My Baby’s Not Breathing
The title of this post is probably number one on the list of “things call takers don’t want to hear”. Unfortunately, it was exactly how the call began.
“My baby’s not breathing,” said the panicked mother. “He’s blue and his face is covered in vomit… I think he’s choked on it!”
I asked for the address immediately. I wouldn’t have understood what she’d said but fortunately she was calling from a landline, so I could see her address. She lived on a dual carriageway. When you get a call to a dual carriageway, it’s important to find which carriageway the address is on, otherwise the ambulance may be sent from the wrong direction, meaning it has to go all the way up to the next junction, go round a roundabout and come back. Not a delay you want when you have a non-breathing baby.
The caller lost it. She couldn’t remember whether it was eastbound or westbound and quite frankly she didn’t care! “Just send the ambulance! Hurry up! My baby’s not breathing. It’s an emergency!” I could see it from her point of view - her baby wasn’t breathing, and there I was asking stupid questions like “what side of the road do you live on?” But of course, from my point of view, the question was vitally important… but there was no time to explain why. I got the baby’s age - one-and-a-bit - then asked her what had happened. She’d heard a strange noise on the monitor and come in and found the baby like this. Straight on to the CPR instructions. Clean the vomit out of baby’s mouth - there was plenty so it took a while - then tilted the baby’s head back and listened for breathing.
I already had the “Start Compressions” card fired up when the mother told me that actually, yes, the baby was taking shallow breaths. He was twitching a little bit too, she noticed, but otherwise unresponsive. I let out an audible sigh of relief and gave the mother the instructions for maintaining the airway, whilst using the breath timer gadget to make sure the baby was breathing regularly. He was. Now there was nothing to do but wait for the ambulance, I decided to ask the mother a few more questions about what had happened (the purpose of these is usually more to distract the caller and make her feel she is doing something than to find out anything important). The baby had been ill with a cold, but didn’t have a temperature. She’d heard choking noises on the baby monitor, which is why she’d assumed he’d choked on vomit. When she cleared the vomit from the baby’s mouth, his teeth had been clenched and he nipped her finger. It was sounding more and more like he’d had a fit, so I marked the ticket “? fitting” so sector could make sure they had dispatched a paramedic crew.
Just before the first ambulance crew arrived (two had been sent, as is protocol with any “working” cardiac arrest - though I had confirmed the baby was breathing, no one wanted to take any chances!) I heard a very welcome sound. The baby started to cry! Ambulance call takers are the only people in the whole who like the sound of a crying baby! (I only wish this were still true when one sits next to me on the bus.) I bet the crew were relieved to find the baby was alive too. I listened in for a couple of minutes (since I have been unable to find any protocol prohibiting is and there weren’t any calls waiting) and what I heard the crew saying confirmed that they also thought the baby had just had a fit. The mother was asked which of the two nearby hospitals she’d prefer to go to, and at this point I’d heard enough and hung up, relieved. They wouldn’t be letting her pick and choose hospitals if the baby was in a life threatening condition. I think he was probably breathing all along and the mother mistook the tail end of a fit for a cardiac arrest. It’s also possible that the vomit was blocking his airway and clearing the airway saved his life - in which case the mother must be thinking that baby monitor was the best investment she ever made! Whatever the case, it definitely felt to me that the baby had come back from the dead. I’m glad to not be bringing you a post about cot death today!
On the subject of babies fitting, I do think that parents should receive more education about febrile convulsions (fits which happen in babies only due to a high temperature - they are nothing to do with having epilepsy and while you should definitely call an ambulance if your baby has one, they are not usually life threatening). It’s obvious that a lot of parents have never heard of them and think their baby is dying when they happen, which must be really traumatic for them.
on December 7th, 2007 at 4:48 pm
As a parent I can attest to how alarming febrile convulsions can be. Our eldest had one when he was about two. He had an ear infection and a high temperature, but after a few days in hospital on antibiotics he was standing in his cot making friends with all the nurses. When it happens in the middle of the night it’s quite dramatic. I don’t recall having been told much about them when he was first born. As he grew he’d sometimes get too hot in bed and we’d have strange surreal conversations in the middle of the night until he cooled and woke. Thankfully it’s been a long time since that last happened.
on December 7th, 2007 at 4:56 pm
Don’t wish to be rude, but I think you mean “I think parents should receive more information…” - the “should” is missing which rather changes the meaning!
on December 7th, 2007 at 5:30 pm
Not febrile convulsions but rigors did for me 18m or so back - my toddler shook and went white & dark blue (lips, nailbeds) *while standing and talking to me* which confused the hell out of me. Had he become unconscious first or presented with a more classic fit I think I’d have been less scared! The call taker (not in the NeeNaw region) didn’t help, failing entirely to understand that he hadn’t lost consciousness at all but was still a deep shade of blue several minutes into the call. But the FRU guy was fab.
on December 7th, 2007 at 6:25 pm
Parents are given quite a lot of information about febrile convulsions but unless you’re one of the fortunate few who go icy calm and controlled in an emergency I can’t imagine the information helping much if you woke up to encounter a fitting baby. It does sound like the baby had a fit, maybe vomited or brought up mucus, and might indeed have been not breathing much until its mouth cleared up.
My children have had high temperatures for days now and I keep waking in the night when their breathing calms down, terrified they’ve died of choking on spit-up during a fit. So far, it’s just paranoia.
on December 7th, 2007 at 11:27 pm
More info for parents would be great on febrile convulsions, I “knew” a little when my son had his first but didnt know they could stop breathing. Thankfully my call taker was fab and the 2 crews that came to us were wonderfull, so the next time it happened I was calm and collected!
on December 8th, 2007 at 12:46 am
I have an eight year old daughter, and I don’t remember being given any information on febrile convulsions. Fortunately we haven’t had to deal with one either, although we had our fair share of other mishaps - nothing serious though, thankfully. Even the apparent coughing up/vomiting blood turned out to be a false alarm - scared the crap out of us though!
on December 8th, 2007 at 10:27 am
2 weeks ago on my way home i stopped at an incident 1 car 1 van lots of people and a mum and baby in the middle of it all.mumm said baby had gone blue choking?but bit her when she tried to clear its mouth(sound familiar?)cold night but baby is still warm to the touch ,quiet but responsive
another first aider arrived and we both agreed on probable febrile convulsion.
ambulance arrived baby and mum off to hospital.end of story?
no following day i was tapped on the shoulder in town by mum with baby.guess was correct baby was now recovered and looking great.nice to get feedback sometimes
on December 15th, 2007 at 11:39 pm
I had a ?febrile convulsion today - first ever, dad sobbing on the phone, mum in the background sounding a bit calmer but still worried.
What’s the problem - tell me exactly what happened? ” My baby stopped breathing!!!! I think he’s having a fit or something!!!”
Sure enough, 2 year old was talking although still drowsy by time crew arrived on scene - parents confirmed the usual ‘he’s not been well all day’ scenario while waiting for crew and said never had fit before. Ho hum, another satisfied customer.
on December 17th, 2007 at 3:24 am
We’ve got five kids (aged now between 18 and 37)…Can’t say I recall being told about febrile convulsions and thank god ours never had them…just how common are these?
on December 17th, 2007 at 8:26 pm
[…] The Ambulance Man reports on the Christmas wind down (NOT),and writes about what happens when an emergency caller reported a baby stopping breathing. Sticking with medics, Crippen Does A Macca Shocker, in which NHS Blog Doctor (was reported to have) suffered a road accident. Fortunately he had not been run over by an ambulance. […]
on December 21st, 2007 at 7:56 pm
Hi all
My daughter has just had a similar experience with her 3 month old son. He has a very nasty chest infection and on Saturday night just gone had great difficlty breathing and started to go an odd colour. Not the best thing at 3 months old!
She did the correct thing and dialled 999 and the local ambulance crew arrived promply and got the wee lad stable. Off to the local A&E on blues and there he received tremendous treatment. Discharged at about 4am none the worse for the event. Wish I could say the same for my daughter and me.
On the subject of febrile convulsions, we at St John do a course called Early Years which is aimed at carers who run play groups and pre school clubs. The course covers all childhood illnesses and is a great cousre to get booked on. Parents would find this of great benefit and their Local St John would be only too happy to point them in the direction of a course being held loclly.
Finally to all those at the LAS and Mark you and your team are counted in this, have a great Christmas and New Year.
Regards
TM
on December 27th, 2007 at 9:58 pm
my two year old had a convulsion because he had a high temp from a chest infection he stoped breathing had to give him mouth to mouth i had never evn heard of it till it happend was horrible and now i panic when he gets hot i carnt sleep at night
on December 29th, 2007 at 3:26 pm
Hi Danielle
At least you knew how to do mouth to mouth. Temperature can cause a lot of problems in young children, be it an increase or decrease.
I know it is hard to try and relax and I have been through this 3 times with my own children. Fortunately I was in St John the whole time and this gave me the skills to deal with most things that children throw at you you when they are ill. What you don’t learn is that when you are dealng with your own child your stress levels rise so much because they are your
children.
If your child sleeps in a separate room to you I guess you have a baby intercom. This was invaluable to us as it gives you round the clock listening. Even now though my youngest is the only one at home (she is
if she rolls over in the night I am awake like a shot. I too cannot relax. It does get easier as they grow older. Its just the problems that change. my elest now both being teenagers.
I hope this helps you in your plight.
Kind regards
TM
on December 29th, 2007 at 4:27 pm
No posts for ages. Waaaahh, where are you Mark?
on February 5th, 2008 at 12:34 am
can you tell me what at “breath timer gadget” as we have no such thing in our control room.
on February 5th, 2008 at 6:30 am
It’s part of the ProQA/AMPDS software… one of the buttons you click on the top row. You click every time the patient takes a breath and it tells you if the breathing is regular and fast enough. I think it came in with AMPDS 11.2, perhaps your control room is still on an older version?
on February 5th, 2008 at 11:49 am
that’d be right! we are still giving out the old CPR 2/15 think our service needs a money injection.
Keep up the good work, i love reading your stories, as i makes me feel like there’s other people out there thinking the same as me!