Infant Emergency

Before adopting “Code Caleb,” Tri-City was like most hospitals in California. It had a pediatric emergency code for patients 14 and younger. But emergency care for an unresponsive infant, who many be only a few hours or even minutes old, is vastly different from the care a 12-year-old needs.

The tools, dosages and expertise needed to diagnose and treat infants are specialized, and, therefore, any hospital with a neonatal care unit needs a code that brings its neonatal physicians and nurses to the emergency department immediately.

Consider also that while pediatric emergency codes are called regularly, only a tiny fraction are called for infants.

This is a high risk, low frequency patient population.

The code is accompanied by several additional best practices. A neonatal cart needs to be equipped in the emergency department with specialized tools so that the neonatal and ED teams can right-size care for tiny patients.

The code should also be treated as one segment of a continuum of care that starts in the field. When first responders receive training from hospital experts, it can also enhance neonatal survival and recovery.

Tri-City found that when EMT’s had been trained in care for babies in cardiac-pulmonary arrest, they worked to keep their body temperatures up during transportation. Any eventually might result in the code being called in the field.

For more information, please refer to Tri-City Medical Center’s Code Caleb policy.

Any hospital with an emergency department and a neonatal intensive care unit can adopt a newborn emergency code to bring its neonatal physicians and nurses to the emergency room immediately. Adopting such a code requires both departments to work together and train prior to the launch of the code.

It might also require equipping the hospital’s emergency room with a neonatal resuscitation cart with tools that are the right size for tiny patients.

In addition to the creation of “Code Caleb,” Caleb’s story was the driving force behind a new law, CA Assembly Bill 1731, requiring California hospitals to screen newborns for critical congenital heart defects before being sent home. Pulse oximetry screening, a simple, inexpensive test to measure oxygen levels, would have diagnosed Caleb’s illness before he was discharged from the hospital where he was born.

For more information about Code Caleb, read these articles:

• “Life-threatening disease does not discriminate” – The Daily Transcript, Feb 8, 2013
• “Infant heart testing law cheered by parents, doctors” – U-T San Diego, Sept. 18, 2012
• “Bill to save newborns from heart disease inspired by local family” – 10News, Sept. 17, 2012
• “Bill advances to compel heart test for newborns” – U-T San Diego, June 11, 2012
• “Vista newborn inspires bill to help children” – U-T San Diego, June 8, 2012