- [Voiceover] Okay.
- Is everything okay?
- [Voiceover] Mom, it looks like she's having
a little harder time breathing.
I'm going to call for some help.
I need some help in here.
- Okay. Hi I'm Liz, I'm the NICU fellow ten,
what's going on?
- [Voiceover] Liz, this is Raven she's Thaddeus
post cardiac surgery now, x-rays this morning.
I'm having some respiratory distress.
- [Voiceover] It looks like we have tractor 67 standpoints.
Start bagging? - [Voiceover] Yes.
- [Voiceover] Maneuver it and (mumbles)
and the bag towards you.
- [Voiceover] I'm going to put an end tight on.
(nurses speaking at once)
- [Voiceover] Who's the team leader?
- [Voiceover] I'm the team leader, Lee Ann.
- They're worried about her saturations.
- [Voiceover] Having a hard time bagging, Liz.
- [Voiceover] All right, I'm not seeing any stats.
- [Voiceover] I have decreased breath sounds.
(nurses speaking at once)
- [Voiceover] (mumbles) Let's do two-handed bagging.
- [Voiceover] Is there any pulse?
- [Voiceover] We're becoming more Bradycardic.
- Let's start chest compressions.
Can we get a backboard?
And stool, and the ZOLL?
What we're gonna try to do is put the backboard
and the ZOLL on the back at the same time.
Continue compressions.
- [Voiceover] It seems she's not getting a good
blood pressure on her.
- [Voiceover] Backboard ready.
- [Voiceover] Put this backboard underneath her.
- Okay, one, two, three, roll.
- [Voiceover] Hey Liz, I'm Doctor Valar, (mumbles).
What's going on?
- So, right now we're in respiratory distress.
We became hypoxic, and now we are Bradycardic.
We have no pulse, we're doing compressions.
We're going to try to put in the airway.
Actually, can you hand me intubation material?
- [Voiceover] Yeah sure.
Kate, do you mind being QC their leader there?
- [Kate] Yeah, I can watch.
- All right, it looks like our heart rate's still 45.
We're still hypoxic, anymore,
any ability to move the airway?
- [Voiceover] I'm still having trouble moving the air.
- [Voiceover] We're not getting good
blood pressures right now,
so if you could press a little bit harder and faster,
our goal is to have our diastolic blood pressures
about 25, and right now it's six.
So I need you to press real hard and real fast.
Our End-Tidal, however, is pretty good.
Well, it was 21 and now it's 21 again.
So that's a good sign.
- All right, continue
compressions. - [Voiceover] Your
diastolic blood pressures have come up a little bit.
- [Voiceover] I'm going to take a look at what you're doing.
- [Voiceover] Keep on compressing, this whole time
I'm just trying to intubate, okay Nikki?
- [Voiceover] All right, you guys see the cords?
- [Voiceover] You're doing a great job, your diastolics
are at 26, which is what we were wanting.
- Can someone take a listen?
- [Voiceover] Nikki.
- [Voiceover] I'm ready here, switch.
- [Voiceover] Just wait they've confirmed--
- Do we have entitle? We have End-Tidal's 21.
- [Voiceover] I have equal breath sounds.
- Our heart rate's still 39.
Stats are in the 60's.
Kate, can you update me on where we are with CPR?
- [Kate] Yes, and Nikki's, continue to compress Nikki,
now that we have an airway in place, you can just
continue compressing continuously about a hundred.
Sam, if you could bust it up six times a minute?
First we need to switch compressors.
So, why don't you guys switch real quickly.
Our heart rate's now in the 140's, stats are improved
75, our diastolic blood pressure is improved,
compressions at around 30 and our End-Tidal is 22.
- All right, sounds like we're still
having issues with hypertension.
We could take a pause in our compressions
and see if we have a pulse.
- [Voiceover] I don't feel a pulse.
- [Voiceover] All right, resume compressions.
So we have a PA arrest right now.
What we're going to need to do is get EPI available.
- [Voiceover] I have a dose of EPI ready.
- [Voiceover] Let's give a dose of EPI.
- [Voiceover] Who's giving the meds?
- [Voiceover] Use EPI and a flush.
- [Voiceover] Are you okay? Do you want to--
- [Voiceover] Can you tell me what's going on?
- [Voiceover] Our blood pressure's 46 over 28.
Our stats are still in the 70's,
our heart rate's better, it's 160's.
- [Voiceover] EPI's in. - [Voiceover] EPI's in, great.
Do we need to switch compressors yet?
- [Voiceover] They need to switch.
- [Voiceover] Is it beating again?
- [Voiceover] All right, it looks like
our blood pressure's improved, we're 86 over 37.
Our stats are coming up.
And our heart rate's great.
Our End-Tidal's in the 50's.
Great job guys.
Yeah, let's stop compressions.
Check her pulse. - [Voiceover] Okay.
- Strong pulse. - [Voiceover] Okay.
- [Voiceover] Anything else?
- Wrap it up. - [Voiceover] Oh sure.
All right, great.
So good job guys.
To summarize, we came in, we were in respiratory arrest.
We were able to get a airway, but then we found out
we were in PA arrest, and gave a dose of EPI,
and we've recovered.
Our heart rate's in the 170's,
our stats are in the upper 90's, and our blood pressures
are 90's over 40's, and our End-Tidal's in the 40's.
Great job guys. (claps)