Disaster averted

Admittedly, the portion of paramedic school that covered the care of the newborn was short. We didn’t learn much aside from managing either a perfectly normal baby, or a baby that was terribly abnormal.

A friend of mine was relating a story recently. He was telling me about a call he ran that morning in which a mother delivered a baby at home. Apparently the mother wanted a home birth, but the HMO’s obstetrician insisted the baby be transported to the hospital after delivery, going so far as calling 911 for the new parents.

My friend Jeff* was explaining that he arrived a few minutes after the local first responders, and walked into the house about 5 minutes after they did. The first responders apparently cheated by having a station less than half a block away from the house, and also cheated by having their vehicle parked outside, doing their morning truck check-off when the call came in.

Jeff was saying he walked into the house to find a first responder putting the finishing touches on an IV that they had established on the baby. The IV that was established before any vitals were obtained. With the exception of a heelstick glucose.

He mentioned that the baby appeared “completely normal and content.” The parents had already given the baby a cursory bath, and clamped and cut the umbilical cord. The baby was born about 15 minutes before Jeff walked in. The baby was full-term, but had not begun feeding yet.

He didn’t say what the cord was clamped with, and I should have asked.

Another first responder on scene was holding an ampule of dextrose. Not D5 or D10. Not even D25.

D50.

The baby’s heelstick glucose was 49.

They were about to administer, according to Jeff, “half an amp of D50 through a 24 gauge IV of saline.” Until they were stopped by my friend.

The first responder who was about to administer the dextrose had recently finished paramedic school. One would think he would know better, but he wasn’t taught.

Who is responsible for errors when the paramedics that we put on the street ‘don’t know what they don’t know?’

 

*Not his real name, of course.

Comments

  1. In my entire 34 year active career in EMS, over 22 of that as a paramedic, I’ve never heard of anything like this. I’ve never once thought of doing a glucose level on a newborn that had a normal APGAR. I’ve never done an IV on a newborn or seen a need to. I don’t even know if I’ve done one on a mother outside of clinicals in the hospital when I was in paramedics school.

    Jeff showed much restraint, more than I could have under those circumstances. I’d probably be out of a job.

    This was malpractice, pure and simple.

    If I were doing a QA review on this, it would be flagged for MD review. In fact, it might be flagged for referral to the state EMS agency for possible revocation proceedings.

    This is incompetence, pure and simple.

  2. Student Paramed says:

    Like my name says, I’m a student. I (theoretically) know how to catch and perform baby CPR. Never seen a real birth, can barely remember how to do an APGAR.

    But WTF???

    Not being taught is NO EXCUSE. What ever happened performing a patient survey before treatment? Vital signs? What was his rational of GIVING A NEWBORN an IV??? And planning the Dextrose????

    Maybe things are different on the other side of the pond. Maybe he is just stupid. I just hope he never treats me.

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