Last night we had a patient in labor and delivery with a history of shoulder dystocia. Shoulder dystocia is an obstetric emergency that occurs when the baby's head is delivered, and then the shoulders get stuck. This situation is life-threatening for the fetus, due to the compression of the umbilical cord.
Anyway, we knew this patient was at risk for this problem again, so everyone was on high alert all night. I was with my attending with another patient when we heard the alarm, and we ran to this patient's room, along with like 10 other people. The head was out but the shoulders were stuck. I did what any smart medical student would do, which is stay out of the way, but try to find a strategic spot where you can still see what's going on. Since midwives perform most of the deliveries here in Sweden, as long as there's not a problem, most women will never see a doctor. Shoulder dystocia, however, is obviously a problem, so the OB took over. There were two midwives holding the patient's legs back, a nurse going through a checklist systematically to make sure everyone was following protocol, and one midwife applying suprapubic pressure to try to manually push the anterior shoulder out. The patient needed an episiotomy too, but after another minute or so, the pressure worked and the OB delivered the baby. The baby had some trouble breathing for a few minutes but was completely fine.
Meanwhile, I'm standing in a corner, watching all of this. Watching the mom scream, the dad look completely terrified, the OB leading the team, and the nurse checking to make sure everyone was doing things in the correct order. It is amazing to see situations like this. Within 2 minutes, approximately 5 extra people were in the room, the baby was delivered safely, and the NICU team had arrived. Protocols are designed so that when situations like this occur, everything works like a well-oiled machine. I've seen it work in the trauma room, and I saw it again last night. It's truly awe-inspiring to witness these situations. Everyone worked together, and did exactly what they were supposed to do, and saved that baby.
Anyway, we knew this patient was at risk for this problem again, so everyone was on high alert all night. I was with my attending with another patient when we heard the alarm, and we ran to this patient's room, along with like 10 other people. The head was out but the shoulders were stuck. I did what any smart medical student would do, which is stay out of the way, but try to find a strategic spot where you can still see what's going on. Since midwives perform most of the deliveries here in Sweden, as long as there's not a problem, most women will never see a doctor. Shoulder dystocia, however, is obviously a problem, so the OB took over. There were two midwives holding the patient's legs back, a nurse going through a checklist systematically to make sure everyone was following protocol, and one midwife applying suprapubic pressure to try to manually push the anterior shoulder out. The patient needed an episiotomy too, but after another minute or so, the pressure worked and the OB delivered the baby. The baby had some trouble breathing for a few minutes but was completely fine.
Meanwhile, I'm standing in a corner, watching all of this. Watching the mom scream, the dad look completely terrified, the OB leading the team, and the nurse checking to make sure everyone was doing things in the correct order. It is amazing to see situations like this. Within 2 minutes, approximately 5 extra people were in the room, the baby was delivered safely, and the NICU team had arrived. Protocols are designed so that when situations like this occur, everything works like a well-oiled machine. I've seen it work in the trauma room, and I saw it again last night. It's truly awe-inspiring to witness these situations. Everyone worked together, and did exactly what they were supposed to do, and saved that baby.
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