2. Baby Akshya
5 months, female
R/O Panruti
DOA :14.03.16, 6:05pm
Date of demise :14.03.16, 07:30pm
Duration of hospital stay : 180 min
Presenting complaints :
Fast breathing 2 days
Fever
3. HOPI
Apparently well 15 days back
Cough and cold- dry cough, associated with coryza
H/o ? Aspiration 2 days back
H/o fast breathing X 2 days
H/o fever X 2 days
H/o excessive crying +
H/o decreased urine output/ decreased feeding X 2 days
4. Family history :
6 yrs 9 mon 5 mon
Birth history: LSCS/2.74kg/CSAB/ LATE
PRETERM/ARTHROGRYPOSIS MULTIPLEX CONGENITA
Developmentally NORMAL
Immunized for age
5. At admission in ER
HR – 190/Min
peripheral pulses- bounding
RR - tachypneic, 84/ min, retractions, audible stridor +
SpO2 – 90 % in room air
100% with 02
CFT - 2 secs
Shifted to PICU with oxygen support.
RESPIRATORY CAUSE
IMPENDING RESPIRATORY
FAILURE
9. 07/11/16
COURSE IN THE HOSPITAL
5 months old female baby by name Akshya
was brought to MGMCRI casualty on 14.03.2016 at 5.55 PM
with chief complaints of severe breathlessness & fever for
two days and poor feeding for one day. On examination baby
was mildly cyanosed with severe distress with inspiratory
stridor and audible wheeze. With O2 support baby was
rushed to PICU, Adrenaline and Salbutamol nebulisation
was given, I.V line was secured and blood samples were
collected. Baby was maintaining 100% saturation with O2
support and heart rate of 190-200. Since baby required
further respiratory support, it was planned to intubate and
connect to mechanical ventilator; written consent from
parent was obtained for the same.
10. 07/11/16
At 6.20PM Intubation procedure was started
with premedication (Inj. midazolam and Inj. Fentanyl). Since
child had continuous cough and copious secretions, procedure
was not successful. Anesthetist help was asked for. At 6.40PM
Anesthetist intubated with premedications (Inj.
succinylcholine, Inj. glycopyrolate and Inj. Midazolam). Baby
had cardiac arrest immediately after intubation. Baby was
resuscitated according to PALS protocol with Inj. adrenaline
and Inj. atropine along with chest compressions. Inspite of
prolonged resuscitation till 7.30pm, baby could not revived
and declared dead on 14/03/2016 at 7.35PM.
Cause of Death: Respiratory failure with severe pneumonia
with septicemia.