As Ramona Council and Debbie Craig walked over to the ICU they saw a man crying. He said he was the husband of this post-partum patient, who had been admitted to the ICU after a devastating cardiac arrest. Debbie and Ramona comforted this man and prayed with him. Ramona and Debbie said it was a ‘coincidence’ that they were in the vicinity when needed, but I believe it was God's will that two of our most compassionate nurses were there to meet his critical need. They are such wonderful nurses!” Our Chaplaincy team represented by Brian Doyle prayed with the father also.

The mother is home. Her condition may require further attention. Her baby is normal and has been at home with the dad. It is nothing short of a miracle that mother and baby survived, due to the remarkable efforts of an immensely talented and compassionate team.

NCH, the only obstetrical service in Collier County, will this year deliver 3,300 babies. We care for 83% of all newborns in Collier County. 81% of the newborns needing a higher level of care stay close to home in NCH’s Neonatal ICU. We will also care for 74% of all the pediatric patients from Collier County needing hospitalization. Observers often debate whether high volume, local, centralized critical services really make a difference. The miraculous story of this mother and her baby ought to answer that question definitively.

Respectfully,

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

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