Saturday, March 13, 2010

14 in 7

Does Friday night have an OB curse everywhere?! It's like a full moon...Friday nights have a reputation for being beyond crazy!! Walk in the door @ 1830 and there are no empty rooms...and the board is FULL of labors! Labors are means that they will get delivered and open up a room eventually...but they also can't be stacked up with one nurse, so it takes more nurses to take care of a board of labors over a board of antepartums. Still...I'd rather take labors anyday! Most of the labors were inductions hanging around from 0700, anywhere from 4-8cm.

First clue that maybe the night is gonna be full of surprises, in the midst of a pushing marathon a family member passes out, splits their head open and is unresponsive on the floor. It took 3 docs and multiple nurses calling down to ED to have them send a gurney up to get her. "Well...can you put her in a wheelchair and bring her down, we're busy." She's unconscious, we can't jus put her in a wheelchair and bring her down!! After a few minutes she woke up and after some stitches she came back up to see the new arrival :)

I started the baby cascae with a vag delivery about 2030, about 3 minutes of pushing. Yay!! I'd taken care of this mom on multiple antepartum admissions and it was fun to get to do her delivery to wrap up the pregnancy.

About 10min into her recovery I took a triage (to our only empty room. She was about 3/100 with a BBOW and contracting every 3min. In the midst of asking her admission questions she mentions "I'm scheduled for a C/S next week." Hmmm...maybe the fact that you're a repeat C/S x3 is something you should mention to the doctor on-call when they tell you to come in. Thankfully that doc was already in-house in the midst of a C/S, so we prepped and followed pretty quickly. Baby #2 for me!!

As soon as I come out of the OR we keep the OR's running and double up PACU recoveries. I headed back out to the battle field and took another labor patient from a nurse going home. This gal never really made leaps and bounds of change but she was hurting and contracting pretty frequently and wanted an epidural. The doctor wanted to AROM her, but I convinced her to let me get Mom comfortable before AROM.

Epidural went fine, and so the doc came in to AROM her. She was having quite a bit of bloody show, and when the doctor checked her there were several clots. The fluid with AROM appeared to be clear but we kept a pretty close watch on the bleeding. About 10min after AROM, heart tones started sliding. Turn, turn, O2, fluid bolus etc. No response. Doctor was sitting at the desk and she came in and put on a scalp lead. Still low heart tones. So to the back we run. No time for an epidural dose, so we had to sleep her. By the time we got to the OR heart tones were much better and we all breathed a little better. 7min from the time we left the labor room to delivery (including waiting for anes to put Mom to sleep) and less than 45sec from incision to delivery. Our manager was there working the floor with us and both she and the doctor said they were pretty impressed with how fast we moved. That was the most people I've ever seen in the OR at one time, but I'm so thankful for each one of them!! Baby came out only slightly stunned but did great and Mom was good afterwards. Pretty good size abbruption.

As a whole, we had 14 babies in 7hrs that night, and I had 3 of them. Needless to say...I slept like a LOG the next day! Funny thing too, I wasn't even originaly scheduled for that night, but had switched nights with someone else...That's one of those nights you don't forget!

Babies total: 80M/99F = 179
Vag:62M/76F = 138
C/S: 18M23F = 41
Babies 'caught' = 2f0.5m

1 comment:

  1. Can you send a little of your craziness out our way????? Our numbers are so low it is scary and ridiculous! Altho we are a much much smaller hospital than yours - deliveries of 1 - 2 every few days is unheard of even for us....