Regional doctors shined, times three

Published 12:40 am Thursday, June 5, 2008

I was recently paged 911 to the Riverland emergency room because a patient of Dr. Kumi’s — for whom I am taking calls — came to their E.R. saying, “My baby is coming!”

She also said that she was six months pregnant with triplets.

I would have had trouble believing this except before Dr. Kofi Kumi left for Ghana he told me that he had a patient with triplets that was about 25 weeks estimated gestational age. She had been doing well, and hopefully I wouldn’t hear from her while he was gone. Surprise!

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Unfortunately, she was in advanced pre-term labor. Arrangements had already been made for her to be transferred immediately to Natchez Regional Medical Center via ambulance, and I agreed to accept her in transfer.

I notified labor and delivery of the situation and told them to gather the troops. L&D notified the nursery, the pediatricians, anesthesia, the operating room crew, and respiratory therapy. The news spread like wildfire and everyone began getting prepared.

For those who are not in the healthcare field, 25 week triplets that are about to deliver unexpectedly and just on the brink of survival is one of the highest risk obstetrical and pediatric problems you can imagine, even in a metropolitan tertiary care center. You realistically need about a week to get everything and everybody ready, and we literally had minutes.

On arrival the situation described was confirmed and a quick ultrasound confirmed triplets all with good heart rates, except the one coming out was having decelerations (a drop in heart rate which can be a sign of distress). While I was assessing the patient, the L&D nurses, the operating room crew, the lab technicians and anesthesia were getting the patient ready for C-section. I don’t know where all the help came from. There were senior level-management nurses that had come from all over helping get the patient and the nursery ready. Dr. Danita Weary and Dr. Jennifer Russ were present and were discussing with the nursery nurses and respiratory techs where each infant would go, what ventilators would be used, etc.

The patient and the mother were quickly informed of what was happening, and the very real chance of a poor outcome for the triplets. Jodi Starr, an excellent nurse anesthetist at NRMC, quickly anesthetized the patient while the rest of the operating room crew got the patient ready for surgery in record time. We then rapidly performed a C-section, delivering the three tiny infants. They were squirming and gasping for air with their premature lungs as they each struggled for life. The first infant was a little girl that weighed one and one half pounds and was halfway through the birth canal on her way out, feet first. I told the nurses that was just like a women to be impatient, cause problems and try to be first. They responded that the boys were probably pushing her out. The two boys came easily, both weighing one pound 6 ounces, and each was handed off one by one to the awaiting pediatricians.

The C-section was the easy part. The magic began when the infants were rushed to the nursery. Dr. Weary and Dr. Russ were incredible. They stayed cool and calm in a situation that would have been easily overwhelming to many. They orchestrated an amazing resuscitation effort. Each tiny infant, with the assistance of the nursery nurses, respiratory therapist, x-ray technicians, and lab technicians was intubated, placed on a ventilator, had IV access obtained with umbilical artery catheters, and monitored with EKG, Pulse Oximeter, blood pressure and temperature monitors.

When I came out of the operating room to see if any of the triplets had made it and to offer to help in anyway, I was amazed at what I saw. The last infant had just been intubated and the tube was being secured in place. At each of the three stations there must have been four to five health care members attending each tiny infant and harmoniously and frantically working to save there lives. It was an incredible sight to witness. A feeling of pride swept over me for being part of this 30-plus member team that had come together to attempt a miracle.

I then went from station to station and to my astonishment each tiny infant was not only alive but had oxygen saturations of 100 percent and was as stable as you could have wished for in 25 week triplets that were roughly one and one half pounds each. The team continued to work diligently over the next several hours systematically stabilizing the triplets and getting them ready for transfer. Later in the day, the University of Mississippi helicopter landed on the new helipad behind the hospital and the three little tiny lives were air lifted to UMC Neonatal Intensive Care Unit in stable condition and doing well. It needs to be known that the doctors and staff of NRMC insist on this level of excellent care and in no way will allow the financial condition of the hospital to affect how we care for our patients.

Dr. Weary, Dr. Russ, and the entire NRMC staff should be commended on a job excellently done. They are truly gifted individuals and give excellent, compassionate care to their patients. They are also a quiet, meek group and if I would have not shared this event you would likely never hear about it. Everyone hears about who won the last big game or the last election, but not of the miraculous outcomes or our team. To these guys it is just another day at work, and the real reason we chose this profession.

I appreciate and thank everyone involved, and am proud to have worked by your side.

Frank Guedon, M.D., is a obstetrician and gynecologist.