Nelson Aquino day four in Haiti: pure adrenaline

Today we all made huge progress with our new OR. Our Children’s team

One of the operating rooms the Children's team is using
One of the operating rooms the Children's team is using

now has teamed up with the Brigham and Women’s and NYU teams to do surgery. Early this morning, our first group headed out to set up the OR and seek out our potential patients.

At the general hospital, we opened a preop area, 4 OR tables and a  PACU. Our team leaders worked hard today with the IMC (International Medical  Corporation) to make this happen.

While searching for extra beds, and the right Red Cross tent, Jay Hartford, a 7 South nurse, and I stumbled upon some chaos. A 2 day old baby had been  seizing on and off since birth. A team of paramedics were screaming for intubation, but only had large endotrachial tubes (ETT). So being a  pediatric CRNA, I naturally swarmed over and told the team that. Immediately they moved everyone aside and said, “Let him intubate.” As  the paramedic removed the ambu bag off the neonate, I used a large blade and intubated this 3 kg baby. As they listened for breath sounds and confirmed placement, everyone was clapping. The U.S. military arrived and helped us transport this neonate in a hummer. With no monitors, no meds and an unstable IV, the military guys shut  the doors and it was pitch black and 100 degrees.

Both Jay and I looked at each other and really couldn’t believe this was happening. This small baby’s life was in our hands. During the 10 minute ride to the DMAT (Disaster Medical Assistance Team) unit, I manually ventilated the baby as Jay held the ETT. We were both praying and hoping this baby would make it there. We felt no pulse at one time and started CPR. When the doors on the hummer opened we rushed the baby to the disaster tent.

When we arrived we were greeted by Dr. Mooney and pharmacist Shannon Manzi from CHB! We couldn’t believe it!!! Also, I was greeted by a fellow Nurse Anesthetist Mike Storey, CRNA (who trained me). We handed off to Dr. Mooney and his team. The baby was alive and stabilized. What a miracle.

As we rode back in the hummer, we were wondering if our team knew we had been gone? When we arrived our first post-op arrived. Our teams today did 7 to 8 cases. Our anesthesiologists, Craig McClain, MD, and David Waisel, MD, teamed up with and did some amazing work. Dr. John Meara and Dr. Gary Rogers worked the entire day repairing broken bones and optimizing wound healing.

Lisa Pixley, a nurse from 7 south, and a team of MGH and Brigham and Women’s nurses, treated wounds, changed dressings and provided pain relief in many tents. Everyone pitched in and at one point I scrubbed in handing over surgical equipment. Joann, our scrub tech, did amazing work translating and working at the same time.

One challenge we had was making sure all our postops had beds and would be cared for tonight. We found a group of paramedics and EMTs to look over everyone!

By the end if the day, everyone was exhausted. We tried to keep up on water and food, but several of us needed IVs for hydration.

We headed home early around 6:30 pm and were welcomed home to mattresses in our tents, dinner, snack room and showers!!!

What an unbelievable day! Tomorrow is another adventure. Everyone here misses all our families and friends! Thank you for all your support!

Nelson J. Aquino, CRNA

PS – Also read an amazing story from Partners in Health Medical Director Joia Mukherjee about how a team that included Children’s Plastic-Surgeon-in-Chief John Meara, MD, DMD, MBA, saved the life of a critically ill newborn.