Already a mom of two, Green Cove Springs’ Lindsey Ford knew instinctively that something was wrong with her baby as soon as he was born on May 4, 2014. When the nurse laid her baby boy Munro on her chest, she could see that his lips and fingers were purplish-blue and unlike normal newborns, he wasn’t crying.
She expressed her concern to the nurse, but Ms. Ford said she was told that her son Munro’s symptoms were likely due to the room being unusually cold due to an A/C problem. “They said, ‘He’s OK’ and took him to the nursery, but Munro wouldn’t wake up for anything. He wouldn’t feed, he didn’t cry at all, and I knew something was wrong. I just knew.”
When Ms. Ford and her baby were sent home two days later, she watched Munro very carefully. “I set an alarm for every three hours to feed him because he never cried and never seemed hungry,” she remembered. “The first time he did cry was when he was five days old, when he started coughing up secretions and mucus.”
Only days later, while she was in line to pick up her five-year-old daughter from school, she was alarmed to hear Munro cry since it was so rare. “I looked back at him in his car seat and I saw secretions and mucus coming from his nose and mouth and he was having a hard time breathing,” said Ms. Ford. “I tried suctioning out the secretions with the bulb, but it wasn’t working, and then he stopped breathing. I gave him CPR and tried to get the secretions out with my mouth since the bulb wasn’t working.”
She drove as fast as she could to the house five minutes away because she was afraid Munro would stop breathing again and needed the baby’s Dad, Rody, to drive them to help. “I called my kids’ pediatrician in Middleburg, Dr. [Suwarna] Tilak, and when I told her his symptoms, she said, ‘Take him to the ER at Baptist Clay right now or he could die.’”
She remembered, “Rody drove us to Fleming Island. On the way, Munro stopped breathing again, so I did CPR on him and tried to clear his lungs of the secretions. He started breathing again, but then began to cry and started vomiting bile. I was afraid we were going to lose our baby!”
Ms. Ford said, “He said, ‘‘Don’t worry. We’re going to take good care of him.’ That was reassuring.”
Morrison and the family walked straight back to the pediatric resuscitation room with Munro, passing by pediatric emergency physician Shareen Ismail, MD, at the desk. “When I saw Jeremy’s face as he carried the baby back to the resuscitation room, I had no doubt he had good reason to be concerned.” Dr. Ismail followed Morrison to the room, as did nearly every nurse and clinical staff member in the ER.
Morrison said, “We each took our role to save Munro. We were calm and that helped make Mom calmer even though she was worried about her baby.”
Dr. Ismail gathered information from the mother about what was happening with Munro, as well as his birth history and her pregnancy history, in order to assess and treat the baby. She told Ms. Ford that the short periods of not breathing were a form of apnea that is not uncommon in newborns. However, if left untreated, it could lead to serious neurological effects. “We started with the least invasive treatment we could, placing a nasal canula to deliver a high flow rate of oxygen that can be extremely irritating to the baby, but also can stimulate him to wake up,” remembered Dr. Ismail. “It was clear in the first few minutes that this wasn’t making a difference.”
Dr. Ismail told Ms. Ford they needed to secure an airway to get Munro breathing and stable. “We first used the bag valve mask to get his oxygen level to 100% before we intubated him to get him breathing steadily.”
The baby started improving immediately. “Munro started fighting and kicking shortly afterward. It was clear he was a strong kid. It was a reassuring sign seeing his strength!” said Dr. Ismail. “I explained to Mom that Munro would need the special care of Wolfson Children’s Hospital to rule out a serious infection or a genetic condition that might be causing these periods of apnea. I also told her that the apnea could simply be caused by a very young brain that wasn’t sending signals to the body to regulate breathing, which was something he would likely outgrow.”
Baptist Clay Emergency Department Nurse Manager Tina Caraway, RN, BSN, who also took care of Munro, said, “While we worked on him, our staff had already alerted Wolfson’s Kids Kare Mobile ICU transport team to come to Baptist Clay to take Munro to Wolfson Children’s Hospital’s Pediatric Intensive Care Unit (PICU).”
Ms. Ford remembered, “The whole time we were at Baptist Clay, we were terrified and we were just asking the doctor and nurses question after question. They stayed calm and answered our questions and made us feel like things were going to be OK. Tina’s the one who started an IV in his tiny vein. Munro was crashing, and they stabilized him. He was dying, and they saved him.”
Once the Kids Kare Mobile ICU arrived, pediatric respiratory therapist Pete Mrgich, RRT, and pediatric critical care nurse Cathy Andersen, RN, worked on keeping Munro stable all the way to Wolfson Children’s Hospital, where he was taken to the Pediatric Intensive Care Unit (PICU).
“He was in PICU for two days and they ran all kinds of tests,” said Ms. Ford. “They did a spinal tap to check for meningitis and they did cultures and blood work on him that all came back normal. They did everything they could to rule out the most serious illnesses that could’ve caused this. By the third day, he was transferred to a regular unit because he had improved so much.”
Munro went home to his Green Cove Springs home May 15, healthy and happy, and with very relieved parents.
“I will never be able to thank the [the pediatric ER] team at Baptist Clay nor Wolfson Children’s Hospital enough for saving my baby,” said Ms. Ford. “And I’m so grateful to Dr. Tilak, who sent us to the Wolfson Children’s Hospital Emergency Department at Baptist Clay. If she hadn’t, I don’t think Munro would be alive today.”
Dr. Ismail said, “Caring for a child is very different than caring for an adult and we are very lucky to have a team that is specially trained and qualified to care for ill children. If you have a heart problem, you would want to be in the hands of a heart specialist. For a sick child, there are no better hands to be in than our pediatric emergency medicine specialists at the Wolfson Children’s ERs at Baptist Clay and in Jacksonville.”