There are few things as miraculous as a newborn’s first gulp of oxygen, yet nothing more frightening for parents when that moment doesn’t come as quickly as it should.
It was just one minute into a brand new day, December 10, 2010, when E.J. (Elliott-James David Hastings) was born at Orillia Soldiers’ Memorial Hospital (OSMH) to parents Krista and Brent Hastings of Orillia. The birth had dual significance for the couple who already had seven children from previous marriages – all daughters ranging in age from six to 16 years old. This was not only the first child together for the couple, but also the first boy.
Aside from an ultrasound indicating that the baby was a bit larger than normal, estimated to be about 6 pounds and 6 ounces at 34 weeks gestation, Krista’s fourth pregnancy was progressing normally. Dr. Becky Van Iersel, Krista’s family physician, was tracking her closely and consulting obstetricians along the way.
However, with her husband and mother in the delivery room, the anticipated elation of E.J.’s arrival was momentarily replaced by sudden fear and uncertainty.
“Once I pushed him out, I knew immediately that something was wrong,” said Krista, pausing momentarily to compose herself as she recounts the story. “It was very scary. He came out and he was purply-blue, and he just flopped onto the table.”
While the family watched in desperation, the obstetrical team quickly responded with a series of interventions to get E.J. breathing on his own.
The first step in neonatal resuscitation is to physically stimulate the infant to encourage breathing. If that doesn’t work, positive pressure ventilation (PPV) will begin, which involves squeezing air into a patient’s lungs using a respirator bag, which if still unsuccessful would be followed by chest compressions.
“E.J. received stimulation, PPV and then approximately one minute of chest compressions before responding to those interventions,” said Dr. Van Iersel.
The process was relatively quick but to Krista and her family, it seemed ‘like an hour’.
“We were just in shock watching it all happen and scared until they finally started saying, ‘he’s coming around, he’s coming around’, so then the compressions stopped and she stopped bagging him.”
A few moments later, E.J. was wrapped in blankets and brought to Krista to hold. After a quick cuddle, Krista was anxious for her newborn son to return to the arms of the professionals who ensured a safe and healthy arrival.
“I’m always impressed by the speed and coordination of the resuscitative team in those first few moments of an emergency,” said Dr. Van Iersel. “The majority of the time, the birth process is a joyous and natural event. When things are unexpected it is reassuring to know we have such a responsive team here at Soldiers’.”
E.J. checked in at a healthy 9 pounds, 2 ounces, and 22.5 inches long, and since his arrival, mom says he’s been growing ‘like a weed’. For Krista and Brent, eight truly is enough and the family is grateful to the team of medical professionals for delivering E.J. to his sisters.
“I’ve always trusted Soldiers’ and their obstetrics ward. I’ve put my full trust in them and I’ve been looked after extremely well. They have always given me and my family the highest quality of care and for that, I’m forever grateful.”
Up to ten per cent of newborns require some assistance at birth to begin and maintain normal breathing, while one per cent requires more aggressive action similar to what E.J. required.
“It’s why we insist that all of our nursing staff have their NRP training and certification (Neonatal Resuscitation Program) and we have a certified NRP instructor on site to ensure our staff are current and engaged in their clinical resuscitation skills,” explains Linda Adams, OSMH Program Director for Maternal, Child, Youth and Mental Health.
OSMH also completed the MOREOB Program to further enhance clinical skills. Managing Obstetrical Risk Efficiently, MOREOB is a comprehensive, three-year, patient safety, professional development, and performance improvement program for caregivers and administrators in hospital obstetrics units.