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Jersey City Medical Center Emergency Physician Saves Baby

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On a quiet morning several months ago while working in the emergency department at Jersey City Medical Center, Vincent Zayas, MD, an emergency medicine physician with Emergency Medical Associates (EMA), was approached by a nurse who asked him to evaluate a young woman who had just arrived by ambulance with severe abdominal pains and bleeding. It was quickly obvious to the doctor that a delivery had just taken place.

Dr. Zayas first treated the woman, who denied that she had given birth or had even been pregnant. After determining that the patient was stable, Dr. Zayas turned his attention to the fetus, which had been neatly wrapped in linen and placed in a basin at the foot of the mother's bed. Gently unfolding the linens, the emergency physician hoped the fetus was in good enough condition to provide the mother with an opportunity to bond and come to closure with it before clearing it for examination by pathology.

"Under the sheets I saw a perfectly formed fetus within its fetal sack," said Dr. Zayas. "She floated within the remnants of her amniotic fluid, motionless, frail and perfect. As I moved closer to the fetus, I stimulated her left arm with my gloved index finger to see if she would respond. Almost as if to say, 'I am here and alive,' she extended her left thumb upward.  The 'thumbs-up' sign was all we needed to know – she was not going to the pathology lab."

The medical team swiftly moved the baby to the nearest open room to begin resuscitation. The gynecology room was equipped with the basics for a term delivery, but not for a child who was 26 to 28 weeks old. Dr. Zayas cut open the sac and finished her delivery. He suctioned her nose and oropharynx and clamped the cord.

The facial mask on the resuscitation device dwarfed her head, making it impossible to function. Improvising, Dr. Zayas cut the tip of the nasal suction device and fitted it to her mouth and delivered small, rapid breaths to her while the nurses procured the necessary equipment and personnel.

"We had her placed in an incubator, warmed and stimulated," said Dr. Zayas. "She was intubated and placed on a monitor, where she had her initial set of vital signs. We found these to be textbook normal for a newborn, and she was moving all four extremities."

The baby was eventually removed from the emergency department and placed in the Neonatal Intensive Care Unit, where she has been progressing well.

"This was an amazing situation," said Dr. Zayas, who says he's been keeping regular tabs on the baby.

Dr. Zayas is a member of Emergency Medical Associates (EMA), one of the country's premier emergency physician groups. Emergency Medical Associates (www.ema.net) staffs the emergency departments at more than 20 hospitals in New Jersey and New York.

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