Wednesday [Emergency and Critical Care]
- Walked into my shift where they were finishing up a C-section and every staff member was trying to revive a puppy. Unfortunately, due to a combination of circumstances, the puppies just weren’t doing well. There were 5 or 6 of them, some started out breathing but then they eventually gave up despite all efforts, including philtrum acupuncture [which I did running around with a bunch of 25 gauge needles to various puppies], Doxapram, and chest compressions.
- One little puppy was actually trying to hold on, though it wasn’t really breathing and it was extremely bradycardic. Our Criticalist took over, he actually intubated the minutes old puppy with our tiniest endotracheal tube, [he was going to put in a tiny tracheostomy but it was actually moving too much for that]. Then, he did the coolest thing I’ve ever seen, he put an IV catheter into the puppy’s umbilical stump. I didn’t even know you could do that, though it makes sense, it is a major vessel for the tiny thing. He could only fit a 24 guage in there, but it doesn’t mater, it was patent and he was able to deliver a dose of naloxone to reverse the sedation the mother had that was transferred to the puppies in-utero.
- I kept up with the tiny chest compressions [which is literally just squeezing it’s little chest with your thumb and forefinger] and eventually the heart picked up on it’s own. An hour later it’s heart rate was about 140, it was extubated, squealing like a puppy and the IV was out. Two hours later it was drinking formula from a bottle.
- Unfortunately, the time it was in a severe hypoxic state may have been too much for it because less than 24 hours later it deteriorated and died. But we tried, and for a while, it appeared to be a normal healthy puppy.
- Here is a photo I took with a friend/co-worker’s phone of the puppy still intubated, after it’s own heart had taken over and with the IV still in. I really need to start bringing my camera to work.