30 Something Baby Doc

I was on 2nd call a week ago and one of my high anxiety patients came in for active labor. Since I was on 2nd call (ie.. sleeping all night...unlike the poor bastard on 1st call), I was trying to keep a low profile. The patient's mother caught me sneaking thru the labor and delivery unit trying to get to my call room. She was very excited and asked if I would be involved in her daughter's delivery and of course I said yes.

Unfortunately the patient had a long difficult labor, developed a high fever and stalled out after only dilating to 6cm. We made the decision to perform a cesarean section. The patient started crying hysterically. I did my best to calm the patient and assure her that everything would be OK.

We took the patient back to the operating room. The patient already had an epidural for anesthesia, therefore she was awake for the procedure. Her mother was also allowed to be in the OR. I scrubbed with the OB resident and we draped the patient in preparation for surgery. I made the incision and the surgery was progressing well.

Suddenly the patient became unresponsive started shaking uncontrollably. The anesthesiologist (who was a 2nd year resident) immediately shouted loudly, " Something's Wrong!!!!....I need help now!!!" I looked at the monitors and all the patients vital signs were normal. I asked the anesthesiologist if the episode was anxiety related and I continued with the surgery. The resident continued to call for help " Get my staff here, get anyone!!!). The patient's mother became very upset ,screaming" What's wrong!". The nurse had to escort her from the OR. The nurses then started running around the OR frantically making phones calls etc. Even the OB resident I was operating with was starting to shake and become nervous.

I asked the anesthesia resident to assess the patient's vital again but I think he just wasn't hearing me.

We quickly delivered the baby thru the incision and the baby started crying immediately. The patients episode quickly resolved and she again became responsive. By that time every anesthesiologist in the hospital showed up in the OR. It turned out to be just an anxiety attack.

I don't disagree with calling for help when you feel a situation is over your head, but panicking tends to be very counter productive especially when it distracts you from objectively evaluating the patient in a code situation.

Am I afraid in these situations?? Hell Yeah I am!!! (we had a patient go into cardiac arrest a few months ago under similar circumstances)

But as a team leader you have to stay calm, if not, everyone will panic....and that sucks.