“When They Are So Young” Topic of Catawba Valley Medical Center’s February ‘Conversations in Ethics’ February 19, 2008 Catawba Valley Medical Center invites healthcare professionals and the community to attend the next ‘Conversations in Ethics’ to be held from 12 noon to 1 p.m. Thursday, Feb. 21 in the Northwest AHEC Lecture Hall, Room 112. This monthly, no-charge meeting provides an opportunity for discussion of some of the most important issues facing the healthcare profession today. The discussion topic for February is “When They Are So Young.” Art and Julia Inskeeps’ new baby, Joshua, was born premature at 24 weeks of pregnancy. He was so small at birth that his feet weren’t even as big as a fingertip. The doctors don’t know what caused Julia to go into premature labor. But when Joshua was born, doctors told the Inskeeps that there had been successes in saving 24-week-old babies. With the new technology Joshua had a good chance of surviving. A normal pregnancy length is 36 weeks, but babies have survived after being born as early as 23 weeks. The biggest problem is the lack of a substance called surfactant. This fatty substance coats the inner surface of the lungs and keeps them from collapsing. A number of advances are helping younger and younger babies survive. One is the development of a surfactant taken from calf fetuses. Another is a Life Pulse High Frequency “Jet” Ventilator. Instead of delivering the normal respiration rate of 30 breaths per minute, the “Jet” ventilator gives 240 - 420 tiny puffs per minute. This keeps the baby’s lungs constantly inflated, and oxygen seems to enter the bloodstream more efficiently. The procedure, however, can be dangerous. The less developed the baby, the more likely the occurrence of a brain bleed, which would cause brain damage and have other serious consequences. The doctors have asked the Inskeeps to decide whether or not to have Joshua connected to the “Jet” ventilator. Art and Julia have never had a more difficult decision. Among the questions that may be considered include: What should the Inskeeps do? What information do the Inskeeps need to make the decision? If the doctors connect Joshua to the ventilator and he then dies, are there grounds for a malpractice suit? If the doctors don’t connect Joshua to the ventilator and he dies, are there grounds for a malpractice suit? Catawba Valley Medical Center’s Department of Organizational Learning is an approved provider of continuing nursing education by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Completion of this activity provides 1.0 contact hour. Catawba Valley Medical Center is a not-for-profit, public healthcare system providing and promoting the physical, mental, emotional and spiritual well-being of the public in addition to serving as a center for health education, wellness services, preventative medicine and acute care. CVMC, recognized by the American Nurses Credentialing Center as a Magnet facility, was recently named a Hospital of Choice by the American Alliance of Healthcare Providers.