VAD

Sunday... I was not meant to be on call at all, I just had my last call on Friday, so being on call on Sunday would be very tiring. Initially, I was supposed to send my patient to HKL for the VP shunt surgery on Sunday, that makes my working hours really short, so I booked a facial at 5pm on Sunday. Luck was not on my side, well, that was what I thought at first, as soon as I stepped out of my car, my friend called me and said that I had to replace her call since her daughter is unwell and she wishes to be home. I was obliged to turn down her request because last week, she replaced me when I on leave due to my flu.

Anyway, I didn't start my day with enthusiasm like any other day, I just hated that feeling. Feelings like this really affects my work, I didn't get to insert any branulas! So I called up my husband, my mum and my dad... they consoled me well, I was feeling better after speaking to them. What made me feel even better was when my MO asked me to go the labour room and stand by for a vacuum-assisted delivery (VAD), as she was doing the UAC procedure. Before I left, she just told me what to do if the baby comes out flat. As soon as I got to the labour room, I heard the nurses and the doctors saying, "teran, teran... ," bla bla bla, all the depressing words, as if they were telling off the mother for not pushing correctly. I certainly wouldn't want to hear those kind of instructions when I am in labour! But anyhow, I guess they were to get their job done well.

The sound of the vacuum was loud, it was my first time seeing a VAD, it was an experience. I told the O&G team MO that I am still new, and I haven't completed my NRP (Neonatal Resuscitation Program) course yet! I was praying hard that the baby comes out vigorous... and thank God, as soon as the head came out, followed my the body, the baby cried, Apgar score 9/10/10. That was a relief, no resuscitation needed. The next challenge was, should I admit the baby to the NICU or not. Seemed like he had a boggy swelling... SAH (subaponeurotic hemorrhage), and this needs admission. But at the same time, it could just be a caput, the swelling wasn't tender. So I ran back to the NICU and asked my MO, she said that if I wasn't sure, it'll be better if I admit the patient to the ward... and so we did. And here is what the baby looks like after 16 hours of life. The head is asymmetrical, the parietal region was a bit edematous, it was from the vacuum... poor boy. He also had capillary hemangioma over his forehead. Luckily he was admitted, it was SAH. So 3 days of vitamin K will do him good!

I went to the labour room twice that day, the second case was for respiratory distress case. The newborn was found to be tachypneic and was grunting at 30 minutes of life. We put him under headbox and he was still tachypneic... and again, I admitted the patient to the NICU. And now, he is just completing his course of C-Penicillin and Gentamicin and is already well. So happy for him.

Ok.. have to go to sleep now. I hope I have a less hectic call this Saturday!