Things you hope never happen

A long time ago in a hospital far, far away.

It was January, the temperature was approaching zero and it was snowing like hell. The ER I worked in was in a resort town that was all but deserted in the winter. There was a PA and myself and we had seen a grand total of seven patients so far that day.

It was after lunch. We had two patients in the department, a lady with vomiting getting IV fluids and waiting for lab results to rule out an appy and a little old man with chest pain that was waiting for an ambulance to transfer him to bigger hospital down the road to repair his broken hip. Both were sleeping and the PA and I were finishing up charting and charges.

A car pulled up to the ambulance dock and a man helped his heavily pregnant wife out of the car. I went out with a wheelchair to help them.

"My water broke and there is something hanging out of me, I think it might be the cord."

Oh my God. My heart almost stopped. We were a half an hour away from the closest hospital that did any kind of obstetrics and this was an obstetrical emergency. A half an hour in good weather and this was anything but.

We zipped into the ER and quickly got her up on the cart, stripping off her bottoms we saw that indeed there was cord protruding from her vagina. I helped her to get onto all fours with her bottom pointing into the air and the PA quickly slipped a sterile glove on and reached inside to push the babies head up off the cord to relieve the pressure and allow blood to flow to the baby. I grabbed the doppler and auscultated fetal heart tones which were 147, in the normal range. I placed an oxygen mask on the mom.

I stepped away to quickly call the supervisor to come and help. The PA couldn't move, if he took his hand away the fetal head would compress the cord cutting off the flow of blood and oxygen. She needed a c-section right away and our hospital couldn't do one. The general surgeon arrived and discussed the options with the parents, The elected to try for a transfer to the other hospital as long as things looked OK. The fetal heart rate remained reassuring.

Thank goodness the transfer went without a hitch, the PA had to go and the surgeon also went in case he was needed, the nursing supervisor had OB experience so she rode up front in case the baby delivered.. The other hospital was alerted and was on full standby, the patient was in the OR within 5 minutes of her arrival where they delivered a healthy baby boy via c-section without incident.

I don't think I've been that scared since.