Death of a baby

Last night I ran the resuscitation effort for a baby who died. This was my first time being in charge and directing the resuscitation efforts, and responsible for the outcome. The baby was well during the labour and there were no hints ahead of time that there was any problem. All the ultrasounds were normal, and as far as anyone knew this would be a routine, happy, normal delivery.

The baby was born still, pale and not breathing. She had a very slow heart rate, which bag and mask ventilation did not improve. I arrived about six minutes later, and nothing had improved. I intubated the baby, and with the improved ventilation the heart rate improved somewhat, but there was no improvement in colour or responsiveness. We rushed the baby to the nursery, with only a word to the mother to imply that all was not well, but we were doing our best.

For a further 90 minutes we did our best - we gave fluid, sugar, blood, bicarbonate, adrenaline and when nothing worked, we gave it all again, and again. Every time we stopped the CPR there would be a transient heart beat which fell away, and stopped. Finally it became obvious that nothing we were doing was making any difference, so we stopped. The parents were called in to hold their child briefly. The baby was declared dead five minutes later.

I suppose this is part of medicine too. Trying and failing. Death is common at the extremes of life, and sometimes these things happen. Life isn't fair. I can't help wondering - was it my fault? Is there anything I should have done differently, or more, or better? Platitudes aside, I really did do my best. I hope the post-mortem finds a reason - everyone feels better when there is a reason for something like this.