Day 3 in Chicaman/Uspantan. Neonatal Resuscitation and the Golden Stethoscope Award.

Day 3 in Chicaman/Uspantan. Neonatal Resuscitation and the Golden Stethoscope Award.

Dana, Lisa and Bianca teaching the steps and cadence of 1-2-Breath

Notice the bag and mask!

 Today was another great day, filled with the resuscitation of many infant mannequins.  We started with a review of yesterday’s content, and then moved on to the subject of the day: helping babies breathe!  Dana asked all of the students to close their eyes, and for each of them to imagine that she (or he) was the attendant at a birth, and because she had the skills to resuscitate a newborn, the baby survived.

Dr. Abel & baby skin to skin

We talked about how they prepare for each birth in the places they work -: gathering equipment and identifying a space and a helper in case a resuscitation is necessary.  We practiced caring for babies during “The Golden Minute” – keeping them warm and making sure that they are breathing - if not, we start ventilation by the end of that first golden minute after birth.

After a mid-morning “light snack” of café con leche, platanos  maduros fritos AND tostados with chicken(!), the lovely Roberta returned for her final performance of the trip.  This time the poor women had a shoulder dystocia – resolved with the Gaskin Maneuver – AND her infant wasn’t breathing at birth, so Dana led a successful resuscitation with assistance from the group.  Then we taught the waltz. 

Now it was time to put it all together

No, really.  It turns out that the triple meter timing of the waltz can help us to time the “breaths” given to a newborn baby who isn’t breathing.  We count: 1-2-3, and give the baby a breath each time we count “1”, which results in about 40 breaths per minute – perfect!  Bob even downloaded the famous blue danube waltz, and together with our students we counted 1-2-3 as we swirled around our salon.  With the strains of the blue danube still in our heads, we practiced with the ambu bags, squeezing the bag on “1” and watching for the baby’s chest to rise.   

Neonatal Resuscitation La Liga Match - Barca vs. Real Madrid.

Everyone took turns working through different resuscitation scenarios – sometimes the baby started to breathe soon after birth, other times the baby required chest compressions and/or many long minutes of ventilation.

We employed a game of our own invention – el bebe caliente (the hot baby) – to select “volunteers” to bring to life the scenarios that our very creative Bob Gobbo had written for his actors/students.  One patient had a postpartum hemorrhage and a baby that needed extensive resuscitation – 2 simultaneous emergencies that required multiple additional assistants to join the initial delivery team. Another patient had a stillbirth, and gave us the opportunity to discuss how to best support the woman and her family when this happens. Yet another had her baby in a “tuk tuk”, and carried her limp baby into the hospital, with the umbilical cord still hanging from beneath her dress.  The students blew us away – not just with their resuscitation abilities, but with the enthusiasm they brought to their roles.

We ended the day with the much-anticipated selection of the recipient of the golden stethoscope award for best acting. The winner was determined by the volume of group applause, and the candidates were all so talented that we needed to select the top two to receive “tie-breaker applause”. In the end, the very deserving Veronika narrowly defeated her colleague Dr Mario Lopez, and accepted the coveted prize. (Picture not yet available)

Tomorrow, we head out into the field to evaluate our students on the job.  Lisa and Bob will be at the hospital in Uspantan, Laurie will be at the CAP in Chicaman, and Dana will take the long drive to the San Sebastian health post.  We can’t wait to see these brilliant nurses and doctors putting their talleres to work!

Hasta Manana.

Lisa “La Colibri” Arnold.